Scientific studies support that moderate exercise may help maintain muscle strength and enhance quality of life for those with ALS. Read our tips on exercising safely with the condition.

Can I exercise with ALS? 

What is ALS?
Amyotrophic lateral sclerosis (ALS), also known as Lou Gherig’s Disease, is a
neurodegenerative disorder characterized by progressive muscle atrophy. For this
reason, some specialists are reluctant to recommend exercise as a treatment
option, hoping to avoid muscle damage through overwork. However, recent
scientific studies support that moderate exercise may help maintain muscle
strength, temporarily improve function, and enhance quality of life for those
with ALS without significant adverse effects.

How to Exercise Safely With ALS:
Below are general tips to support a safe and effective exercise routine for
people with ALS who have been cleared by their doctor to perform physical
activity:

Establish a Routine
Adults with ALS should aim for 150 minutes (2.5 hours) of exercise per week,
consistent with the US Department of Health and Human Services physical activity
recommendations. Whether achieved over a few days or many, it's important to
break exercise into manageable amounts and to perform it consistently to
maintain strength as long as possible. Using a calendar, planning exercise
around therapy sessions, or enlisting the help of a friend or family member to
reinforce physical activity are all ways to create a lasting routine.

Monitor Heart Rate
People with ALS are advised to stick to moderate-intensity exercise, as
high-intensity exercise can cause lasting muscle damage and fatigue. By
contrast, too little exercise can promote muscle atrophy and contracture
formation faster than what would occur with natural disease progression.

Exercise intensity is based off of a person’s heart rate, with
moderate-intensity physical activity defined as 50 - 70% of maximum heart rate
(MHR). MHR is calculated by subtracting your age from 220 beats per minute. The
following formula can be used to calculate a minimum to maximum range of beats
per minute that would be considered moderate-intensity exercise:

MHR x 0.5 = THR minimum
MHR x 0.7 = THR maximum

Do the math yourself or use a heart rate calculator
[https://www.active.com/fitness/calculators/heartrate] to define an ideal heart
rate range. Consider investing in a wearable heart rate monitor
[https://www.techradar.com/news/affordable-heart-rate-monitors] to easily check
in on your heartbeat during a workout. If it's difficult to figure out what type
of physical activity you can do within your moderate range, consult your medical
or therapy team.



Monitor Fatigue
If your exercise routine leaves you tired the next day, even after staying
within your target heart rate range, it is a sign that you have overworked your
muscles. It's important to pace yourself during exercise and take rest breaks as
needed to avoid lingering fatigue that prevents you from participating in
necessary tasks later.

One way to measure fatigue is to perform a “talk test” during exercise. Pick a
familiar saying and recite it while performing physical activity. During
moderate exercise, you should be able to say a few words up to a short sentence.
If you can finish multiple, full sentences, you can pick up the pace of your
exercise. If it's hard to get any words out, slow down the pace or take a break. 

Alternate Stretching and Strengthening
Another way to avoid lasting fatigue is to vary the days you perform certain
types of exercise. You may choose to perform strengthening, stretching, aerobic,
and coordination exercises on different days of the week to engage different
muscle groups while letting others recover.

Avoid Pain
“No pain, no gain” should never be the motto driving an individual with ALS’
exercise routine. When engaging in exercise, it is important to avoid activities
that cause pain during or after performance. Modify activities so that they can
be performed in pain-free ranges. Avoid applying additional weight to perform
strengthening exercise if doing so causes lasting pain or fatigue. Isometric
exercise
[https://www.cheatsheet.com/health-fitness/6-exercises-you-can-do-while-sitting-at-your-desk.html/] 
can help maintain muscle strength using only the resistance from your own body.

Although more research is needed to better understand the effects of physical
activity on disease progression, therapeutic exercise may be a valuable option
for some individuals to increase feelings of comfort and capability surrounding
their journey with ALS.



For More Information on ALS & Exercise:
ALS News Today - ALS & Exercise [https://alsnewstoday.com/als-and-exercise/]
ALS News Today - 7 Tips for Starting an Exercise Program with ALS
[https://alsnewstoday.com/2017/04/27/seven-tips-for-starting-exercise-with-als/]
ALS Worldwide - Exercise: Helpful or Harmful in ALS
[https://alsworldwide.org/care-and-support/article/exercise-helpful-or-harmful-in-als]



Bello-Haas, V. D., & Florence, J. M. (2013). Therapeutic exercise for people
with amyotrophic lateral sclerosis or motor neuron disease. Cochrane Database of
Systematic Reviews. doi: 10.1002/14651858.cd005229.pub3

*Exercise intensity: How to measure it. *(2019, August 6). Mayo Clinic. 
https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/exercise-intensity/art-20046887

HHS Office & Council on Sports. (2019, February 1). Physical Activity Guidelines
for Americans. US Department of Health & Human Services. 
https://www.hhs.gov/fitness/be-active/physical-activity-guidelines-for-americans/index.html

Miller, R., & McDade, S. (2015). Exercise: Helpful or Harmful in ALS? ALS
Worldwide. 
https://alsworldwide.org/care-and-support/article/exercise-helpful-or-harmful-in-als

Tsitkanou, S., Gatta, P. D., Foletta, V., & Russell, A. (2019). The Role of
Exercise as a Non-pharmacological Therapeutic Approach for Amyotrophic Lateral
Sclerosis: Beneficial or Detrimental? Frontiers in Neurology, 10. doi:
10.3389/fneur.2019.00783

Waehner, P. (2019, January 14). How to Use the Talk Test to Monitor Your
Exercise Intensity. Verywell Fit. 
https://www.verywellfit.com/talk-test-fitness-term-1231121


All content provided on this blog is for informational purposes only and is not
intended to be a substitute for professional medical advice, diagnosis, or
treatment. Always seek the advice of your physician or other qualified health
provider with any questions you may have regarding a medical condition.