Newswise — Delhi college student Vinai Jani has been able to build strength and lose weight through exercise. However, in 2005 he started having seizures. Seizures were difficult to control and Jani fell into depression. He stopped his exercise and regained more than half of his lost weight.
After being hospitalized for a stroke, Jani returned to the gym. He was still having seizures, so he asked his friend to take care of him during training.
His seizures were briefly controlled but then recurred. He changed neurologists, tried new drugs, and eventually had surgery. Through it all, he exercised. His visits to the gym have led to indoor cycling, which has led to outdoor endurance cycling.
Today, Jani is an endurance cyclist, marathoner and epilepsy advocate who encourages everyone with epilepsy to be physically active, not just for fitness reasons, but for social and emotional reasons. doing.
“Often people isolate themselves when they are diagnosed with epilepsy,” Jani said. “They don’t share a heart. They start living on their own. If they go out to work out, any kind of workout, they’ll meet people and be stress free.”
ILAE Recommendations for Exercise
Studies suggest that exercise improves physical fitness, mood, thinking and memory, and overall quality of life in people with epilepsy. Physical activity does not increase the risk of seizures, except in rare cases (exercise-induced reflex epilepsy). However, research has shown that people with epilepsy tend to be less active and less fit than the general population, and have lower objective fitness on muscle tests than people without epilepsy. is shown.
People with epilepsy are often excluded from sports and exercise, usually because of fear, overprotection, and ignorance of the specific benefits and risks associated with such activities. These same fears and misconceptions can also lead to avoidance of physical activity.
In 2015, the ILAE Task Force on Sports and Epilepsy published a report providing guidance on the types of sports and exercise that are considered safe, depending on the frequency and type of seizures.
Jaime Carrizosa and Ricardo Arida led a recent survey of Latin American neurologists to assess their knowledge of the importance of physical activity in patients with epilepsy and their perception of ILAE reports.
“I’m pleasantly surprised that most neurologists are aware of the benefits of exercise in epilepsy,” said Arida of the Federal University of São Paulo, Brazil.
More than 90% of surveyed neurologists supported physical activity in people with epilepsy and agreed that exercise can reduce comorbidities. However, only 40% of them were aware of the ILAE recommendations, and 35% said they had no information about physical activity in people with epilepsy.
“It’s one thing to recognize the benefits of exercise, but one to discuss it with patients and prescribe or recommend it,” says Carrizosa, professor of pediatric neurology at Antioquia University in Medellin, Colombia. “How many people tell their patients how important it is that they do physical activity for a certain amount of time, three to five times a week? Would you like to talk about it?”
Researchers have completed a literature review on physical activity and epilepsy, Carrizosa said. “In more than 30 years of research literature, fewer than 42 people have experienced an association between exercise and seizures,” he said.
Misconceptions about exercise are widespread
“I think there’s a lot of misconceptions about exercise in people with epilepsy, and this is a problem,” says Hayley Briglia Alexander, a neurologist at Wake Forest Baptist Health in Winston-Salem, North Carolina, USA. “I think it’s a clear gap that people caring for people with epilepsy are lagging behind in current knowledge.”
People with epilepsy may still be afraid to exercise, or their family members may be afraid to let them exercise. said it was necessary.
“We really don’t know what kind of horror it is,” she said. “Fear of injury from a seizure? Fear of embarrassment? Are you afraid that if you have a seizure, other people won’t know what to do? Your health care provider can help dispel all of these fears.” But we have to talk about it.”
Alexander suggests providing handouts on exercise and epilepsy for time-constrained physicians, or referring patients to the Epilepsy Foundation website, which has a section on exercise.
Dr. Alexander says some people with epilepsy have risk factors for cardiovascular disease that put them at greater risk than the general population. Although uncontrolled, physical activity can improve cardiovascular health in people with epilepsy.
If the provider waits for the patient to ask questions about exercise, she said, it may never happen. It may be different in pediatrics asking about it, but in the adult realm we don’t get asked much.”
“Movement may be something we should promote,” she said. “In addition to answering questions when problems arise in the clinic, in the same way that we start conversations and encourage exercise, we also advise people on the importance of getting enough sleep and not missing medications. Is the same.”
ILAE Task Force Recommendations for Exercises: An Overview
*Resolved epilepsy is defined as being seizure-free for at least 10 years and free from antiepileptic drugs for at least 5 years.
