Specifically:
- Generalized fatigue is common in individuals with MS. It is best to perform exercise testing early in the day because energy levels in those with MS quickly worsens throughout the day. Testing in the morning will yield more accurate and consistent results.
- Avoid exercising during an acute exacerbation of MS symptoms
- Problems with balance and coordination may require use of an upright or recumbent cycle leg ergometer. When using a cycle leg ergometer, the use of foot straps may be needed to prevent the foot from falling off the pedal because of weakness and/or spasticity.
- A recumbent stepping ergometer that allows for the use of upper and lower extremities may be advantageous because it distributes work to all extremities, thus minimizing the potential influence of local muscle fatigue on maximal aerobic testing.
- Depending on the disability and physical fitness level of the individual, use a continuous or discontinuous protocol of 3-5 minute stages increasing work for each stage from 12 to 25 W.
- Heat sensitivity is common in individuals with MS so it is important to use a fan or other cooling strategies during testing.
- Assessment of joint ROM and flexibility is important because increased tone and spasticity can lead to contracture formation. (MS Spasticity Information)
- Isokinetic dynamometry can be used to accurately evaluate muscle performance. However, use of an 8-10 RM or functional testing (e.g., 30 second sit-to-stand test) can also be used to measure muscular strength and endurance in the clinical or community setting.
- Use physical performance tests as needed to asses endurance (6-min walk test), strength (5 rep sit-to-stand), gait (walking speed), ad balance (Berg Balance Scale, and Dynamic Gait Index).
(Sourced from ACSM's Guidelines for Exercise Testing and Prescription Ninth Edition)
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