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Previously, patients with neuromuscular diseases were advised not to exercise because of the fear that too much exercise might produce “overuse weakness”however no controlled studies have demonstrated overuse weakness actually exists. Most studies of exercise training in patients with neuromuscular disease, suggest that strength and aerobic capacity gains can occur in patients with slowly progressive disorders. Four forms of exercise training are relevant to patients with neuromuscular disorders: flexibility, strengthening, aerobic, and balance exercises.
But exercise is an important component in the overall treatment plan of neuromuscular disorders. As a client becomes physically fit, his mind opens to additional challenges and his spirit strengthens. Lifelong physical activity will improve function, independence and self-efficacy and will assist in reducing the progression of secondary complications and degenerative changes that typically accompany neuromuscular disorders.
Individuals with neuromuscular disorders (spinal-cord injury, stroke, traumatic brain injury, multiple sclerosis, muscular dystrophy, polio, post-polio and Parkinson’s disease) are often released from medical care after receiving only a few months of rehabilitation. Many sufferers have very little hope of regaining more functional mobility or improving their level of independence from that point on. There has been considerable success in helping individuals with neuromuscular disorders advance to higher levels of function through consistent, dedicated, long-term assisted (one-on-one) exercise programs that provide physical and emotional support with appropriate exercises.
Programming Must Be Personalised – custom designed according to the findings of the evaluation process for each client. A well-designed exercise program should be challenging and achievable, enjoyable and rewarding, intense and interesting. Using personalised training in two to three 60 plus minute sessions per week for several months can result in considerable improvement in speed, coordination, agility, quickness, balance, reaction time, musculoskeletal strength, musculoskeletal and cardiovascular endurance, flexibility, power, body composition and motivation to exercise.
Clients should be able to exercise without becoming completely fatigued. Exceeding the degrees of motion will cause laxity in the ligaments, which will compromise the structural integrity of the joint and could even lead to an injury such as a subluxation or dislocation of the joint.
Remember to stretch – Moving into a stretch too fast can elicit the myotactic stretch reflex. This reflex protects the joint from injury by preventing the muscle from stretching too far, too fast. The stretch reflex is mediated through the muscle spindle. When stretched too fast, the muscle spindle sends a message to the muscle, instructing it to contract. When this occurs, the muscle becomes shorter, stiffer and less pliable. Start off slowly and gently without causing any discomfort – if there is pain, that is too far. Never stretch through a muscle spasm.
Individuals with neuromuscular disorders need aerobic conditioning in a (preferably) daily exercise program to decrease the risk of coronary artery disease; to increase energy and decrease fatigue; to increase cardiovascular and musculoskeletal endurance; and to break up the vicious circle of disability.
It’s all about balance – Individuals with neuromuscular disorders typically have impaired balance owing to deficiencies in movement capability and a partial or complete absence of sensation and proprioception resulting from damage to the central nervous system. The focus of balance training is to realign the center of gravity. Like any fitness component, balance must be challenged with a progressive program in order to improve. Subsequently, balance progresses in a cephalocaudal direction (head to toe); from static to dynamic; and from a wide to a narrow base of support. The visual, somatosensory and vestibular systems are challenged by performing the balance activities with eyes closed, on an unstable surface and with an upward posterior head tilt, respectively.
Individuals with neuromuscular disorders are prone to postural deviations. Preventive corrective exercises should be routinely implemented to prevent the postural deviations from occurring in the first place.
Fundamentally speaking, the process is the progress! To reach strength training goals, individuals must follow a consistent, well-designed program that provides balanced development to all parts of the body. Then possibilities can happen.