Aerobic walking in slowly progressive neuromuscular disease: Effect of a 12-week program

Wright, Nancy C.; Kilmer, David D.; McCrory, Megan A.; Aitkens, Susan G.; Holcomb, Bryan; Bernauer, E. M.

doi:10.1016/s0003-9993(96)90222-1

Cited by 85 publications

(47 citation statements)

References 14 publications

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“…Two patients and two healthy control subjects withdrew from the study after beginning to exercise for reasons unconnected to exercise. Overall, adherence to the programme judged from participant completed diaries and telephone contact was good and similar to previous community based studies in neuromuscular disease [1,16,40]. Informal exit interviews revealed that participants found the programme uncomplicated and enjoyed exercising.…”

Section: Discussionsupporting

confidence: 78%

A prospective study of physiotherapist prescribed community based exercise in inflammatory peripheral neuropathy

2007

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There is insufficient evidence to support the use of exercise in the management of chronic disablement in people with inflammatory peripheral neuropathy. Therefore, our study aimed to determine the feasibility and effectiveness of a physiotherapist prescribed community based exercise programme for reducing chronic disablement in patients with stable motor neuropathy. We assessed the effects of a 12 week unsupervised, community based strengthening, aerobic and functional exercise programme on activity limitation and other measures of functioning in 16 people with stable motor neuropathy and 10 healthy control subjects. Fourteen of 16 patients and 8 out of 10 healthy control subjects completed the study and exercised safely in the community with no adverse events. Significant improvements were seen in all measures of activity limitation and in wider measures of health including anxiety, depression and fatigue in the patient group. Improvements were sustained at six months after completion of the exercise programme, except for depression. Ten patients continued to exercise regularly at six months. These findings demonstrate that individually prescribed community based exercise is feasible and acceptable for people with stable motor neuropathy and participation in exercise may be successful in reducing chronic disablement. Future randomised controlled trials are needed to examine the efficacy of this complex community based intervention.

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Section: Discussionsupporting

confidence: 78%

A prospective study of physiotherapist prescribed community based exercise in inflammatory peripheral neuropathy

2007

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“…For some NMDs, there exists a cycle in which gradual loss of strength leads to a sedentary lifestyle, which leads to deconditioning and further intolerance or disincentive for activity. 296 At least 2 small studies have suggested that patients with progressive NMDs are at increased risk of adiposity because of reduced physical activity and multiple cardiovascular and metabolic risk factors. 297,298 Although physical activity is well recognized to maintain cardiovascular and metabolic health in the general population, 299 as well as in certain populations with heart disease, including HF patients, 300 the impact of exercise in patients with NMDs is unknown.…”

Section: Other Therapies and Considerations For Nmd-associated Cardiamentioning

confidence: 99%

“…Current consensus is that submaximal effort strengthening regimens, designed to avoid disuse atrophy while preventing exercise-induced muscle injury and disease progression, are probably safe and appropriate. 301,302 Wright et al 296 examined the effects of a 12-week walking program in adults with slowly progressive NMD and found that walking 15 to 30 minutes 3 to 4 days a week at 50% to 60% of heart rate reserve produced very modest but statistically significant decreases in submaximal heart rate and systolic blood pressure. Whether such exercise is capable of producing meaningful benefits to significantly impact the trajectory of cardiac involvement in patients with NMDs is not known.…”

Section: Other Therapies and Considerations For Nmd-associated Cardiamentioning

confidence: 99%

Management of Cardiac Involvement Associated With Neuromuscular Diseases: A Scientific Statement From the American Heart Association

