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Old 03-08-2013, 11:31 AM
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Default DISCUSSION: Heat sensitivity and exercise

Heat sensitivity and exercise

Andrea T White

University of Utah, Salt Lake City, UT, USA

Andrea T. White, Research Associate Professor, University of Utah, 250 S. 1850 E, Rm 241, Salt Lake City, UT 84112, USA.

Thermal sensitivity in multiple sclerosis (MS) has been reported as early as 1824 by Charles Prosper Ollivier d’Angers, who observed that a hot bath induced leg numbness and reduced feeling and dexterity in the hands of a patient with MS.1 However, Wilhelm Uhthoff’s 1890 report, in which exercise-induced amblyopia was observed in four patients with MS, is often cited as the earliest observation of heating reactions in MS, referred to as “Uhthoff’s symptom.”2 Since then, heating reactions in MS have been reported in dozens of studies [for a review, see Guthrie and Nelson3]. Further, work in the mid-20th century demonstrated that MS symptom exacerbation was proportional to the degree of temperature elevation, with initial neurological signs appearing after 8 minutes of heating, when body temperature increased by 0.8°C, and maximal signs appearing at temperatures 1.7°C above normal.4 Symptoms resolved an average of 15 minutes after heating ended.4

In this issue of the Multiple Sclerosis Journal, a paper by Skjerbaek et al. demonstrates that heat-related symptom increases in MS are significantly greater following 30 minutes of endurance exercise (EE) compared to a 30-minute session of resistance exercise (RE), results that are consistent with the above-cited work. The purpose of this editorial is to underscore the idea that the inherent difference in EE and RE with respect to heat stress is metabolic heat production, and the selection of one exercise mode over another should be based on fitness and/or rehabilitation goals.

http://msj.sagepub.com/content/19/7/833.full

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Old 03-08-2013, 11:44 AM
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I also recently read that many MSers avoid exercise because of the temporary worsening symptoms. If it makes it hard (or even impossible) to walk safely without aid after exertion, folks frequently don't bother to work out. The reason? Often they don't want to be seen as "disabled." Use your cane, your forearm crutches, your walker, your wheelchair, your scooter, your whatever. Your symptoms will soon calm—I let my temps get back to normal during my 15-minute stretching post work out—and then you can go about your merry way.
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Old 03-09-2013, 01:20 PM
AMFADVENTURES AMFADVENTURES is offline
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Dave,
If,
30 minutes of Endurance Exercise (EE) produces 248 Kcal of Metabolic heat,
while
30 minutes of Resistance Exercise (RE) produces 96 Kcal of Metabolic heat,
I don't see how it follows that,
"(the) inherent difference in EE and RE with respect to heat stress is metabolic heat production."

On the contrary, it appears that the inherent difference is the amount of work performed in 30 minutes of EE vs. RE. Or, put another way, about 12 minutes of EE appears to equal 30 minutes of RE in terms of work performed and Metabolic heat produced. I do agree with the conclusion though, that
"the selection of one exercise mode over another should be based on fitness and/or rehabilitation goals", and I would add, ability.

In terms of cooling after whatever workout one chooses, I know one MSer who swears by cold milk. Low fat cold milk, with a little chocolate added, is a good, post workout drink. It contains carbohydrate to replace energy, protein for muscle repair and may be more effective for cooling core temperature than an equivalent amount of equally cold water.

I'd be interested to know to what degree people with MS are able to acclimate to heat? In my experience, although it is a very, very uncomfortable procedure, it can be done.

AMF

ps: It will be a huge issue up here today. It's currently snowing like mad. Forecasters are predicting 18 inches. I wonder how many Kcal shoveling 18 inches of snow will produce in 30 minutes? Actually, considering the temperature and wind velocity outside, I may need HOT chocolate milk to recover.

Last edited by AMFADVENTURES; 03-09-2013 at 01:22 PM.
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Old 03-09-2013, 06:58 PM
penkalet penkalet is offline
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What about exercise on the front of big fan!
It should add a parameter to the formula.
With 50 to 70 degres out door temperature I can ride my bike for several hours without feeling really hot.
I also know of a MSer that take cold shower after his ride !! I do it sometimes and it is not fun but feel good after!
Alain
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Old 03-20-2013, 05:12 PM
AZgal AZgal is offline
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Actually my brother and I were chatting about this the other day. His suggestion: Get a recumbent bike, one that sits close to the floor. Set in the middle of my living room, in front of the tv, with my yoga mat laid out next to it. Sweat it out for 30 mins or so, roll out of the bike onto the yoga mat, and chill there (while stretching and drinking your water) until you cool down enough to be safely mobile.
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Old 03-22-2013, 04:18 PM
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AZgal, that's a brilliant solution! Except for one minor detail that one does not want to discover the hard way: When you really have to go, and you have no way to transport yourself to the potty! That's one of the reasons I recommend a walker for exercise, even if you use it no other time. Don't look at it as a sign of disability, and call it a mobile rolling device or MRD for short.
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Old 03-25-2013, 12:04 PM
Dad2jd# Dad2jd# is offline
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Default Heat Insensitivity and Exercise

We know that heat even when created by exercise makes our symptoms worse. One thing a lot of people do not do is pre-cooling the body especially the core before exercise. Studies have shown that cooling the core before exercise increases exercise performance and tolerance as well as recovery times. There are several ways to pre-cool your body: (1) cold vest, (2) wet and cold ice towels, (3) ice massage, and (4) wetting the body and sitting in front of a fan. The key here is not to cool the entire body, only the core (the trunk). Hope this helps.
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Old 03-25-2013, 09:09 PM
teena marie teena marie is offline
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Good point.I have had this experience a few times by using an ice vest and by havung freezing cold baths. My timed walk is always much faster.
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Old 03-26-2013, 06:03 PM
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Smart tips, Dad. Pre-cooling is smart, smart, and often overlooked. You can also park it in front of your home or car A/C and drink icy cold drinks.
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Old 03-27-2013, 08:53 AM
Marinadca Marinadca is offline
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I do get the jello legs after exercise, but what is most disturbing to me is my vision going fuzzy. I usually just keep going and the fuzziness goes away after 15-20 minutes.

It made me feel unsafe on my bike, and I am still trying to decide what the way to go for me is. Trike, tandem. riding my heavier hybrid much slower, or not biking at all.

Its less of an issue running, I still the fuzziness but I am closer to the ground.

I think I will give pre-cooling a go and see if it can make a difference for me, thanks for the tip!
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