BENEFITS OF EXERCISE IN PATIENTS WITH EPILEPSY: A LITERATURE REVIEW
Abstract number :
3.336
Submission category :
8. Non-AED/Non-Surgical Treatments (Hormonal, ketogenic, alternative, etc.)
Year :
2014
Submission ID :
1868784
Source :
www.aesnet.org
Presentation date :
12/6/2014 12:00:00 AM
Published date :
Sep 29, 2014, 05:33 AM
Authors :
Frank Gilliam, R. Edward Hogan and Greg Gilmet
Rationale: Patients with epilepsy (PWEs) tend to be less active than the general population and may have been discouraged from exercising due to fear of exacerbating their seizures. More recently, some publications indicate that exercise may benefit PWEs. Despite the potential benefit of exercise, there are currently no formal guidelines on how exercise can be integrated into a comprehensive care plan for PWEs. The purpose of this presentation is to identify evidence in the literature regarding how exercise can influence seizure control, epilepsy-related quality of life measures, and other comorbid conditions in PWEs. Methods: PubMed literature searches were conducted in May 2014 with no limit on publication date, filtered by ‘English language' and ‘human' using the following terms: (physical exercise OR activity) AND (epilepsy OR AEDs OR seizure OR antiepileptic); exercise-induced seizure. Returned articles were reviewed for currently published data regarding impact of exercise on seizure outcomes, quality of life, and comorbid conditions. Results: After removal of duplications, 73 unique citations meeting our criteria were identified. Almost all references, including 9 articles assessing baseline exercise and activity levels in PWEs, indicated that PWEs exercise less than the general population. Only 3 of the 73 references described exercise-induced seizures, in a total of 9 patients. Twenty-five articles, based on self-reported assessments (ie, surveys, questionnaires, and verbal reports), found that exercise was a positive adjunctive activity to antiepileptic drug (AED) treatment that reduced seizure frequency, seizure worry, and improved quality of life measures. None of these references provided evidence from randomized clinical trials of PWEs on a stable AED regimen. Data from 19 references indicate that exercise and dietary regimens in PWEs reduce the risk for comorbidities, including cardiovascular disease, depression, anxiety, stress, and dementia, with a subsequent reduction in the healthcare burden associated with these conditions. In addition, 18 articles suggested that most types of exercise were deemed safe for PWEs, except those where a loss of consciousness could lead to injury or death. Conclusions: Although multiple citations report that exercise could be beneficial to PWEs, we found no randomized trials to provide class I evidence for the efficacy of exercise in PWEs. This may explain the lack of published guidelines on the best ways to implement exercise in a patient care plan. The identified articles support the reinforcement of increased physical activity and improved fitness within an individualized comprehensive health program as well as the potential value of utilization of new technologies (eg, motion trackers) to monitor activity levels and quantify the link between exercise and seizure outcomes in PWEs. Future studies evaluating the impact of exercise on epilepsy, particularly randomized controlled trials, could provide additional evidence for improved clinical care. Supported by Upsher-Smith Laboratories, Inc.
Non-AED/Non-Surgical Treatments