In years past, it was thought that ALS patients should not exercise in order to preserve their remaining muscle strength. But this point of view has been largely proven to be outdated and incorrect. In fact, because muscle has memory, which enables motor function to become improved and/or automatic the more it is practiced, it appears highly beneficial for patients to exercise in a moderate, controlled manner.
Hiroshi Mitsumoto, MD, D.Sc., Medical Director, Eleanor and Lou Gehrig MDA/ALS Research Center and Director of Neurology, opened the discussion with his 2008 study, The Role of Exercise in Amyotrophic Lateral Sclerosis. More recently, a September 2014 study, Evidence that Physical Activity is not a Risk Factor for ALS, by Dr. Benoit Marin, a neuroepidemiologist at the French Institute of Health and Medical Research in Paris provides welcome confirmation. The motto is “Do all that you can do without exercising to a point of pain or stress.”
Furthermore, lack of exercise, movement and proper hydration can lead to swollen arms, legs, feet and hands due to retention of excess fluid. With that in mind, here are some suggestions for ways to exercise appropriately.
Range of Motion Exercise
Range of motion exercises, described in detail on this website, are designed to help preserve flexibility and mobility. Consider seeking the assistance of a physical therapist or occupational therapist. If that isn’t possible, a caregiver, friend or family member can follow the simple instructions provided on this website.
Electronic pedalers help patients exercise their legs and arms at home. Many patients have had success with FootSmart model which improves blood flow, muscle strength, coordination and joint range of motion when used for a suggested 15 minutes per day. Less expensive models available through Paradigm. Both can be purchased at Amazon.
Cycling is one of the safest avenues to good muscle tone and cardiovascular health for those whose legs are not stable or those who have foot drop tendency. A recumbent bike offers support and exercise opportunity. It’s important to start slow, listen to your body, stay at level one for at least a month, then increase by 15 minutes each week. Be sure to monitor heart rate and respiration rate for any signs of distress. And it’s best to have someone available for assistance at all times. Recommendations include the clipless pedals and cycling shoes that have foot and ankle support. Exercise for the ALS Patient by John Roberts, USA, offers a personal experience of cycling.
Additional Exercise Options
Swimming and/or water aerobics with supervision is a great way to exercise. Warm water pools are sometimes available at health clubs and physical therapy facilities. Also recommended are yoga and tai chi.
Whatever method of exercise is chosen, be certain to give yourself plenty of resting time between exercises, cautiously increase length of time spent, always have someone nearby for assistance if needed. If edema persists, try the JuxtaFit Lower Leggings, a non-invasive support option in addition to exercise. If drop foot is an issue, the Hans Koch Angle Flexion Device, by Hans Koch, the Netherlands, offers a simple solution to the issue of dropped foot. It is easily made at home from a keyholder, steel spring, and a strip of double-sided Velcro.
If you or your physician have any questions or would like to discuss our viewpoints regarding these suggestions, please email us at [email protected]