How exercise physiology can help people living with neurological conditions

Exercise is considered a highly effective intervention in the management of various neurological conditions including multiple sclerosis (MS), Parkinson’s disease (PD), Huntington’s disease, etc., this is due to the response the nervous system has toward exercise and its ability to adapt to new stimulus.  

At MSWA, our experienced EPs will work alongside you to address any concerns you may have and keep you feeling independent for longer. Whether you’re newly diagnosed or have been living with your condition for years, your neuro EP can design a suitable program and adjust accordingly based on your abilities, goals and changing needs to enable you to live life, not limits.  

Neurological conditions result in physiological irregularities that alter the way the nervous system, immune system and neuromuscular system operate, often resulting in the following common symptoms:  

• Fatigue: Neural fatigue is very different from general tiredness. Neurological conditions often cause fatigue symptoms due to the breakdown of communication pathways between the brain and the body, meaning more energy is used to send out more signals in hopes that one will get through to its target destination. 
• Spasticity: Spasticity is muscle stiffness that is caused by damage to the nerves. The increased stiffness resists opposing movement inputs becoming more energy demanding. Over time this can result in a reduced range of motion and joint flexibility, limiting overall functional capacity. 
• Movement breakdown: Movement breakdown/ataxia occurs when the nervous and muscular system are unable to synchronize and coordinate signals effectively resulting in clunky or frozen movements. This can create a feeling of unsteadiness on the feet or make typical day-to-day activities more challenging as the body feels unresponsive to what the individual intends. 
• Balance concerns/high falls risk: A byproduct of poor neuromuscular coordination, balance can become quite challenging in neurological conditions as the body is unable to synchronize with the brain. This can lead to instability while standing, walking, or completing activities of daily living (ADLs).  

The human body is the most adaptable device out there and responds very well to a challenging stimulus. The MSWA EP team will deliver exercises to create an adaptive stimulus through various techniques to achieve the following:  

• Muscle strength & activation: Progressive overload is a principle that looks to challenge the neuromuscular system by increasing weight, reps, or difficulty of movement in order to improve muscle strength and coordination. This, coupled with isometric holds where the muscle contraction is held for a period of time, can improve muscle activation and give you more control over your body. 
• Muscle endurance: Increased muscle endurance through added reps or reducing rest times can improve the muscle’s capacity to perform in a fatigued state. This can lead to improved quality of movement when fatigued and reduce movement breakdown due to fatigue. 
• Balance and functional stability: Dynamic and static exercises can improve balance by replicating typical balance requirements in ADLs to improve your confidence and movement coordination resulting in greater stability and nervous system efficiency. 
• Essential life-skills: Graded exercises can help re-train and/or refine essential life-skills such as walking, on and off floor transfers, balance recovery and general transfer mobility. Your MSWA EP can provide modified exercise variations that replicate these essential life skills to either rebuild capacity, improve movement efficiency or increase your confidence in your own abilities in a safe and controlled environment. Continued practice of these essential skills ensures that your body and nervous system are ready for whatever you may throw at it.  

The following are examples of exercises your MSWA Exercise Physiologist may recommend to assist in the management of common neurological symptoms. It is important to always check with your EP prior to commencement of these exercises to ensure they are appropriate for you.  

Stretching problem areas can reduce muscle tightness and the onset of spasms, particularly in the lower limbs that are commonly affected in neurological conditions.  

Example: Knee to chest 

1. Lie down onto your back.
2. Using your hands, pull one knee as close to the chest as you can.
3. Hold for at least 60 seconds per side. 

This simple stretch assists in lengthening lower limb muscles, reducing stiffness and improving mobility.  

Practicing getting on and off the floor is a highly valuable daily skill that gives you the ability to engage in activities such as spending time with children/grandchildren, while having peace of mind you can get yourself back up in case of a fall.  

Example: Assisted reverse lunge 

1. Hold onto a firm object such as a couch, bed, chair, table with one hand.
2. Slowly bring one knee down to the ground until you achieve a half kneeling position. 
3. Using leverage and assistance from the hands, stand back up by pushing through your front heel. 

The frequency of this exercise is dependent on the individual, ensure to consult your EP for appropriate dosage.  

Strength exercises help maintain muscle power and activation, reducing the overall energy lost during everyday tasks.  

Example: Straight leg raise with hold 

1. Lie down onto your back
2. Straighten one leg out and lift as high as you can or approximately 45 degrees
3. Hold the leg in this position for 10 seconds
4. Return to starting position and repeat 6 times 

This exercise will improve strength and control of the hip flexor muscle which plays a vital role in walking and foot clearance, reducing overall falls risk.

Exercise Physiology can be accessed through MSWA service centers under various funding schemes: 

• NDIS EP: The NDIS recognizes and provides funding to access EP services for appropriate neurological conditions. EP services may be included as part of your NDIS plan under “Capacity Building” or may be requested if your plan permits.
• Support at Home (SAP): Formerly known as a Home Care Package (HCP), a SAP plan functions similarly to NDIS funding, but is designed for individuals over the age of 65 who are not eligible for the NDIS.
• Department of Health (DoH): DoH funding enables new clients who are not yet on a funding package to access limited services free of charge, supporting them to undergo assessments and develop a plan.
• Fee for Service (FFS): FFS is an out-of-pocket expense in which you pay to access EP services at a competitive rate provided by MSWA. 

If you have a neurological condition, reach out to the MSWA Exercise Physiology team and discover how you can learn ways to stay independent for longer and live your version of best.