Abstracts

Rationale:
People with epilepsy (PWE) are more sedentary than the general population, have poorer physical fitness, and higher BMI, all of which have significant impact on the overall health and mortality of these patients. The general health benefits of exercise are well established, but the effects of exercise within the specific context of epilepsy remains undetermined. Animal studies suggest that exercise can reduce seizure frequency and therefore may be a promising therapeutic to improve epilepsy and epilepsy-associated comorbidities, along with overall general health in PWE. However, factors such as lack of transportation, dependence on caregivers, and seizures themselves may limit the ability of PWE to participate in traditional exercise interventions. Thus, we conducted a cross-sectional survey of PWE at Wake Forest Baptist Medical Center (WFBMC) to examine the perception of exercise, the barriers to exercise, and the willingness and ability to participate in an exercise intervention in this population, in order to inform the design of future exercise intervention trials.
Method:
Adult patients presenting to the Adult Epilepsy Clinic at WFBMC in Winston-Salem, North Carolina were surveyed via a 45 item survey aimed to address current activity habits, beliefs regarding exercise, barriers to routine exercise, and interest in participating in an exercise intervention. Data was also collected via chart review regarding additional demographics, medications, type of epilepsy, and medical history.
Results:
From 112 respondents, 95 reported a clinical diagnosis of epilepsy (56 female, median age 42). Sixty-six (68.0%) believe that exercise could improve their seizure frequency, and 67 (69.8%) were willing to participate in an exercise intervention. However, almost half (40%) said their neurologist had never talked to them about exercise. Those with a history of depression were less likely (58.3%) to report that they were willing to participate in an exercise intervention compared to those without (71.0%). The most commonly reported barriers exercise were lack of time and fear of having a seizure. In fact, the majority of respondents (53.7%) who were interested in an exercise intervention reported they were unable to come to in-person exercise sessions on a regular basis, most commonly due to the distance required to travel to the Medical Center for the intervention, time constraints, and lack of transportation.
Conclusion:
Despite the fact that PWE are more sedentary than the general population and less likely to comply with the recommended physical activity guidelines, this study shows that the majority of PWE believe exercise could improve their seizures and are willing to exercise. Of concern, almost half of patients reported that their neurologist has not talked to them about exercise. Common reasons for not exercising included fear of having a seizure and not being sure what exercises to do, which are issues that could be dispelled through discussion with their treating physician. Most PWE are willing to participate in an exercise intervention, but a lack of transportation and distance needed to travel to an in-person session is a unique barrier for this population. Thus, a remote, telehealth-based delivery of an exercise intervention may be more accessible in this population and the feasibility and sustainability of such should be explored in future research. Those with a history of depression were less willing to participate in an in-person exercise intervention, suggesting that epilepsy-associated comorbidities in PWE may impact their involvement in exercise and should be examined in future studies. 
Funding:
:This study was supported by the Wake Forest NeuroNext Fellowship Award