Motor Neurone Disease.

Motor Neurone Disease (MND) is the most common chronic neurodegenerative disorder of the motor system in adults. The most common type of the disease is known as Amyotrophic Lateral Sclerosis (ALS), so MND is often referred to as ALS.  MND typically presents with progressive weakness of the limbs, trunk and muscles that support swallowing and breathing. Unfortunately, there is currently no cure. Therefore, the focus of treatment for individuals with MND is symptomatic and supportive. Here, we will discuss whether exercise should be continued after a diagnosis of MND.

Should you exercise with MND?

The most common questions that people with MND ask a physiotherapist are,

“What can I do to help my symptoms?

Should I be doing exercise?

How much exercise and what type of exercise should I be doing?”

These are fundamental questions to discuss. For many people with MND, exercise played an integral role in their pre-diagnosis lives. Therefore, a desire to keep engaging in this is understandable. In addition, people are keen to know what they can do to try and live the best they can with this disease.

The evidence.

There is overwhelming evidence that exercise has been shown to have psychological and physiological benefits in the general population and those with neurological conditions. The effect of exercise in people with MND is a growing area of research, the general consensus is that exercises should be completed at a low to moderate intensity, guided by an therapist specializing in MND. Exercise can provide benefits such as optimising muscle strength, improving joint range of motion, reducing pain related to immobility and optimise functional particularly in the earlier staged of MND. Previously, people have been discouraged from undertaking an exercise program. 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. However current research suggests that low to moderate intensity exercises are safe for people with MND. For people with MND, fatigue is usually a huge issue, therefore, exercise program should be guided by a  therapist with good understanding of MND.

Effects of reducing physical activity.

In any case, a longstanding reduction of physical activity can lead to muscle wasting and reduced strength. This subsequently leads to a decrease in their functional ability and capacity. Therefore, strength loss can be caused by the disease itself and an element of deconditioning. Loss of strength in people with MND makes them more susceptible to muscle and joint tightness, leading to pain and decreased range of motion in their limbs.  Once the motor neurones that control a particular muscle have weakened, the muscle cannot be repaired by exercise or anything else. However, exercise can help to keep weakened muscles as strong as possible. It will also help to strengthen muscles that have not yet been affected by the disease. In addition, regular exercise can help maintain muscle elasticity, improve the range of movement for joints and prevent muscles from shortening.

However, overly strenuous or ‘high-intensity exercise can add to fatigue and be functionally detrimental – leaving a person with MND without the power to manage their activities of daily living.

So, considering this, should people with MND continue to exercise?

Every person with MND is different – both in the effects of the disease,  their life priorities and exercise enjoyment. Therefore, these factors should be considered when prescribing exercise and monitoring the impacts. Conversations with a neurological physiotherapist or exercise physiologist should work through these elements because a low to moderate-intensity exercise program monitored closely by a physiotherapist can be safe and beneficial.

Research carried out in this area suggests that in the early stages of MND, an exercise program; 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. Still, the effects of deconditioning have been reduced, meaning people can maintain as much independence as possible for as long as possible.

Our experienced team of Physiotherapists and Exercise Physiologists are knowledgeable, sensitive and responsive to your needs by work closely with you, your family and your support network. Our support involves addressing your functional difficulties which MND brings, help you manage problematic symptoms and work with you to create a suitable exercise rehab program to enable you to do the things you want to do in everyday life.

If you would like to know more about exercise and MND, you can click here to read more, or call the clinic to make an appointment with one of our ARC Neurological Physiotherapists.