Motor Neurone Disease (MND) also known as Amyotrophic Lateral Sclerosis (ALS) is the most common chronic neurodegenerative disorder of the motor system in adults. MND causes paralysis of swallowing, breathing and limb muscles and there is currently no cure. The focus of treatment for individuals with MND is symptomatic rehabilitation and palliative therapy.
Commonly when people are first diagnosed and have the initial assessment with a physiotherapist their first questions are “What can I do to help? Should I be doing exercise? How much exercise and what type of exercise should I be doing?”
Exercise has been shown to have both psychological and physiological benefits. The effect of exercise in people with MND is poorly understood and there is limited high quality evidence in this area. Previously people have been discouraged from undertaking an exercise programme. This was because it was thought that a weak muscle was more susceptible to damage from being overworked because it is already functioning close to its maximal limits.
Many people when first diagnosed with MND withdraw from activity and notice a sudden decline in their physical capabilities which they associate with a progression of their disease. They notice an increase in fatigue and a decrease in cardiovascular fitness as well as independence in activities of daily living.
However, if anyone was to reduce their physical activity for a prolonged period of time they would develop muscle wasting and reduced strength; subsequently leading to a decrease in their functional ability. Strength loss in MND can therefore be caused by the disease itself as well as an element of deconditioning. Loss of strength in people with MND are more susceptible to muscle and joint tightness which can lead to pain and decreased range of motion in their limbs.
The research that has been carried out in this area suggests that in the early stages of MND an exercise programme; guided by a physiotherapist; consisting of both resistance and cardiovascular training can improve function and an individuals’ quality of life. This research does not suggest that the disease process has been slowed down but the effects of deconditioning have been reduced; meaning people can maintain as much independence as possible for as long as possible.
Top 5 tips for exercising with MND
- Be aware of fatigue levels both during and after your exercise. Fatigue can continue into the next day.
- Exercise does not have to be strenuous. The evidence available suggests that low intensity exercise is beneficial.
- Make exercise functional; mimicking activities of daily living as much as possible.
- Exercise should be specific to your needs and tailored to your abilities.
- Ensure exercises are regularly reviewed and adapted as required.
If you would like to know more about exercise and MND please call the centre to make an appointment with Emma Lee or one of our Senior Neurological Physiotherapists.