Exercise In Epilepsy Research Articles

Research productivity in the field of physical exercise and epilepsy: A bibliometric analysis of the scholarly literature with qualitative synthesis

ObjectivesThis study aimed to quantitatively, qualitatively, and visually analyze, describe, evaluate, and identify trends of the published scholarly documents on physical activity/exercise in epilepsy. MethodsScopus database was systematically searched using the keywords relevant to “exercise” and “epilepsy”. The Bibliometrix R-Tool was used to quantify, analyze, visualize, and describe the data set of the scholarly documents identified through the systematic search. Data collected from the retrieved documents were synthesized qualitatively. ResultsSearch of the database resulted in 182 scholarly documents reporting on physical activity/exercise in epilepsy. The scholarly documents were obtained from 93 indexed sources, authored by 516 researchers, indexed by 1311 keywords, and cited 4648 references. Epilepsy and Behavior was the fastest growing source for documents on physical exercise in epilepsy and the Universidade Federal De So Paulo in Brazil was the most productive institution in the field. Thematic analysis showed that epilepsy and physical exercise were basic themes, quality of life and depression were motor themes, and yoga was a niche theme. Quality of life and sport were trendy topics after the year 2015. A total of 14 barriers and 2 promoters of physical activity/exercise were qualitatively synthesized. ConclusionFindings of this analysis might be helpful to librarians, institutions, and professionals interested in the field of physical activity/exercise in epilepsy. Researchers might be informed of collaboration opportunities, trendy topics, and emerging themes in the field.

Relationships between cognitive function, seizure control, and self-reported leisure-time exercise in epilepsy

Exercise may be a strategy for improvement of cognitive deficits commonly present in people with idiopathic generalized epilepsies (IGE). We investigated the relationship between cognition and level of physical exercise in leisure (PEL) in people with IGE who have been seizurefree for at least 6 months (IGE−) as compared to those who have not been seizurefree (IGE+) and healthy controls (HCs). We hypothesized that higher level of physical exercise is associated with better cognitive functioning in patients with IGE and HCs, and that seizure control affects both PEL levels and cognitive functioning in patients with IGE.We recruited 75 participants aged 18–65: 31 people with IGE (17 IGE−, 14 IGE+) and 44 HCs. Participants completed assessments of quality of life (SF-36), physical activity levels (Baecke questionnaire and International Physical Activity Questionnaire (IPAQ)) and cognition (Montreal Cognitive Assessment (MoCA), Hopkins Verbal Learning Test – Revised (HVLT), and flanker task). Group differences (HCs vs. IGE; HCs vs. IGE+ vs. IGE−) were assessed. Pearson correlations examined linear relationships between PEL and cognitive performance.Groups were similar in age and sex. Compared to HCs, patients with IGE had higher body mass index, fewer years of education, and consistently scored worse on all measures except flanker task accuracy on incongruent trials. When examining IGE− and IGE+ subgroups, compared to HCs, both had higher body mass index, and fewer years of education. Healthy controls scored significantly better than one or both of the IGE groups on SF-36 scores, PEL levels, IPAQ activity level, MoCA scores, HVLT learning and long-delay free-recall scores, and flanker task accuracy on congruent trials. Among patients with IGE, there were no significant differences between age of epilepsy onset, duration of epilepsy, number of anti-seizure drugs (ASDs) currently being used, or the group distribution of type of IGE. In the combined sample (IGE+, IGE− and HCs), PEL positively correlated with MoCA scores (Pearson’s r = 0.238; p = 0.0397) and with flanker task accuracy on congruent trials (Pearson’s r = 0.295; p = 0.0132).Overall, patients with IGE performed worse than HCs on cognitive and physical activity measures, but the cognitive impairments were more pronounced for IGE+, while physical exercise levels were less for patients with IGE regardless of seizure control. While positive relationships between leisure-time PEL and cognitive performance are promising, further investigations into how exercise levels interact with cognitive functioning in epilepsy are needed.

Sport and Physical Activity in Epilepsy.

