Ask the Doc: Q & A with Edward Kasarskis, MD, PhD

Edward Kasarskis, MD, PhD is Director of the University of Kentucky ALS Multidisciplinary Clinic at Cardinal Hill Rehabilitation Hospital in Lexington, Kentucky, professor in the Department of Neurology at the University of Kentucky, and Chief of Neurology at the VA Medical Center in Lexington KY. 

Dr. Kasarskis

Q:  What should I know about getting exercise? Will it help or will it hurt?

Dr. Kasarskis:  While we need to do more research on this question, the best approach for now is common sense, something between being a couch potato and pumping iron.

The goal should be to use and maintain the muscle power you have. I don’t recommend using free weights, which puts you in danger in case your muscle gives out. And binge exercise (also known as being a “weekend warrior”) is bad for everyone, especially for people with ALS.

I suggest you aim for moderate exercise if it can be done safely. I have one patient who has had ALS for 15 years, and she rides a stationary recumbent bike 100 miles a month and loves it. She sees the exercise as an important part of how she manages her disease. She has tiny muscles, but they’re strong!

There are also some respiratory exercises you can do. Some people like to use a Power Lung, a drug-free, easy-to-use, handheld breathing trainer. You can set inspiratory and expiratory resistance differently, based on suggestions from your respiratory therapist or physician. We think it helps maintain respiratory muscle ability but we need research to understand the impact of these exercises.

By and large, as long as it’s safe, exercise is relatively risk free and offers a psychological benefit.

Each issue we feature a leading neurologist specializing in ALS responding to a question. If you would like to submit questions for a future Q & A, please send your questions to Amber Walters. Please understand that we won’t be able to address all questions and we won’t be able to respond to individuals personally.