Multiple Sclerosis & Pool-based Exercise – Lauren Turner AEP

Multiple Sclerosis (MS) is a neurological condition which affects the function of the central nervous system (brain and spinal cord), resulting from swelling of the myelin sheath that surrounds the neural pathways casing lesions and/or scarring. Damage to these connective tissues can block or impair neural signals within the CNS resulting in impaired physical and mental function. Physical symptoms may include, but are not limited to, muscular weakness, reduced functional capacity, spasticity, balance and stability problems, gait abnormalities and pain symptoms. As MS is a degenerative condition and symptoms can progress over time it is important to maintain and improve physical function.


Whilst exercise has been shown to help improve MS related symptoms, there are some barriers people with MS may face when participating in an exercise regime. Firstly those who suffer from severe fatigue may find it difficult participating in exercise because of their reduced functional capacity and can be limited in the amount/type of exercises they can perform. Additionally, people with MS can commonly experience an increase in symptoms due to heat sensitivity. This includes being exposed to high temperatures or high physical work (including exercise). However, there are ways to overcome these barriers through different modes of exercise. In particular, pool-based exercise is a great alternative to help promote increased physical activity.


When submerged in a pool, the buoyancy of water enables de-loading of the joints to occur. This reduction in stress on the targeted joint allows the exercises to focus on maintaining and improving joint range of motion and functional movement patterns. The reduced demand on energy expenditure to move the limbs can assist people with MS complete more exercises/activities then they may be able to achieve on land. However there are a few things to consider. As mentioned above, people with MS most commonly do not tolerate high temperatures, therefore hydrotherapy pools should be avoided as these pool temperatures sit around 32-34 degrees. When assessing pool temperature it has been shown that temperatures around 28-29 degrees is appropriately comfortable for people with MS and has the potential to regulate body temperature through heat dissipation. It is also important to have regular fluid intake throughout the exercise session to aid in managing body temperature.


Although water provides resistance against the moving limb/body part, this type of exercise does not allow for large strength gains and there are limitations to the skills acquired through this intervention that can be transferred into daily life. Therefore, water-based programs are more suited to be prescribed in early stages of treatment.


If you would like to know more about how we can help those with multiple sclerosis, please call our reception on 46 383 777.