For many years, people with epilepsy were advised not to engage in sports. In this systematic review, we investigated whether persons with epilepsy exercise less than the general population, and what effect physical activity has on epilepsy. A literature search was carried out in PubMed and the Web of Science, and 14 269 studies were entered into the selection process. The selected studies were assessed for their methodological quality and accordingly assigned an evidence level. 42 studies were included in the review; 10 were classified as evidence level 3, 27 as evidence level 2-, 2 as evidence level 2+, and 3 as evidence level 1-. Persons with epilepsy are less physically active and less physically fit than the general population. Reduced physical activity is associ- ated with a higher frequency of comorbidities and lower quality of life. Physical interventions can improve quality of life. In most cases, physical exercise did not increase seizure frequency. There is no reason to forbid persons with epilepsy to participate in sports; they should, rather, be encour- a particular type of sport should, however, be taken individually in each case.

Exercise as a therapeutic strategy in epilepsy: a literature review

Epilepsy is a common neurologic disease with emotional and physical consequences. Thirty percent of patients have drug-resistant epilepsy, therefore adjuvant non-pharmacological therapies, such as physical activity, have been proposed. This study reviews the literature about physical activity in people with epilepsy, to evaluate the benefits, potential side effects, impact on comorbidities, the risk classification of sports, and the barriers to their practice. Multiple animal and human models evaluate the benefits of exercise in epilepsy, explained by modulation on neurotransmitters, hormones, and neurotrophic factors. Furthermore, exercise demonstrates positive impact on comorbidities such as obesity, cardiovascular disease, depression, and osteoporosis. Despite being a practice that has been shown to be safe, people with epilepsy are less physically active due to barriers that limit their practice. Physical activity is beneficial and safe for people with epilepsy. Literature suggests better control of seizures, psychosocial benefits, and improvements on the comorbidities. There is a low risk of injury associated. Exercise should be promoted after a careful clinical evaluation, considering seizure control in the last year, potential triggering factors and the sport chosen.

The Feasibility and Impact of the EMOVE Intervention on Self-efficacy and Outcome Expectations for Exercise in Epilepsy.

The purpose of this pilot study was to evaluate the feasibility of the self-efficacy based Epilepsy-Motivate and Outcome Expectations for Vigorous Exercise (EMOVE) intervention and report on the preliminary efficacy of this intervention aimed at improving exercise behaviors in adults with epilepsy. Methods: A single-group, repeated-measures design was used in 30 outpatients. Data were collected at baseline and 12 weeks after the intervention. Participant outcomes included Self-Efficacy and Outcome Expectations for Exercise in Epilepsy, Beck Depression Inventory-II, Quality of Life in Epilepsy Inventory-31, seizure frequency, average daily steps, and body mass index. Daily number of steps was measured using a wrist-worn activity monitor. Feasibility data were assessed using evidence of treatment fidelity including intervention delivery, receipt, and enactment. Results: Participants were single (63%), white (53%), female (63%), had a mean (SD) age of 46.7 (13) years (range, 26-68 years), had low levels of self-efficacy (mean, 5.10; range, 0-10) and high outcome expectations (mean, 3.90; range, 0-5), took under the recommended 10 000 steps per day (mean, 5107), and had an average of 6 seizures per month. Postintervention testing showed statistical improvement in depressive symptoms (mean [SD], 9.95 [9.47]; P < .05). There were no significant differences found for the other study outcomes. Our study showed the EMOVE intervention was feasible. Study participants had improved depressive symptoms. Future research should focus on increasing the sample size, improving exercise performance through group or individualized exercise sessions, and adding a control group to better evaluate the relationship between the intervention and improved depressive symptoms.

Epilepsy, Physical Activity and Sports: A Narrative Review.

