How do you exercise with epilepsy? Insights into the barriers and adaptations to successfully exercise with epilepsy

Abstract

Exercise has been shown to be a physiological and psychological benefit for people with epilepsy (PWE). However, barriers prevent many PWE from exercising safely and confidently. This research explored current perceived barriers to exercise and adaptation techniques used by PWE in order to maintain physical activity levels. Three focus groups (2-3 participants per group) and three semi-structured interviews were conducted (11 participants total). Constructive grounded theory was used to frame the study and analyse the findings, presenting new insight into the motivation, perceived barriers, and adaptation techniques used to exercise. The main motivator to maintain physical activity levels was the benefit of exercise on physical and mental health. This was shown in an increase in mood, higher social interaction, and perceived improvement in overall physical health as a result of exercise. Current barriers to exercise included a fear of injury, lack of social support, and exercise-induced seizures (e.g., through overheating and/or high exercise intensity level). Adaptation techniques used were self-monitoring through the use of technology, reducing exercise frequency and intensity level, and exercising at certain times of the day. The importance of social support was shown to provide increased confidence and positive encouragement to exercise, contrasting with family and friends worrying for his/her safety and medical professionals requesting termination of some physical activities. These findings provide new insight into current adaptation techniques that are used and developed by PWE to overcome common barriers to exercise. These new additions to the literature can lead to further development of such techniques as well as examine current medical professionals' knowledge of the benefits of exercise for PWE.

Physical activity and sedentary levels among people living with epilepsy: A systematic review and meta-analysis

“…For example, it is unknown whether there are differences in physical activity and sedentary levels between different subtypes of epilepsy, between people with active and inactive epilepsy and between people with epilepsy with and without mental and/or physical co-morbidity. Previous individual studies have demonstrate that presence of co-morbid anxiety and depression [19][20][21], fear of exercise-induced seizures [22], sideeffects of antiepileptic drugs [19], and perceived stigma [23,24] contribute to lower physical activity levels in people with epilepsy.…”

“…Despite the benefits of an active lifestyle, people with epilepsy experience a range of barriers to engaging in more physical activity and becoming less sedentary, such as the presence of co-morbid anxiety and depression [19][20][21], fear of exercise-induced seizures [22], side-effects of antiepileptic drugs such as drowsiness, fatigue, headache or migraine, gastrointestinal disturbances, dizziness and faintness, rash or skin disorders [19] and perceived stigma [23,24]. Given that an active lifestyle is related to a better seizure control and quality of life in people with epilepsy, understanding physical activity and sedentary levels among people with epilepsy is critical to improving long-term health outcomes.…”

Practical aspects of childhood epilepsy

“…Social support can provide encouragement and may help overcome perceived barriers to exercise 12. Young people should be encouraged to take regular physical exercise, including contact sports if they wish, and be supervised for water sports, harnessed climbing, and horse riding 13.…”

Sport and Physical Activity in Epilepsy

“…In all, 17 studies investigated the effect of physical activity on comorbidities such as anxiety and depression, as well as quality of life. Ten of these studies ("2−" n = 8, "3" n = 2; survey-/interview-based studies, combined studies, studies on one-time physical effort) showed physical activity to have a positive effect (4, 9,12,14,[16][17][18][19][20][21]. The results of six interventional studies (n = 2 evidence-level "1-", n = 4 "2−") revealed a similar picture.…”

“…• Epidemiological study with 1 173 079 male conscripts aged 18 and "2+") referred to in this review are additionally shown in Table 1.…”