Tailoring Exercise Support for People With Multiple Sclerosis in Queensland

Exercise interventions for people with multiple sclerosis (MS) are becoming more individualised across Queensland. Rather than prescribing a single routine, clinicians and researchers are considering mobility, fatigue, heat sensitivity, balance, cognition, vision, pain, cardiovascular health, work demands, and access to local services.

This approach reflects the varied nature of MS. Symptoms can change over time, and an activity that is suitable during one period may need to be adapted during a relapse, after a change in medication, or when fatigue becomes more disruptive. Personalised exercise planning can help people remain active while managing risk and preserving independence.

Queensland’s health translation environment provides an opportunity to connect research institutes, universities, hospitals, community providers, and people living with MS. The aim is to move evidence into practical programs that fit real lives, including those in regional and remote communities.

Why Individualisation Matters

MS affects the central nervous system, so its impact differs widely between individuals. Some people may primarily experience weakness or foot drop, while others may manage tremor, spasticity, reduced coordination, bladder symptoms, depression, or cognitive fatigue. Exercise planning must account for this combination rather than focusing on diagnosis alone.

Fatigue is a frequent consideration. A program may use shorter sessions, rest intervals, alternating muscle groups, or lower-intensity activity at particular times of day. Someone who struggles in Queensland’s heat may benefit from an air-conditioned gym, aquatic exercise with appropriate supervision, indoor cycling, or an early-morning walking plan.

The starting point is usually a functional assessment. Physiotherapists, exercise physiologists, neurologists, nurses, and other health professionals can examine strength, gait, balance, endurance, falls risk, and confidence. This information supports goals that are meaningful to the person, such as carrying groceries, returning to work, caring for children, or walking safely at a local park.

What Tailored Programs Can Include

Aerobic training may involve walking, cycling, rowing, swimming, or seated equipment. Resistance exercises can target the legs, trunk, arms, and muscles needed for transfers and posture. Balance work may include supported standing, stepping patterns, weight shifting, and dual-task activities that combine movement with attention or memory.

Programs are often adjusted through intensity, duration, frequency, equipment, and supervision. A person with reduced lower-limb control might begin with supported strengthening and recumbent cycling, while someone with good mobility but poor endurance may progress through interval walking. Home exercises can complement clinic sessions when transport, work, or caring responsibilities create barriers.

The setting also matters. Aquatic therapy can reduce weight-bearing demands and provide a cooler environment, although pool access, fatigue after sessions, and supervision requirements must be considered. Community-based programs may improve confidence and social connection, while telehealth can support people who live far from specialist services.

Connecting Queensland Research With Care

Health translation helps ensure that promising findings become usable clinical services. Research teams can work with people affected by MS to identify outcomes that matter in daily life, test interventions in realistic settings, and refine delivery for Queensland’s diverse population. This process is described clearly in lab discovery pathways, which show how evidence can move from research into bedside practice.

Partnerships are especially important for regional Queensland. A specialist service in Brisbane may contribute assessment protocols or professional training, while local physiotherapists, primary care teams, rehabilitation providers, and community organisations deliver ongoing support closer to home. Cultural safety, transport availability, digital access, and local workforce capacity should be included when programs are designed.

Clinical innovation can also involve testing different models of supervision. Some people may need frequent face-to-face review, while others can safely follow a structured home program with periodic check-ins. Shared decision-making helps match the intervention to a person’s priorities, symptoms, confidence, and available resources.

Using Technology Beyond the Clinic

Wearable sensors, activity trackers, smartphones, and telehealth platforms can provide information about movement outside appointments. Step counts, walking speed, heart rate, activity duration, and sedentary time may help clinicians understand how symptoms affect daily routines. The data can also reveal whether a program is manageable or causing excessive fatigue.

However, technology should support clinical judgement rather than replace it. A lower step count may reflect a flare, hot weather, pain, poor sleep, or a deliberate recovery day. Devices can also be inaccurate for people who use walking aids or have altered gait patterns. Privacy, consent, affordability, and digital literacy must be addressed from the beginning, as outlined in guidance on wearable monitoring.

Remote monitoring may be particularly useful between appointments. A person could record perceived exertion, fatigue, balance confidence, and recovery time alongside device data. This combined picture allows a practitioner to adjust the exercise dose without requiring every review to occur in person.

Measuring Benefits That Matter

Fitness is only one possible outcome. A tailored program may be successful if it reduces falls, improves transfers, supports participation in work, increases confidence outdoors, or makes household tasks less tiring. Measures can include walking tests, strength assessments, balance scales, fatigue questionnaires, mood, quality of life, and self-reported participation.

Evaluation should occur at suitable intervals rather than relying on a single before-and-after assessment. MS symptoms fluctuate, so clinicians may look for patterns across several weeks. The person’s own goals should remain central, supported by clinical measures that show whether function and safety are changing.

Health services and research partners can use these findings to judge whether an intervention is effective, acceptable, equitable, and practical to deliver. Resources on research translation outcomes emphasise the importance of connecting research activity with changes in patient experience and health outcomes.

Principles for Safer Participation

Exercise is generally considered an important part of MS management, but new or changing symptoms warrant professional review. A qualified clinician can help distinguish expected exertion from signs that the plan needs modification, particularly when there is significant weakness, dizziness, chest discomfort, visual change, or a recent relapse.

Safety planning may include cooling options, hydration, appropriate footwear, rest periods, fall-prevention strategies, and a clear method for reporting symptoms. Medication schedules, other health conditions, pregnancy, osteoporosis, and cardiovascular risk may also affect the choice and progression of activity.

Useful principles for an individualised program include:

• Begin with goals that relate to daily function and personal priorities.
• Increase duration or intensity gradually, changing one major variable at a time.
• Schedule recovery and adapt sessions around fatigue, heat, illness, or symptom variation.
• Combine professional assessment with feedback from the person living with MS.
• Review access barriers so the program remains affordable, practical, and sustainable.

From Evidence to Everyday Activity

The most effective exercise intervention is one that a person can perform safely and continue over time. For some, that may mean supervised rehabilitation followed by a community program. For others, it may involve a home-based routine, aquatic sessions, strength training, or carefully monitored walking supported by technology.

Queensland’s collaborative research and health services can strengthen this pathway by involving people with MS in program design, sharing evidence across disciplines, and evaluating outcomes that reflect real life. Health professionals, researchers, carers, and community organisations can explore local partnerships and evidence-informed support through Brisbane Diamantina Health Partners. Begin the conversation with a clinical team to identify a safe starting point and build an exercise plan around the individual, not simply the diagnosis.