People with epilepsy (PWE) are less physically active compared with the general population. Explanations include prejudice, overprotection, unawareness, stigma, fear of seizure induction and lack of knowledge of health professionals. At present, there is no consensus on the role of exercise in epilepsy. This paper reviews the current evidence surrounding the risks and benefits associated with physical activity (PA) in this group of patients. In the last decade, several publications indicate significant benefits in physiological and psychological health parameters, including mood and cognition, physical conditioning, social interaction, quality of life, as well as potential prevention of seizure presentation. Moreover, experimental studies suggest that PA provides mechanisms of neuronal protection, related to biochemical and structural changes including release of β-endorphins and steroids, which may exert an inhibitory effect on the occurrence of abnormal electrical activity. Epileptic discharges can decrease or disappear during exercise, which may translate into reduced seizure recurrence. In some patients, exercise may precipitate seizures. Available evidence suggests that PA should be encouraged in PWE in order to promote wellbeing and quality of life. There is a need for prospective randomized controlled studies that provide stronger clinical evidence before definitive recommendations can be made.

Role of Physical Activity and Exercise in Alleviating Cognitive Impairment in People With Epilepsy

Many persons with epilepsy (PWE) experience problems with a wide range of cognitive functions, including learning, memory, attention, and executive control. These deficits in cognition result in diminished quality of life for PWE and are related to many factors, including the etiology of their epilepsy, recurrent seizures, side effects of antiseizure medications, or a combination of these factors. Various treatments to ameliorate cognitive deficits experienced by PWE have been implemented, although noninvasive and nonpharmacologic strategies may be more appealing options due to their relatively low cost, reduced risk of side effects, and/or reduced potential interactions with antiseizure medications. Physical activity and exercise may improve cognition in PWE but have not been well researched in this respect. To date only 1 study has directly investigated the effects of exercise on cognition in PWE, and it showed improved performance on tests of attention and executive function. The goal of the present article was to examine how increased physical activity and exercise contributes to 3 strategies (reducing seizure frequency, reducing epileptiform discharges, and decreasing symptoms of depression) that have been described as having a positive impact on cognition in PWE, as well as highlight related findings in experimental models of epilepsy. There is a definite need for more randomized controlled trials to establish greater clinical evidence for the use of physical activity and exercise in ameliorating cognitive impairment in PWE. We also need to better understand the factors contributing to reduced physical activity in PWE, as well as ways to overcome such barriers. With the available research in the area of exercise in epilepsy showing positive results, and a supportive research climate encouraging PWE to engage in greater physical activity overall, further investigations into the relationships between physical activity and cognition in epilepsy are warranted.

Participation of People with Epilepsy in Sports

People with epilepsy (PWE) have been discouraged from participating in exercise and sports because of the fear of inducing seizures or increasing seizure frequency, risks associated with such activities, stigma, and overprotection. Recently, there has been a shift in the medical recommendations toward encouraging, rather than restricting, participation. Cases of exercise-induced seizures are rare. Physical activity can exert beneficial actions, such as a reduction in seizure susceptibility and the number of seizures, improvement in quality of life (QOL), and better social integration. The antiepileptogenic and neuroprotective effects of exercise in epilepsy have been shown. The majority of sports are safe for PWE to participate in when special attention is paid to seizure control, direct supervision, etc. Human and animal studies have supported the use of exercise as a therapy for epilepsy, complementary to standard treatments. The International League Against Epilepsy (ILAE) Task Force on Sports and Epilepsy offers general guidelines concerning the participation of PWE in sports activities. Sports are divided into three categories based on the potential risk of injury or death. Engaging in physical exercise and sports activities has positive effects for PWE. The ILAE propose to use the regulations governing the issuance of fitness certificates for driving as a possible guide. The decision to participate in sports is based on whether the benefit outweighs the risk.

Reliability and Validity of the Self-Efficacy for Exercise in Epilepsy and the Outcome Expectations for Exercise in Epilepsy Scales.

The purpose of this study was to test the psychometric properties of the revised Self-Efficacy for Exercise With Epilepsy (SEE-E) and Outcome Expectations for Exercise with Epilepsy (OEE-E) when used with people with epilepsy. The SEE-E and OEE-E were given in face-to-face interviews to 26 persons with epilepsy in an epilepsy clinic. There was some evidence of validity based on Rasch analysis INFIT and OUTFIT statistics. There was some evidence of reliability for the SEE-E and OEE-E based on person and item separation reliability indexes. These measures can be used to identify persons with epilepsy who have low self-efficacy and outcome expectations for exercise and guide design of interventions to strengthen these expectations and thereby improve exercise behavior.

