Which Type of Exercise is Better for People with MS?

Patient Expert

Physical activity is an important part of staying healthy. Not only do we, as people living with MS, need to maximize cardiovascular health, we also need to maintain muscle strength and flexibility. However, multiple sclerosis is often associated with reduced physical fitness and lower quality of life.

Before I began riding the exercise bike regularly last fall, I would get winded much more easily. My heart and lungs were not functioning at their full capacity and I realized that I needed to do something about it. Although I really started riding the bike to improve my osteoarthritic knees, doing so helped me to get my heart pumping and to work up a sweat.

Over these past several months, I’ve noticed that both my strength and endurance have improved. I definitely feel better, physically and mentally.

Endurance training vs resistance training

Both options are good! People with MS are able to improve their physical fitness, including aerobic capacity and muscle strength, with either a combination of endurance and resistance training or endurance training alone, according to a recent study. Both forms of exercise used in the study reduced fatigue and improved quality of life for MS patients, especially in the areas of general health, mental health, vitality, and social functioning.

Trial participants (n=60; 44 female, 16 male) were randomized into one of two groups: the combined workout group (CWG) or the endurance workout group (EWG). MS patients completed a physician-supervised training program that lasted three months and consisted of two moderate-intensity training sessions per week, each of which was 40 minutes long. The CWG group exercised 20 minutes on a bicycle ergometer, followed by 20 minutes of resistance training. The EWG group focused on endurance exercise for the full 40 minutes. Twenty-three patients dropped out of the trial due to lack of time, long distance to training location, new workplace, or exacerbation.

The exercise programs

Both groups started with a 20-minute workout on an exercise bike. Patients in the endurance group continued with another 20 minutes on their choice of machine: cross-trainer, stepper, arm ergometer, treadmill, recumbent ergometer, or rowing machine.

Patients in the combination group continued with a dynamic resistance training program, performing two sets of 10-15 repetitions on each of eight machines used to train multiple muscle groups (leg press, hamstring curl, chest press, row, pull down, overhead press, abdominal, and back extension).

Although the World Health Organization recommends 150 minutes of moderate-intensity activity per week for healthy adults, results from this study demonstrate that 40 minutes of endurance or combination training, twice a week, is sufficient to improve aerobic capacity in MS patients with low to moderate disability. If resistance training is not possible, strength of the extremities can be enhanced by using machines that target specific upper or lower limbs.

Very encouraging news to know that people with MS can improve their physical fitness with a reasonable twice-a-week exercise regime in as little as three months. I imagine that many of us would be motivated to continue a similar routine after we noticed that our heart and lungs were working more efficiently and that our body was growing stronger, especially if we were feeling less fatigued as well.

More helpful information:

7 Assistance Programs MS Patients Need to Know

Weight Loss and Exercise: Staying on Track with MS

“But You Don’t Look Sick”


Kerling A, Keweloh K, Tegtbur U, et al. Effects of a Short Physical Exercise Intervention on Patients with Multiple Sclerosis (MS). Int J Mol Sci. 2015 Jul 10;16(7):15761-75. doi: 10.3390/ijms160715761.