Multiple sclerosis follows a different course in every person, and for a long time the common recommendation after this diagnosis was rest. Conserve your strength and you will lose less of it, the thinking went. Today we know the opposite is true. Targeted, adapted training is among the most effective measures for preserving mobility, strength and quality of life in MS over many years.
Why exercise was underestimated for so long
The caution had an understandable basis. Many people with MS experience a temporary worsening of symptoms during exertion and in heat, a phenomenon known as Uhthoff's phenomenon. This deterioration is reversible, however, and differs from a genuine relapse. Out of concern about precisely this effect, patients were for decades often advised to hold back. The consequence was frequently a gradual loss of conditioning, strength and balance, caused not by the disease itself but by the lack of movement.
What the research shows today
Numerous studies in recent years demonstrate that regular, adapted training in MS is safe and brings measurable benefits. Endurance training improves cardiovascular fitness and has a positive effect on the fatigue that so many find debilitating. Strength training preserves muscle and counteracts the relapse-independent loss of strength that can progress gradually regardless of acute episodes. Balance and gait training demonstrably reduce the risk of falls, which can be elevated in MS due to coordination difficulties and altered sensation in the legs. Exercise also has a positive influence on cognitive function, sleep quality and mood, which should not be underestimated in the long-term care of a chronic condition. International professional bodies therefore now recommend exercise therapy as an established component of MS treatment, alongside medication.
Which forms of training are suitable
An effective programme in MS is always individual and oriented towards the current level of disability, the course of the disease and personal goals. Combinations have proven themselves: endurance training on a cycle ergometer or treadmill, targeted strengthening of the trunk and leg muscles, and balance exercises. Robot-assisted gait training, for instance with the Lokomat, can be particularly valuable where walking ability is restricted. It allows a high number of guided, physiologically correct steps without additionally burdening the muscles through compensatory movements, and the level of support can be adjusted precisely to how you feel on the day. A C-Mill gait analysis complements this by detecting subtle changes in the gait pattern early and directing the training accordingly.
How therapy is adapted to fatigue and relapses
The decisive difference from a general fitness programme lies in the adaptation. In MS, capacity often fluctuates from day to day, and a good therapy programme responds to this rather than pushing through a rigid quota. That means shorter but more frequent sessions on days of pronounced fatigue, breaks and cooler rooms where there is heat sensitivity, and a careful reduction in intensity during a relapse and in the weeks that follow. A data-driven approach makes this adaptation transparent: when every session is recorded, limits can be identified objectively rather than guessed at, and setbacks can be distinguished early from a genuine relapse. This close monitoring gives patients the confidence to move without overexerting themselves.
What a therapy programme at Nextherapy looks like
At Nextherapy every course of treatment begins with a thorough initial assessment in which we establish the current state of your mobility, strength and endurance. Building on this, our physiotherapists and occupational therapists create an individual programme that combines endurance, strength and balance training with our robot-assisted systems, adjusted continuously to how you feel on the day. The use of the technology incurs no additional costs: it is part of the regular therapy programme billed through your health insurance.
If you live with MS and would like to know what a programme tailored to you might look like, we invite you to a free pre-assessment in Zürich or St. Gallen. Together we will discuss your situation, your goals and the options for cost coverage, with no obligation.
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