Allison Reed loves to dance, something she has been doing since she was a little girl. Now a senior in high school with plans to major in performing arts in college, the 17-year-old from Hamilton, New Jersey, is in ballet, tap, jazz and lyrical dance.
Diagnosed with multiple sclerosis in 2013 at age 14, she has no plans to hang up her dancing shoes on account of the chronic neurological condition, which can cause symptoms ranging from numbness in limbs to difficulty swallowing and blindness in severe cases.
“In the beginning, it was all I thought about, ‘How is this going to affect my school, my dance?’ Everything like that. But now it has become something [that’s] at the back of my mind — I’m not always conscious of it,” Reed says. “Some days I go where I don’t have any symptoms … It’s not really preventing me from doing anything.”
Along with receiving twice-monthly injections of Plegridy — a drug that can help reduce relapses of disease symptoms, decrease brain lesions and delay progression of physical disability from MS, according to company literature — Reed takes medication for fatigue caused by her MS. But otherwise, she and her mother, Melinda, say she has been able to continue with dance classes, save for skipping an occasional lesson when she’s exhausted
In fact, new research published online in the journal Neurology shows that strenuous activity in children with MS, like Reed, is associated with lower levels of disease activity, as measured both in terms of inflammation, or lesions in the brain seen through MRI, and rates of relapse, when symptoms flare up. The study provides a first-of-its-kind glimpse into the potential impact exercise has on those with MS.
The researchers found that disease activity levels were greater in kids with MS who didn’t report doing strenuous activity, such as running. What’s more, those children also had greater rates of disease relapse, in which symptoms reappear, says study author Dr. E. Ann Yeh. She notes that little is known about the effect of lifestyle on kids with MS, which causes as many as three-quarters of children with the condition to suffer from depression, fatigue or impairments in memory and thinking. It’s estimated that 400,000 people have MS in the U.S. While most are adults, about 8,000 to 10,000 children have the disease, and most have a form marked by relapses.
Yeh, a neurologist and director of the MS and Demyelinating Disorders Program at The Hospital for Sick Children in Toronto, emphasizes that the research — which featured a small sample of 31 MS patients, along with a control group — doesn’t prove cause and effect. But she says it’s an important first step toward understanding the relationship between physical activity and disease activity.
MS attacks the central nervous system, and a relapse, when symptoms flare up, can do permanent damage that often goes undetected. Experts say that’s all the more reason to look at managing MS through every means available, from medication to lifestyle changes. “It’s a very quiet form of injury,” Yeh says. “So within MS, our focus really is trying to prevent the attacks from happening. Because we feel that the more attacks someone has, the more likely it is that someone is going to suffer from irreversible injury.”
“Physical activity can and should be encouraged in kids just from a safety perspective, and from a general health perspective,” Yeh says. She notes that in the patients studied, researchers didn’t observe worse outcomes in those kids who were more active.
Dr. Amy Waldman, a neurologist at Children’s Hospital of Philadelphia, where Reed receives treatment for MS, says it’s known that increased physical activity helps decrease certain symptoms of the condition, such as depression and fatigue. “This research raises the possibility that exercise may also reduce the inflammatory disease burden in pediatric-onset MS,” she says.
The hospital recommends exercise for children with MS, noting advantages already proven in the general population, such as the fact that physical activity can also boost energy levels and increase mobility, cognition — including school performance — endurance and improve overall quality of life.
Children who suffer from MS do face unique challenges to being physically active. “Most limiting in the pediatric population is going to be balance and … Uhtoff’s phenomenon,” Waldman says. The former can be undermined by disease flare-ups; the latter phenomenon involves a worsening of neurological symptoms thought to be caused by the effect of heat on nerves damaged by MS. “If they do have some symptoms, that’s where it’s helpful to have a physical therapist,” who can weigh in and help create an activity program suitable for the child, Waldman says.
“Heat is really the one thing that triggers my symptoms a lot,” Reed says. “If I’m out all day with friends, sometimes my feet will start tingling or something, so that’s one of the things that tells me that I need to cool off or do something to get it to calm down.” Normally, she says, she carries water with her wherever she goes. In addition, Reed prioritizes getting adequate sleep to combat fatigue, which was recommended after her disease flared up following involvement in her school musical, a very high-stress affair with intense practices, Melinda says.
Generally speaking, Waldman says, pediatric-onset MS tends to be less physically debilitating than MS diagnosed in adults. However, as is advised for anyone taking on a new exercise program, it’s important to start slowly and ease into higher levels of strenuous activity, she says.
Waldman adds that more research is needed to determine exactly what levels of activity are beneficial. For example, is a run required, or is brisk walking enough? Further research, Yeh notes, is also needed to prove that exercise causes lower levels of MS disease activity, rather than simply being associated with it.
But both experts say parents of children with MS can safely encourage kids to be active, and they recommend consulting health care providers for guidance to balance out any concerns.
“I mean sometimes I have my days where I just get really tired, but then I have a bunch of other good days. You gotta take the good with the bad,” Reed says.
Looking ahead to college, she plans to continue following her passion. “Dance is something I’ve done for like 12 years now,” she says. “I’m not going to let my MS stand in the way of something I love doing.”
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Physical Activity May Benefit Children With Multiple Sclerosis originally appeared on usnews.com