**See table for list of activities by group and specific recommendations.
face the fear
Clinicians can make a difference by addressing people’s fears through conversation.
Sports and exercises sorted by groups – click to expand
“Physicians can influence a patient’s decision to become more physically active or start an exercise program,” said Arida. “They can help patients feel more confident about doing exercise and talk about which activities they are more comfortable doing.”
It is also important to address the fear of having a seizure while exercising.
Jane Allendorfer, associate professor of neurology at the Heathink School of Medicine at the University of Alabama at Birmingham, said, “This is not a realistic fear for a well-controlled person in the United States. A respected doctor for medical advice.” It really helps to hear it from ‘You are not having a seizure.There is nothing stopping you from doing physical activity.’
There are other barriers to physical activity for people with epilepsy.
- Access to safe and suitable exercise areas, such as gyms and boardwalks
- Access and Availability of Group Activities
- Cost of membership, lessons, transportation or equipment
- Depression and anxiety that make it difficult to initiate and maintain exercise
- Fear of being stigmatized for having a seizure in public
Exercise Recommendations for People with Epilepsy – Click to Expand
“Some people may want to play sports with other people, but they can’t find a way to do it,” says Carrizosa. “Or maybe they have the opportunity to do it, but they feel afraid or ashamed because of their epilepsy. prevents the involvement of
Stigma drives people away from exercise, but exercise can help reduce stigma and strengthen self-advocacy. He said that he would help me to spend my time in Japan. When he started outdoor cycling, his trainer and co-riders were aware of his condition and learned what to do if he had a seizure.Running in DelhiWhen he joined his club, He told the group that he had epilepsy and needed someone to accompany him.
Before the surgery, Jani had an aura that allowed her to shut down and let someone know. He remembers only one seizure during physical activity in 15 years. It happened while cycling outdoors. “When I had the aura, I stopped the bike and let my passengers know,” he said. “My passenger carries my medicine with him.”
What types of activities are safe?
“If you don’t have a seizure, nothing should stop you,” Allendorfer said. Some types of exercise require caution.”
The tables in this article have been reproduced with minor changes from the ILAE Consensus Report.
A recent study of physical activity in people with epilepsy found improvements in quality of life and cardiovascular health. Several studies using EEG monitoring found that interictal epileptiform discharges decreased during the post-exercise period.
Controlled physical activity trials in epileptic patients are complex. Allendorfer recently conducted a pilot study on the effects of exercise on cognition. Study participants completed weight training sessions and exercise on an indoor recumbent bicycle. During the six-week program, participants visited the study site three times a week for supervised training.
“Memory is the number one cognitive complaint of people with epilepsy, and there are no medications that can be taken to improve memory function,” she said. Memory improved and was slightly reduced in the non-exercise group.”
Allendorfer found alterations in hippocampal functional connectivity on MRI that correlated with alterations in verbal learning and memory. She is currently conducting a randomized controlled trial to further investigate the effects of exercise on cognition.
“The people who did the pilot study really appreciated and encouraged me to be able to exercise to the level they did,” she said. What I did during my research, all the gym machine settings and intervals, etc.”
Not everyone has access to training in a gym, but everyone can start somewhere, Jani said. You can walk, you can run, you can do yoga, and exercise gives you options for socializing, going out, meeting people and exercising together.”
Carrizosa says it’s important to remember the impact of a healthy lifestyle. “There is a lot of talk about new technologies, new drugs, surgeries, etc., but not enough about what we can do in our daily lives, like exercise,” he said. “This is something you can do anywhere in the world and it has a big impact. So I think it’s important to raise awareness.”
Capovilla G. et al. (2016). Epilepsy, Seizures, Exercise, and Sports: A Report from his ILAE Task Force on Sports and Epilepsy. epilepsy 2016; 57: 6-12.
Arita RM et al. (2022). Neurologists’ Knowledge and Attitudes about Exercise in People with Epilepsy in Latin America. epileptic behavior 2022 Jun;131(Pt A):108705.
Exercise and Sports Safety (Patient Information): Epilepsy Foundation of America
Fitness and Exercise with Epilepsy: Epilepsy Foundation of America
UAB Study Whether Exercise Boosts Memory in People with Epilepsy (Press Release, Allendorfer Study) – December 2021