If they’re undertaken with care and supervision, exercises that strengthen and build muscle, and exercises that burn calories, can help you lose weight — or at least enjoy a little more food without gaining.
Limited research suggests that most people with slowly progressive muscle diseases can do some exercise and gain muscle strength. Careful exercise even may protect muscles against damage from daily activities.
Exercise programs always should be developed under the supervision of a doctor, physical therapist or other professional who understands NMDs.
Slow, slow progress, carefully monitored at every step, is the watchword here. Measurements should be taken of strength gains and losses, and a physician should monitor blood levels of creatine kinase (CK), an enzyme that leaks from damaged muscle cells.
CK levels should be checked before you start an exercise program, then about four days after the first few sessions. Although CK will go up when you begin exercising, it should gradually return to baseline or below over a period of weeks to months.
A dramatic rise in CK (higher than 50 percent above baseline) without a subsequent return to baseline is a signal to decrease exercise intensity. Another sign of excessive muscle damage is urine that darkens to a tea or cola color.
In a careful exercise program, the body will adapt and muscles will actually gain some protection, says Mark Tarnopolsky, associate professor of pediatrics and medicine at McMaster University in Hamilton, Ontario.
Tarnopolsky recommends the following regime to strengthen muscle:
Calories are burned through endurance exercise, in which the heart rate increases to 120 to 150 beats per minute for at least 20 minutes.
For those who can do it, Tarnopolsky recommends:
Endurance exercise can help shed pounds but it’s not essential to weight loss, says Ted Abresch of UC Davis.
"Eighty percent of losing weight is diet, and 20 percent is exercise,” he notes. “You can do it without exercise, but it’s harder, and endurance exercise appears to confer other health benefits.”
People with metabolic disorders need to understand which types of activities will trigger a metabolic crisis. Those with glycogen storage diseases like McArdle’s disease or Tarui’s disease will notice exercise intolerance with high-intensity strengthening activities, while those with mitochondrial disorders or disorders of lipid (fat) metabolism will have difficulty with endurance activities.
However, almost anyone with a metabolic disease can adapt to regular exercise, though the progression must be very slow and dietary issues are critical. Given the complexities of these conditions, consult a doctor or neurometabolic specialist for advice.
Gentle stretching or passive exercise in which someone else moves your muscles, and gentle movements in a swimming pool don’t build muscle or burn calories. But these activities can help you maintain flexibility and comfort, and may whet your appetite for more strenuous exercise.