Thread: Exercise
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Old 05-31-2016, 01:36 AM #3 (permalink)
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Default Re: Exercise

Strenuous, or resistance exercise is designed to cause micro tears in the muscle. This stimulates the muscle to heal that area by invading it with more muscle cells, and by this means we increase our muscle mass.

One of the theories behind being very careful about exercise of this nature is that the nerve that makes that muscle work is dying or dead. This means the micro tears are not able to repair and heal. Causing these tears to the muscle that has no nerve impulse will then cause the muscle to waster faster because it is now injured.

So while it seems a fair thing to say - let's get you exercising and try to build up as much muscle as we can. In fact doing too much of, or the wrong kind of, exercise can give the opposite effect.

There isn't a blanket rule however, as it does depend on the fitness and strength of the muscles the person had pre-ALS. It also depends on which motor neurones are dying off and at what speed. Complicated formula!

For example a PALS who had never done any running or real leg work, then suddenly starts to work on a treadmill and exercise bike, they are likely to find it causes a lot more muscle breakdown than someone who reduces the amount of this they do so that they are getting some exercise. So someone who did an hour every day may find doing a half hour every second day keeps them feeling good, and it isn't straining their muscles much as they are used to this.

The rule of thumb that is most easily applied is about recovery. If you exercise hard and then find you are wiped out for a couple of days, you are doing way too much. In fact if you are wiped out for more than an hour or two, you have done too much.

ROM is great as it keeps everything moving, and helps by gently stretching and moving the joints. When a PALS can't move a limb anymore, another person can move it for them doing passive ROM. When there is a lot of spasticity and muscle wasting, then joints become frozen quickly and this painful, and makes the risk of injuring the person when doing personal care and transfers much higher as pulling on a limb with a frozen joint can cause a tendon rupture so easily.
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