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Water temperature should be between 80-84 degrees. Individuals with MS have a negative reaction to warm water due to nerve transmission dysfunction and fatigue, following exercise in warm environments. They may also have absent sweating responses which severely compromise their ability to deal with heat. Swimmers may fatigue easily, so you should provide frequent rest periods. Also, set realistic goals.

Swimmers may have difficulty with balance and coordination. Therefore it is important to teach recovery from float positions early. Instruction should be provided on how to be very careful while they walk on the pool deck and during entrance and exit from the pool. Swimmers may not be able to roll over while swimming. Encourage activities on the back, due to difficulty turning the head. The swimmer may need floatation devices for buoyancy and safety.

The National Multiple Sclerosis Society established an aquatics program for use at community facilities. Certified instructors implement a program which consists of a Warm-up, Stretching, Strengthening Exercises, Endurance, Cool-Down or Relaxation Exercises. Focus consists of the following components:

  • Reduce spasticity by incorporating active exercises based on everyday movement. All movements should be performed slowly and smoothly to reduce fatigue and assist relaxation.
  • Maximize strength potential Deep water exercises, including water walking and running, can achieve this goal effectively. Some devices used with these exercises are ankle weights, a diving weight belt, and a floatation tube. Exercises include the bent arm pull, straight arm pull, shoulder circles, shoulder press, cross-country skiing, stride jumps and double knee lifts. The use of kick-boards, floating barbells, pull buoys, hand paddles, and fins can also be effective.
  • Maintain or increase endurance potential. This can be accomplished with repetitions of the exercises listed above. A circuit training program can influence muscular endurance. The use of continuous or interval training can assist in the development of aerobic endurance.
  • Maintain or improve the Range of Motion and flexibility of joints. Exercises incorporating floatation devices can assist in this development. Floatation devices can be tailored to fit the individual's needs through alteration of the size of the float or the amount of air in the device. Exercises should begin in chest-to-neck deep water to keep movements more controlled and weight and gravity limited. As ROM increases, the swimmer should complete exercises in progressively swallow water.
  • Prevent symptoms secondary to MS (muscle atrophy and joint contracture). Regular use of the muscles assist in maintaining their tone and effectiveness. Aquatic activities and swim strokes done underwater can increase ROM in joints and provides a wider range of positions on differing planes.
  • Aid in weight control. Implementation of any regular fitness program will help the individual turn fat into muscle, burn calories and increase metabolism.
  • Improve socialization and decrease isolation. Participating in a class environment will in turn provide social support for the individual.
  • Promote an inner sense of achievement and improved self-esteem. When faced with the daily challenges of dealing with MS, accomplishments in an aquatics program can improve self-worth.


Canadian Red Cross (1980). Manual for Teaching Swimming to the Disabled.  Toronto, Ontario: Author.

Bates, A., & Hanson, N. (1996). Aquatic exercise therapy. Philadelphia, PA: W.B. Saunders Company.

This content was created by Kristi Roth,
Doctoral Student in Adapted Physical Education at Texas Woman's University,
as part of requirements for
"Aquatics for Special Populations", Huettig, Summer, 1999.

page last updated 1/3/2017 1:00 PM