Looking Beyond Neurological Impairment in Patients With Multiple Sclerosis During Exercise Intervention: Evidence for Muscular, Cardiac, Pulmonary, and Metabolic Dysfunction Related to Exercise Intolerance and Prognosis

Abstract

Rehabilitation and exercise intervention is a cornerstone in the treatment of multiple sclerosis (MS). However, most clinicians tend to focus on neurological deficits only, and thus prefer to prescribe rehabilitation programs specifically to counteract these deficits. Evidence is accumulating that patients with MS (pwMS) also experience significant muscular, cardiac, pulmonary, and metabolic dysfunction, which independently contributes to exercise intolerance, and even is related to elevated morbidity and mortality. pwMS should thus be systematically screened for muscular, cardiac, pulmonary, and metabolic function, especially during exercise (which provokes these anomalies): this may lead to clinically relevant adaptations in clinical care/medical treatment and optimization of exercise prescription. Currently, the impact of exercise intervention on these anomalies in pwMS is mostly unknown. Future studies should thus focus on the impact of exercise intervention on muscular, cardiac, pulmonary, and metabolic function (during exercise) in pwMS, to contribute to better treatment and care of pwMS.