Along with physical therapy and occupational therapy, one of the most popular alternative therapies is regular exercise.
The challenge for health providers in recommending physical exercise lies in the wide range of disease manifestation and severity of LGMD2I. Some studies have shown that moderate exercise was beneficial for ambulatory LGMD2I individuals. In one study published in 2007 in the journal Neurology, the participants were asked to do steady-state cardio exercise. Over 12 weeks, participants did 30 sessions of 30 minutes at 65% of their Maximal oxygen uptake, increasing the number of weekly sessions so that they would exercise 5 times a week during the last 8 weeks. At the end of the study, the clinicians did not see adverse events like for example change in muscle degeneration/regeneration and change in satellite cells activation, or change in centronucleated fibers. However, 8 out of 9 participants reported significant increase in physical endurance, 7 out of 9 participants reported an increase in leg muscle strength and 6 out of 9 participants reported an increase in walking distances. Physical fatigue did not changed. Creatine kinase increased moderately but not more than in the healthy participants. While these results help to understand the benefits of moderate exercise in ambulant patients, it is not easy to understand how these results apply to other LGMD2I individuals such as partially wheelchair bound individuals, pre-symptomatic individuals, or even children.
Appropriate nutrition and alternative medicine are great complement to exercise.
Recently, a tool has been created by a team of physical therapy researchers in Amsterdam. This tool is available to any physical therapist that would like to help you. Remember that, traditionally, doctors have recommended that people with any muscle diseases stay away from exercise because it would destroy muscles even faster and accelerate the progression of the disease. This view has drastically changed with several research studies that all point to an improvement of the quality of life, strength, and even social interactions if patients practice “adapted” exercise. Here is a link to a video that describes a protocol to design the right level of exercise for people with muscle diseases – video on the B-FIT Training Guide. In addition, a manual for therapists who are interested in trying this tool can be found on this page.
Exercise must be adapted:
It is easy to imagine ambulant patients doing exercise to maintain tone and strength. However, people who lost ambulation can still do exercise and stretching that may help to maintain their wellbeing. These activities are usually done with the assistance of a physical therapist/physiotherapist. The importance of a knowledgeable healthcare provider cannot be underestimated. For non-ambulant individuals, three types of exercise should be part of a daily routine.
- Lung volume recruitment exercises and chest physiotherapy to decrease the risk of respiratory complication.
- Passive or active assisted “Range Of Motion” exercises to keep joints loose and flexible.
- Stretching especially of the heel cords to prevent stiffening of the ankle joints.
Physical activities of all kinds including traditional exercise like swimming, running, biking, hiking can be beneficial to people with LGMD2I and other muscular dystrophies. However, it is essential that people practice these activities safely. Because LGMD muscles are vulnerable during exercise, people with LGMD2I must pay attention to the warning signs that indicate the safety limit has been crossed.
- For muscle damage
- Unusual cramping in muscles
- Pain in muscles
- Weakness of exercise muscles
- Dark urine after exercise
- Cardiac stress
- Shortness of breath
- Chest pain
- Unusually elevated heart rate during exercise
Other activities recommended for people with LGMD2I
A 2012 survey revealed that aquatherapy (and special diets) were most often recommended by healthcare providers to people with neuromuscular disease. Aquatherapy is beneficial because water provides just enough resistance to help patients get stronger in their hips, knees, back and shoulders. Land-based “Range Of Motion” exercises and stretching can also be done in a warm water pool.
Activity that may help to improve balance, coordination, head control and fine motor skills.
Together with Qigong, Tai chi has shown evidence of improving bone health, cardiopulmonary fitness and related biomarkers, and physical function as well as balance in people without LGMD. Some exercise may be applicable to people with LGMD2I and may provide benefits.
- Dynamic Physical Therapy: Benefits of Physical Therapy in a Pool
- ALS Worldwide: Range of Motion Exercises
- Muscular Dystrophy Association: Exercising with a Muscle Disease
- Muscular Dystrophy News Today: 3 Types of Exercises for Slow-Progressing Muscular Dystrophy
- Muscular Dystrophy Association: Riding High in the Saddle