Feingold¹,

Mahle²,

Auerbach³

et al. 2017

Circulation

223

195

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For many neuromuscular diseases (NMDs), cardiac disease represents a major cause of morbidity and mortality. The management of cardiac disease in NMDs is made challenging by the broad clinical heterogeneity that exists among many NMDs and by limited knowledge about disease-specific cardiovascular pathogenesis and course-modifying interventions. The overlay of compromise in peripheral muscle function and other organ systems, such as the lungs, also makes the simple application of endorsed adult or pediatric heart failure guidelines to the NMD population problematic. In this statement, we provide background on several NMDs in which there is cardiac involvement, highlighting unique features of NMD-associated myocardial disease that require clinicians to tailor their approach to prevention and treatment of heart failure. Undoubtedly, further investigations are required to best inform future guidelines on NMD-specific cardiovascular health risks, treatments, and outcomes. N euromuscular diseases (NMDs) encompass a broad spectrum of diagnoses with overlapping but distinct phenotypes. Common to many NMDs is cardiac involvement. Although the past 3 decades have seen marked advances in our understanding of many NMDs, significant gaps in knowledge remain on how best to approach cardiac care in these patients. For example, survival in Duchenne muscular dystrophy (DMD) has been extended through the use of glucocorticoid use and respiratory support, yet cardiac complications remain a significant cause of morbidity and mortality.1-3 To achieve further gains in care, we will need to improve our understanding of the pathophysiologies driving cardiac involvement in NMDs and advance treatments aimed at preventing the progression of heart failure (HF) and sudden death in NMDs. The recently published findings of an expert working group on cardiac involvement in DMD, which outlined key gaps in knowledge and made specific recommendations aimed at improving diagnosis and management, are a step toward this goal. 4 In this statement, we include a comprehensive overview of the major categories of NMDs with cardiac involvement. For each, a brief background of the gene defect(s), common clinical manifestations (particularly cardiac findings), and current therapies is summarized. Gaps in knowledge are highlighted, and where possible, clinical treatment suggestions are made by the expert writing group appointed by the American Heart Association to review the available literature. Selection of the writing group was performed in accordance with the American Heart Association's conflict-of-interest management policy. Participants volunteered to write sections relevant to their expertise and experience. CLINICAL STATEMENTS AND GUIDELINESconducted a general search of the literature, restricted to human subjects research published between 1980 and 2016. Drafts of each section were written and sent to the chair of the writing group for incorporation into a single document, which was then edited. The edited document was discussed electron...

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“…Exercise training improves motor function after clinical and experimental peripheral nervous lesion, and it can be considered as an effective treatment of sensorial function [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Effect of Treadmill Exercise on Serotonin Immunoreactivity in Medullary Raphe Nuclei and Spinal Cord Following Sciatic Nerve Transection in Rats

et al. 2009

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The serotoninergic system modulates nociceptive and locomotor spinal cord circuits. Exercise improves motor function and changes dopaminergic, noradrenergic, and serotonergic central systems. However, the direct relationship between serotonin, peripheral nerve lesion and aerobic treadmill exercise has not been studied. Using immunohistochemistry and optic densitometry, this study showed that the sciatic nerve transection increased the serotoninergic immunoreactivity in neuronal cytoplasm of the magnus raphe nuclei of trained and sedentary rats. In the dorsal raphe nucleus the increase only occurred in sedentary-sham-operated rats. In the spinal cord of trained, transected rats, the ventral horn showed significant changes, while the change in dorsal horn was insignificant. Von Frey's test indicated analgesia in all exercise-trained rats. The sciatic nerve functional index indicated recovery in the trained group. Thus, both the aerobic treadmill exercise training and the nervous lesion appear to contribute to changes in serotonin immunoreactivity.

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Aerobic walking in slowly progressive neuromuscular disease: Effect of a 12-week program

Cited by 85 publications

References 14 publications

A prospective study of physiotherapist prescribed community based exercise in inflammatory peripheral neuropathy

A prospective study of physiotherapist prescribed community based exercise in inflammatory peripheral neuropathy

Management of Cardiac Involvement Associated With Neuromuscular Diseases: A Scientific Statement From the American Heart Association

Effect of Treadmill Exercise on Serotonin Immunoreactivity in Medullary Raphe Nuclei and Spinal Cord Following Sciatic Nerve Transection in Rats

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