Clinical Research Physical Exercise in Outpatients with Epilepsy

Abstract

EpilepsySummary: Purpo.se: To compare the exercise habits in a sample of adult outpatients with epilepsy with those of a general population of the same age and sex and furthermore to m d y physical exercise as a seizure precipitant and the risk of sustaining seizure-related injuries while exercising.Metlzods; Two hundred four adult outpatients with active epilepsy responded to two questionnaires. The first one, addressing exercise habits, was a selected part of a broad selfassessing screening used every second year by a marketing and media research institute to reveal changes in the average Norwegian's lifestyle. The exercise habits of the epilepsy population were compared with those of the average population. The other questionnaire, addressing seizures and injuries related to physical exercise, consisted of eight sections and was developed at the National Center for Epilepsy in Norway.Results: The portion of those never exercising was significantly higher among the patient group compared with the average population. Otherwise, the exercise patterns were very similar in the two populations. However, the patients exercised more often in fitness centers and together with friends, whereas individual activities like skiing and swimming were more often preferred by the average Norwegian. Of the 204 patients, 53 and 63% had never experienced seizures during or immediately after exercise, respectively. About 10% of the patients claimed that they had seizures quite often in connection with exercise. However, only 2% had genuine exercise-induced seizures. here arbitrarily defined as having seizures in >SO% of the training sessions. Among those prone to have exercise-related seimres. there was a predominance of patients with symptomatic localization-related epilepsy (i.e., with an underlying structural brain lesion). Most exercise-related seizures occurred during strenuous activity. About 38% of the patients claimed to have personal experience regarding whether regular physical exercise influenced their seizure disorder; of these, S3% claimed there was no influence, 36% claimed there was ;I positive influence. and 10% reported a negative influence. Thirty-six percent of the patients had experienced injuries in connection with physical exercise, but in only 10% were these injuries associated with seizures. The injuries were mostly mild.Conclusions: The surveyed >ample of epilepsy outpatients was more active than expected, and their exercise pattern closely resembled that of the average Norwegian population. In the majority of the patients, physical exercise had no adverse effects, and a considerable proportion (36%) claimed that regular exercise contributed to better seizure control. However. in -10%) of the patients, exercise appeared to be a seizure precipitant, and this applied particularly to those with symptomatic partial epilepsy. The risk of sustaining serious seizure-related injuries exercising seemed modest.

The psychosocial impact of exercising with epilepsy: A narrative analysis

“…This finding of fear as an exercise deterrent is in accordance with current research [1,4,7,8,10,30,31], however, the qualitative approach taken allowed for the diverse ways in which fear manifested itself to be revealed. Such manifestation included the fear that seizures could prevent Maya from achieving her end goal and would cause teammates to keep away from Andrew at the gym, as well as create the feelings of a loss of independence for Rose and Gwen.…”

“…Medical advice in maintaining exercise habits differed amongst the participants and created a barrier to exercise. Although recommendations to continue exercise for emotional benefit are prevalent in current epilepsy and exercise literature [2,3,7,8,34,36,37], and were shown through recommendations to Rose and Gwen, it was interesting to witness the emotional effect of the differences in medical advice provided, as was shown through Andrew's narrative. This first-hand insight into advice provided by medical professionals as well as the support that is needed by people with epilepsy to maintain an exercise routine has yet to be presented within the literature.…”

“…The main reasons reported for inactivity are the fear of the seizure occurring [4,5], fear of seizure-related injuries [6], and being inadequately informed about the possibilities of playing sports [7]. As a potential result of this inactivity, social isolation, low self-esteem, weight gain, and depression are commonly found among people with epilepsy [7,8].…”

“…The abundance of research exploring the benefits of and barriers to exercise for people with epilepsy has been primarily quantitative and medico-scientific [4,8,9,10] , leaving an omission in our understanding of the first-hand exercise experiences of people with epilepsy. Therefore, through the use of narrative inquiry, this research aims to present the psychosocial impact of exercising with epilepsy over time.…”

Physical exercise in rats with epilepsy is protective against seizures: evidence of animal studies

“…Indeed, seizures exacerbated by physical exercise are uncommon in humans 7,9,18 . one study 19 found that only 2% of patients with epilepsy had exercise-induced seizures (defined as seizures in >50% of training sessions). we also might suggest that in refractory epilepsy, the possibility of exercise to provoke seizure could be increase.…”