Making Muscle, Burning Calories

by Christina Medvescek and Margaret Wahl on July 1, 2004 - 3:00pm

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.

Strengthening exercises

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:

  • Warm up with gentle stretching before exercising.
  • Start with low weights or a resistance to push/pull against, and 10 to 12 repetitions. In some cases, simply moving a limb through a range of motion with no added weight is a good starting point.
  • Slowly increase to three sets of repetitions, spaced about two minutes apart. Wait at least 48 hours before exercising the same muscle again to allow for recovery.
  • Gradually increase weight and/ or resistance force under the supervision of a physical therapist or kinesiologist (movement specialist).
  • In diseases in which the muscle cell membrane is particularly fragile (such as Duchenne, Becker and some limb-girdle MDs), be sure the weight isn’t excessive. In FSHMD and other diseases in which, some observers say, strength in the dominant arm deteriorates faster, be even more cautious about exercising.

Calorie-burning exercises

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:

  • Exercising at least 20 minutes, five to seven times a week.
  • Swimming, cycling on a stationary bicycle, using a treadmill or hand cycle.

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.”

Metabolic disorders

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.

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