Symptoms can temporarily worsen on exposure to Heat or during physical exercise.
Exercise programmes must be designed to activate working muscles but avoid overload that results in conduction block. Before developing recommendations, physical activity patterns and the physical effects of MS should be assessed in individual patients. Patients may then be functionally classified. Physical activity can also be classified in a pyramid structure, with the most basic functions forming the base and the most integrated functions on top. The muscular fitness pyramid progresses through passive range of motion, active resistive, specific strengthening and integrated strength exercises.