Podcast Summary: Living Well with Multiple Sclerosis – Webinar Highlights: Physical Activity with Dr Robert Motl (S7E20)
Date: September 24, 2025
Host: Overcoming MS
Guests: Dr. Robert Motl (University of Illinois Chicago), Frances Loy, Duarte Valente, Heather O’Neill (facilitator)

Episode Overview

This episode focuses on the role of physical activity in managing Multiple Sclerosis (MS), exploring both the scientific understanding and real-life experiences. Moderator Heather O’Neill guides a panel discussion with leading researcher Dr. Robert Motl and OMS community members Frances Loy and Duarte Valente. The conversation covers the benefits of activity at all levels of ability, practical ways to start and maintain a routine, overcoming barriers such as fatigue and mobility challenges, and the motivational power of finding your “why.”

Key Discussion Points & Insights

The Science: Physical Activity's Broad Benefits for People with MS

• Physical activity benefits people with MS on every level—from reducing inflammation at the cellular level to improving brain health, cognition, fatigue, mood, and participation in society.
  • “We talk about physical activity in the context of ‘exercise is medicine’ in MS, because there is really no other behavior that you can engage in that has such broad-based evidence for benefits.” (Dr. Motl, 07:58)
• Physically active people with MS show:
  • Lower inflammation and higher nerve growth factors (neurotrophins)
  • Larger gray/white matter in the brain and stronger inter-brain connections (MRI evidence)
  • Better cognitive speed, learning, memory, balance, and walking
  • Less fatigue, depression, pain, and anxiety, plus better sleep and higher quality of life
• Physical activity slows or prevents MS progression:
  • “In those who were physically active, their disease didn’t progress, it stayed flat. But in those who were inactive…it slowly progressed.” (Dr. Motl, 37:02)
• Reduced relapse rates:
  • “Relapse rates actually went down by 25% in those who were exercising versus those who are not exercising—which is the same magnitude as many common disease-modifying therapies at the time.” (Dr. Motl, 18:19)

Finding Your “Why” (Motivation)

• “The first step…is we always talk to them about their why. The range of reasons is very broad…when people have that why, particularly when it’s meaningful for them, that is such strong motivation.” (Dr. Motl, 09:15)
• Frances was motivated by his family—wanting to stay active with his children. Duarte emphasizes the desire for independence as his core “why”.
• “When you hear those words [MS diagnosis] for the first time…you have to work so hard in mindset and have confidence. As Rob says, start small, but those marginal gains all add up over time.” (Frances, 20:59)

Real-Life Experiences & Successes

Duarte Valente

• Follows the OMS program, no relapses in four years
• Gradual, incremental approach: “Start with a program that fits your level. Step by step, it’s an incremental thing. There’s actually no rush.” (Duarte, 11:03)
• Enjoys yoga, running, cycling, surfing, and group classes
• Becoming social and enjoying activity, not just focused on performance gains

Frances Loy

• Ex-endurance athlete, diagnosed in 2021
• Initially motivated by family, later by his own sense of identity and achievement
• Has completed the demanding Mallorca 312km cycling challenge post-diagnosis—“My bike fitness is far stronger now than it was before, even before my diagnosis. We don’t have to reduce our wish list.” (Frances, 15:09)
• Started CrossFit to focus on strength, now a semi-finalist in the adaptive CrossFit Games
• Emphasizes the power of community, accountability partners, and inspiration from others overcoming diverse challenges

Starting Small & Adapting for All Abilities

• Everyone can benefit—regardless of ability or disability:
  • “Being physically active has these benefits from cell to society across the spectrum of disability…We’re not just talking about elite athletes. This benefits everybody with MS.” (Dr. Motl, 24:06)
• First-ever major exercise study in MS used a stationary Schwinn Aerodyne bicycle (which uses both arms and legs, and keeps participants cool and safe).
• For people with greater mobility impairment:
  • Seated exercises (arm/leg steppers, resistance bands, even using canned vegetables as weights)
  • Focus on strength to aid independence and reduce fatigue
  • Gradual increases: “Don’t try to go out and do 30 minutes at once. Go for a 1-minute walk and see how your body responds…success starts with these really small bouts.” (Dr. Motl, 42:53)

