Table 1.

Recommended exercise prescriptions for adults with mild to moderate MS

	General aerobic exercise	Advanced aerobic exercise	General resistance exercise
How often?	2–3 days per week	5 days per week	2–3 days per week
How much?	Gradually increase the duration of exercise from 10–30 minutes over time.	The duration of the exercise bouts can approach 40 minutes.	The exercise bouts should range from 1– 3 sets between 8–15 repetitions of each exercise. Try to do 5–10 exercises.
How hard?	These activities should be performed at a moderate-intensity. Moderate-intensity of exercise is usually between 11 and 13 on the 20-point RPE scale. Alternative way of measuring moderate-intensity of exercise is 40–60% VO2peak or HRpeak	Intensity of exercise can approach a 15 on the 20-point RPE scale. Alternative way of measuring intensity of exercise is 70% VO2peak or 80% HRpeak.	Pick a resistance that you can finish 8–15 repetitions of the last set comfortably.
How to?	Some options for activity include: • Ergometry (arm, leg, or combined) • Walking (over-ground or treadmill) • Aquatics (including swimming) • Elliptical	Some options for activity include: • Same as general guidelines • Running • Road cycling	Resistance training activities mainly target major/large muscle groups: • Weight machines • Free weights • Elastic bands
Special Considerations	• Overall progression should start with either duration or frequency, and finally progress intensity per tolerability of the person. • Rest your muscles 2–4 minutes duration in between sets and muscle groups. • Rest your muscles for at least one day between strength training sessions. • Aerobic and resistance training can be performed on the same day as aerobic exercise training, depending on tolerability. • MS-specific symptoms (i.e., fatigue and heat sensitivity) should be identified and discussed before prescribing an exercise routine.

RPE, rating of perceived exertion; VO_2peak, peak oxygen consumption; HR_peak, peak heart rate