White Lesley J, Dressendorfer Rudolph H
Department of Applied Physiology and Kinesiology, Center for Exercise Science, Applied Human Physiology Laboratory, University of Florida, 27 FLG, PO Box 118206, Gainesville, FL 32611, USA.
Sports Med. 2004;34(15):1077-100. doi: 10.2165/00007256-200434150-00005.
The pathophysiology of multiple sclerosis (MS) is characterised by fatigue, motor weakness, spasticity, poor balance, heat sensitivity and mental depression. Also, MS symptoms may lead to physical inactivity associated with the development of secondary diseases. Persons with MS are thus challenged by their disability when attempting to pursue an active lifestyle compatible with health-related fitness. Although exercise prescription is gaining favour as a therapeutic strategy to minimise the loss of functional capacity in chronic diseases, it remains under-utilised as an intervention strategy in the MS population. However, a growing number of studies indicate that exercise in patients with mild-to-moderate MS provides similar fitness and psychological benefits as it does in healthy controls. We reviewed numerous studies describing the responses of selected MS patients to acute and chronic exercise compared with healthy controls. All training studies reported positive outcomes that outweighed potential adverse effects of the exercise intervention. Based on our review, this article highlights the role of exercise prescription in the multidisciplinary approach to MS disease management for improving and maintaining functional capacity. Despite the often unpredictable clinical course of MS, exercise programmes designed to increase cardiorespiratory fitness, muscle strength and mobility provide benefits that enhance lifestyle activity and quality of life while reducing risk of secondary disorders. Recommendations for the evaluation of cardiorespiratory fitness, muscle performance and flexibility are presented as well as basic guidelines for individualised exercise testing and training in MS. Special considerations for exercise, including medical management concerns, programme modifications and supervision, in the MS population are discussed.
多发性硬化症（MS）的病理生理学特征包括疲劳、运动无力、痉挛、平衡能力差、热敏感和精神抑郁。此外，MS症状可能导致身体活动不足，进而引发继发性疾病。因此，MS患者在尝试追求与健康相关的健身相适应的积极生活方式时，会受到残疾的挑战。尽管运动处方作为一种治疗策略，在慢性病中越来越受到青睐，以尽量减少功能能力的丧失，但在MS人群中，它作为一种干预策略仍未得到充分利用。然而，越来越多的研究表明，轻度至中度MS患者进行运动所获得的健康和心理益处与健康对照组相似。我们回顾了大量研究，这些研究描述了特定MS患者与健康对照组相比，对急性和慢性运动的反应。所有训练研究均报告了积极的结果，这些结果超过了运动干预的潜在不良影响。基于我们的综述，本文强调了运动处方在MS疾病管理的多学科方法中，对于改善和维持功能能力的作用。尽管MS的临床病程通常不可预测，但旨在提高心肺功能、肌肉力量和活动能力的运动计划，在增强生活方式活动和生活质量的同时，降低了继发性疾病的风险，带来了诸多益处。本文还提出了评估心肺功能、肌肉性能和灵活性的建议，以及MS个体化运动测试和训练的基本指南。此外，还讨论了MS人群运动的特殊注意事项，包括医疗管理问题、计划调整和监督。
