Exercise for patients with neuromuscular diseases

Abstract

Background: Neuromuscular diseases (NMD) vary widely with regard to their onset, progression, and symptoms, which include muscle weakness, sensory loss, pain, fatigue, and joint contractures. Owing to this diversity, creation of a unified exercise therapy approach is challenging. Current Concepts: Exercise recommendations for patients with NMD prioritize maintenance of patients' current functional status, prevention of further decline, and provision of compensatory training. Conventionally, highintensity exercises are not recommended owing to the risks of overwork weakness and muscle injury. Recent studies indicate that tailored aerobic exercises can improve endurance, cardiovascular function, and overall health without worsening muscle injury. Flexibility exercises are essential to prevent joint contractures. Resistance training should focus on avoidance of high-intensity and eccentric exercises and on maintenance of rather than an increase in muscle strength. Discussion and Conclusion: Evidence regarding the benefits of exercise in patients with NMD is inconsistent. Aerobic exercise is usually safe and may help maintain function and increase maximal oxygen uptake; however, low-intensity exercise is preferred to avoid fatigue and muscle injury. Resistance training may help preserve muscle strength in some patients; however, high-intensity workouts are not should be avoided to mitigate the risk of muscle overload and injury. Tailored exercise programs designed according to disease characteristics are essential.. Further well-designed, large-scale studies are necessary to establish effective and safe exercise guidelines for patients with NMD.