![](https://thelimbic.com/wordpress/wp-content/uploads/2018/11/Broadley-Simon-1-300x300.jpg)
Prof Broadley
Exercise and other non-drug approaches are often the most effective and acceptable ways to manage common symptoms in MS such as weakness, spasticity and fatigue, an Australian specialist says.
Speaking at PACTRIMS 2018, Gold Coast neurologist Professor Simon Broadley said exercise should be promoted more widely for people with MS because it had some of the highest levels of evidence for effectiveness for improving muscle strength and spasticity.
And while some MS-focused programs involve physiotherapists, it often did not really matter what form of exercise was done, and could be recommended based on patient preference such as tai chi exercises, he said.
Evidence showed that the potassium channel blocker fampridine (Fampyra) could help improve walking distance in about a third of patients, but it was not listed on the PBS, he noted.
Exercise was also an important component of managing spasticity in MS because restoration of lost muscle strength is needed when spasticity is alleviated by other treatment, to avoid collapse, he added.
Management of fatigue in MS requires a comprehensive assessment of the many possible causes, Professor Broadley told the meeting. Fatigue might be secondary to immune responses to drug treatment or a consequence of deconditioning or pain.
Fatigue might also be due to sleep disturbances, which was another key symptom of MS, Professor Broadley noted.
“This is why I have a low threshold for sleep studies,” he said
As well as conditions such as OSA, identifying sleep problems such as insomnia would allow them to be managed with non-drug approaches such as sleep hygiene programs and mindfulness apps, said Professor Broadley.