Benefits of Exercise for Friedreich’s Ataxia

Muscle weakness, balance issues, impaired sensory functions such as speech, hearing and vision — these are just some of the common symptoms of Friedreich’s ataxia (FA).

This rare genetic condition commonly begins in childhood. And as it progresses, people with FA may lose strength, have trouble standing, walking or running, and feel tired.

At first, you may think that refraining from exercise or movement is best. You don’t want to fall or injure yourself, right?

But exercising and physical therapy are key components of living with Friedreich’s ataxia. Staying active can help increase strength and flexibility, maintain balance and coordination, and improve your heart health.

Neurologist Ilia Itin, MD, explains why exercise is vital for people with Friedreich’s ataxia and outlines the best types of exercise.

Why is exercise important for people with Friedreich’s ataxia?

The benefits of exercise are well-documented. For example, exercise can help:

• Maintain a healthy weight.
• Improve mood.
• Improve energy levels.
• Improve sleep.
• Promote social connections.
• Prevent or manage health conditions like Type 2 diabetes and high blood pressure.

When it comes to Friedreich’s ataxia, exercise can help in a variety of ways.

“Friedreich’s ataxia is a disease that affects your neuromuscular system and affects balance,” explains Dr. Itin. “The better physical shape you’re in, the better you’ll be able to function. And the fewer possibilities you have when it comes to falls and injuries.”

Exercise can help maintain or improve your balance, flexibility and coordination. It can also help fight off fatigue and improve the overall quality of your life.

Additionally, Dr. Itin says it’s best to work with a physical therapist, who can recommend the best exercises for you.

“They can conduct an assessment and suggest activities to avoid that cause falls and injuries,” he explains. “They’ll also recommend appropriate exercises and how often to do them based on your specific needs.”

During a physical therapy assessment, a physical therapist will evaluate such areas as posture, balance, range of motion, spinal alignment, functional abilities and endurance.

What type of exercises should you do?

A physical therapist can help you figure out the best exercises for you.

And in some cases, there are certain modifications they can show you to assist with mobility issues.

For example, some exercises can be done while sitting if standing or walking is a challenge for you. If you need help from a mobility aid or assistive device, a physical therapist can help adapt exercises as well.

So, what kind of exercise should you focus on? While your needs are unique to you and your disease, consider talking with your physical therapist about the following exercises.

Strengthening exercises

Keeping muscles strong is key for someone with Friedreich’s ataxia. Strengthening exercises can help with posture and help with overall mobility. A physical therapist can recommend the types of strengthening exercises you should do.

Some common muscle groups you may want to focus on include your core, shoulders, upper body, hips, hamstrings and ankles. You may need equipment like light weights and resistance bands, but some moves can even be done using a wall.

Again, it’s important to note that many of these exercises can be modified to fit you and your level of mobility.

Stretching exercises

Try to do some stretching every day, as doing so can help reduce muscle tightness and improve flexibility.

A physical therapist can help determine which kind of stretching exercises you should do, but some common areas that people with FA may want to concentrate on are legs and feet to help reduce foot issues such as pes cavus, or a shortened foot with a high arch.

Another skeletal issue people with FA may have to manage is scoliosis, or a side-to-side curving of the spine. About 67% of people with FA will develop scoliosis. Certain stretches can help manage pain and strengthen muscles.

Gait training

How you walk may change as your FA progresses. A physical therapist may suggest gait training, which aims to improve the ability to stand and walk.

These coordination exercises strive to improve or maintain a sense of motion. Many times, you may be instructed to watch your movements (for example, performing these exercises in front of a mirror), as this helps improve hand-eye coordination and the signal between your brain and muscles.

Balance exercises

As your Friedreich’s ataxia progresses, you may find you have trouble with walking, coordination and balance.

Balance exercises — such as sit-to-stand exercises or using a balance board — can help maintain balance and stability. This can help you feel stronger when sitting, standing, moving or walking, and may help reduce the risk of falls and injuries.

As with other types of exercise, Dr. Itin again recommends working with a physical therapist to find the right balance exercises based on symptoms and the severity of the disease.

Conditioning

Cardiovascular exercises can help increase or maintain endurance, energy, and heart and lung function. Regular cardio can also benefit your brain, joints, muscles, digestion and mood.

The goal is to raise your heart rate for an extended period of time. You may need to monitor your heart rate and breathing during conditioning exercises.

A physical therapist can help tailor a cardiovascular program for you. Some examples of cardiovascular exercise that may be recommended for people with FA include swimming, seated aerobics, wheelchair basketball, adapted yoga, stationary cycling or seated rowing.

Bottom line?

Exercise is an important part of living with Friedreich’s ataxia. As you age and the disease progresses, your needs and abilities can change as well. You and your physical therapist can work to determine the right kinds of exercise for all the different stages of your life and your disease.

“Everybody who has Friedreich’s ataxia is different and is at different stages of the disease,” notes Dr. Itin. “It’s important to see a physical therapist for an assessment to help us recommend what’s appropriate in any given case.”