Fatigue: Challenge & Paradox

• Counterintuitive benefit: Movement can reduce fatigue in the long run, though it may feel draining at first.
  • “My mantra is you need to spend energy to get energy. I feel worse if I don’t exercise.” (Frances, 27:49)
• Both Duarte and Frances experience less fatigue and better daily productivity with regular morning activity.
• For those with intractable fatigue:
  • Start with energy conservation and pacing strategies
  • Once balanced, slowly introduce gentle activity, allowing the body to adapt over time

Safety and Exercise Types

• Reduce fall risk:
  • Assess both personal risk and the exercise environment
  • Use devices (canes, walkers) as needed
  • Safer choices: recumbent bikes, seated steppers, aquatic exercise (though evidence is not as strong as for land-based activities)
  • Home adaptations: Walking in hallways, holding onto furniture
• What type of exercise is best?
  • “The best exercise is the exercise that you’ll do.” (Dr. Motl, 34:19 & 45:19)
  • No single modality: Benefits for aerobic (walking, cycling), strengthening (bands, machines, weights), stretching, and balance exercises
  • Experiment to discover what you enjoy and will repeat
  • Short bouts add up; does not have to be 30 minutes at once

Mindset, Enjoyment, and Community

• “Don’t compare yourself…these stories are meant to inspire, not to create anything else…hopefully they generate some ideas, open some doors, or even start a friendship.” (Duarte, 41:16)
• Find accountability partners: Community support, exercise buddies, or online platforms help maintain motivation and consistency
• “Just enjoy it. Do it for pleasure—don’t see it as a chore. Be creative and solution-focused.” (Frances, 46:20)

Notable Quotes & Timestamps

• Dr. Robert Motl (07:58): “There is really no other behavior that you can engage in that has such broad-based evidence for benefits is physical activity.”
• Dr. Motl (18:19): “Relapse rates actually went down by 25% in those who were exercising versus those who are not exercising.”
• Frances Loy (15:09): “My bike fitness is far stronger now than it was before…we’re really still capable of doing hard things.”
• Duarte Valente (11:03): “There’s actually no rush…having that mindset of no rush, actually I started to love it quite a lot.”
• Dr. Motl (42:53): “Don’t try to go out and do 30 minutes all at once. Go for a 1-minute walk…see how your body responds.”
• Frances Loy (27:49): “You need to spend energy to get energy. I definitely feel a different person when I come out of the gym.”
• Dr. Motl (45:19): “The best exercise is the exercise that you’ll do.”

Recommended Resources & Advice

• Start small, build up gradually; success comes from consistent small steps
• Creativity counts: Adapt activities to your environment, needs, and abilities
• Don’t compare yourself to others; focus on personal progress and enjoyment
• Utilize community support: Accountability partners, local groups, OMS resources
• It’s okay to break up activity into several short bouts across the day

Segment Timestamps

• [02:52] – Dr. Motl’s research background and overview
• [10:31] – Duarte’s personal experience and incremental approach
• [13:19] – Frances’ experience & athletic goals after diagnosis
• [18:19] – Research on relapse reduction through exercise
• [22:27] – Exercise adaptations for all levels of ability
• [26:05] – Strategies and stories for managing fatigue
• [30:32] – Exercise for those at high risk of falls
• [34:19] – Which exercise types are best; importance of personal preference
• [38:14] – Community advice for struggling to start or maintain activity
• [42:53] – The risk of “too much” exercise; importance of gradual build-up
• [45:19] – How to choose where to start with exercise

Conclusion
Physical activity is a cornerstone of managing MS—backed by science, adaptable to all abilities, and deeply personal. Starting small, staying safe, and focusing on what you enjoy, while leaning on community support, can help everyone reap the full benefits, both physically and mentally.