Mild and motivational exercise in social supporting environment for over passing primary fatigue in patients with multiple sclerosis

The most common symptom displayed in patients with multiple sclerosis (MS) is a pronounced sense of fatigue that can have negative effect on functional ability and quality of life (QOL). An important goal of researchers and clinicians involves improving the QOL of individuals with MS and the exercise therapy represents potentially modifiable behavior that positively impacts on pathogenesis of MS and thus the QOL. However, the main barrier for its application is low motivational level that MS patients experience due to fatigue with adjacent reduced exercise tolerability and mobility, and muscle weakness. Getting individuals with MS motivated to engage in continuous physical activity may be particularly difficult and challenged, especially those with severe disability (Expanded Disability Status Scale; EDSS 6-8). Till now, researchers have focused their attention mainly on the moderate or vigorous intensity of exercise and on cardio respiratory training in MS patients to achieve improvements in daily life quality and less pointed on exercise content, and most importantly, on breathing exercise. We assume that MS patients experience more stress with aerobic exercise or moderate to high intensity program exercise and hardly keep continuum including endurance exercise, or treadmill. It is important to make exercise more applicable and accessible, motivational and easy to handle, and most of all productive for everyone with MS. We propose that specific exercise content, including breathing exercise in a group led by physiotherapist at first, efficiently reduces primary MS fatigue and brings more motivation for this patients to support personal continuous exercise at home by themselves.