A strength exercise program in rats with epilepsy is protective against seizures

The beneficial effects of physical exercise on epilepsy, such as a decreased seizure frequency, have been observed following aerobic exercise programs in both clinical and experimental studies. However, it is not well clarified whether other types of exercise, including strength exercise, can provide similar benefits for epilepsy. Forty four animals with epilepsy were continuously monitored 24h a day for 60days and divided into two periods of 30days. The first period was used to determine the number of seizures before beginning the physical exercise program, and the second period was utilized to determine the number of seizures during the strength training. The mean frequency of seizures in the control and SHAM groups increased significantly from period 1 to period 2. Although the frequency of seizures did not change significantly between the two periods of 30days of observation in the strength exercise group, a significant reduction in the seizure frequency was observed compared with the control and SHAM groups in period 2. Our study demonstrated that a strength exercise program exerted a significant influence on the seizure frequency in animals with epilepsy and strengthens the observed beneficial effect of exercise on epilepsy that has been demonstrated in animal studies. The finding of this nonclinical study can open a new window to verify the beneficial contribution of strength exercise in epilepsy. Further experimental and clinical investigations are necessary to explore the extent to which strength exercise interferes with the epileptic condition.

Exercise, diet, health behaviors, and risk factors among persons with epilepsy based on the California Health Interview Survey, 2005

Based on the 2005 California Health Interview Survey, persons with a history of epilepsy report lower educational attainment, lower annual income, and poorer health status, similar to other state-based epidemiological surveys. Previous studies have found persons with epilepsy exercise less and smoke more than the nonepilepsy population. The medical literature has also shown that antiepileptic drugs may cause nutritional deficiencies. Persons with a history of epilepsy in the 2005 CHIS report they walk more for transportation, drink more soda, and eat less salad than the nonepilepsy population. Exercise and dietary behaviors at recommended levels have been found to reduce mortality from many comorbid conditions such as cardiovascular disease, stroke, depression, anxiety, and osteoporosis for which persons with epilepsy are at increased risk. Health professionals in the epilepsy field should step up their efforts to engage patients in health promotion, especially in the areas of exercise, diet, and smoking cessation.

Physical exercise program reverts the effects of pinealectomy on the amygdala kindling development

Several studies have demonstrated the anticonvulsant effect of melatonin. In view of the positive effects of physical exercise in epilepsy, this study analyzed the influence of physical exercise program on the amygdala kindling development in pinealectomized rats. Animals were divided into six groups: pinealectomized rats (PX), sham rats (SHAM), control rats (CTL), pinealectomized rats submitted to an aerobic exercise program (PX ATL), sham rats submitted to an aerobic exercise program (SHAM ATL) and control rats submitted to an aerobic exercise program (CTL ATL). The stimulus parameters consisted of 60 Hz frequency, diphasic square pulses of 1 ms duration applied for 2 s. The mean number of stimulations and the after-discharge (AD) duration for each stage of kindling were similar among CTL and SHAM animals. PX animals showed particular characteristics during kindling development. They did not present stage 1 and spent a shorter time in stage 2 in relation to the CTL and SHAM animals. Consequently, the AD duration and number of stimulations required to reach stage 5 was lower for the PX group when compared to the CTL and SHAM groups. Concerning the exercising groups, CTL ATL and SHAM ATL animals spent a higher time in stage 1 compared to CTL and SHAM groups. Thus, CTL ATL animals also presented a higher number of stimulations in stage 5 compared to CTL animals. The stage 1 not observed in PX animals was present in PX ATL. Consequently, the number of stimulations required to reach stage 5 was statistically higher for the PX ATL group in relation to the PX group. Our results demonstrate that the acceleration in the kindling development of pinealectomized animals can be reverted by physical exercise.