FITT Recommendations for Individuals with Multiple Sclerosis

For patients with minimal disability (EDSS score of 0-2.5), the FITT principle of exercise prescription is fairly consistent with those outlined for healthy adults located in Chapter 7 of ACSM's Guidelines for Exercise Testing and Prescription. The following FITT recommendations are for people with increased disability:

Aerobic Exercise

• Frequency - 3-5 days per week.
• Intensity - 40%-70% VO2R or HRR; RPE 11-14.
• Time - Increase exercise time initially to a minimum of 10 min before increasing intensity. Progress to 20-60 min. In individuals with excessive fatigue, begin with lower intensity and discontinuous bouts of exercise.

Resistance Exercise

• Frequency - 2 days per week.
• Intensity - 60%-80% 1-RM.
• Time - 1-2 sets of 8-15 repetitions. When strengthening weaker muscle groups or easily fatigued individuals, increase rest time (i.e. 2-5 min)between sets and exercises as needed to allow for full muscle recovery. Focus on large anti-gravity muscle groups and minimize total number of exercises performed. 

Flexibility Exercise

• Frequency - 5-7 days per week, 1-2 times per day.
• Intensity - Stretch to the point of feeling tightness or mild discomfort.
• Time - Hold static stretch 30-60 sec, 2-4 repetitions.

(Sourced from ACSM's Guidelines for Exercise Testing and Prescription Ninth Edition)