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Should You Dive into Aquatic Exercise for Multiple Sclerosis

aquatic exercise for multiple sclerosis

Exercise can help with management of multiple sclerosis symptoms, but physical activity is often a challenge for people who live with this disease. Aquatic exercise, or exercise in the water, is an option that could be just what the doctor ordered.


Swimming is one of the best exercises for people who have multiple sclerosis. However, aquatic exercise doesn't involve swimming, so nonswimmers can enjoy the benefits of being in the water as well. Just wade into a pool up to your waist, chest, or shoulders and the fun can begin!

Is it really worth your time and effort to find a pool, don a bathing suit, and do exercises in the water? According to the results of a number of recent studies, the answer is a yes.

Aquatic exercise and multiple sclerosis
Thirty-seven women with multiple sclerosis were assigned to participate in an aquatic exercise group (18) for 45 minutes three times a week for 8 weeks; or to a control group (19) in which no water exercises were done. Here’s what the researchers found:

  • Significant effects on scores of physical and psychosocial fatigue perception, quality of life, and fatigue severity among women who participated in aquatic exercise when compared with controls
  • No significant improvement in cognitive fatigue perception among women who did water exercises

Another study involved 21 women with relapsing-remitting MS and lasted 8 weeks as well. However, each aquatic exercise session (10 participants) was for 60 minutes three times a week. The 10 controls did not participate.

The findings were similar to those of the other study: Women who participated in aquatic exercise enjoyed significant improvements in fatigue and quality of life when compared with controls. These findings led the authors to recommend considering this exercise option to help manage what they called a “relatively common public health problem.”

About aquatic exercises
Aquatic exercises are a form of physical therapy and therefore are frequently done, at least initially, with a physical therapist who can help choose the movements that are best suited for your personal needs. Some people with multiple sclerosis try aquatic exercise on their own, but it is recommended you speak with a knowledgeable professional before getting started.

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A specific type of aquatic exercise that has been shown to be effective for individuals with multiple sclerosis is called Ai-Chi. This water-based movement method is performed in shoulder-deep water and embodies tai chi, watsu (a gentle form of bodywork done in the water), and shiatsu techniques.

Ai-chi is used by physical therapists, personal trainers, and rehabilitation professionals to help individuals improve total body strength, relax, and improve mobility and range of motion. Deep breathing is coordinated with movement of the torso, legs, and arms.

A recent study evaluated the use of Ai-chi in women with multiple sclerosis. Fifteen women participated in Ai-chi exercises in a swimming pool for eight weeks while eight women served as controls and performed leg and arm exercises along with abdominal breathing exercises at home.

The women who participated in Ai-chi showed improvements in functional mobility, upper and lower extremity muscle strength and fatigue, and standing balance. Those in the control group did not.

Read about yoga for multiple sclerosis

Bottom line
Not everyone has a swimming pool, so access to one at a gym, community center, senior center, school, or health club is the most likely option. Family members or friends who have a pool may be another possibility.

Before diving into an aquatic exercise program, you should talk to your healthcare provider. If you already engage in water exercises, please share your experience with them.

Bayraktar D et al. Effects of Ai-Chi on balance, functional mobility, strength and fatigue in patients with multiple sclerosis: a pilot study. NeuroRehabilitation 2013; 33(3): 431-37
Kargarfard M et al. Effect of aquatic exercise training on fatigue and health-related quality of life in patients with multiple sclerosis. Archives of Physical Medicine and Rehabilitation 2012 Oct; 93(10): 1701-8
Kooshiar H et al. Aquatic exercise effect on fatigue and quality of life of women with multiple sclerosis: a randomized controlled clinical trial. Journal of Sports Medicine and Physical Fitness 2014 Oct 10