Your guide to exercise and epilepsy. Sarah Bolitho and Steve Shreeve offer guidance to sport and fitness professionals who are working with people with epilepsy.
Last year, Steve was approached by a new client who disclosed during her consultation that she had epilepsy.
Having more than two decades of experience in the fitness industry, including 12 years running his own fitness business, Steve had the confidence and experience to talk to the client about appropriate medical consent for her training and discuss a risk assessment for the exercises he would be recommending. This particular client was used to exercise and hadn’t had a seizure for many years but, despite that, additional research was needed to fill in knowledge gaps around exercise and epilepsy.
Unsurprisingly, research showed there are many benefits of exercise for people living with epilepsy. However, a lot of this research also came with a message that people living with epilepsy, and those working with them, often worry about exercise triggering seizures. This, in addition to outdated and inaccurate information, means that many people with epilepsy have difficulty accessing opportunities to exercise or participate in sport. Clients may be nervous about activity, while fit pros are worried about causing harm. Yet, with some basic understanding, fit pros can provide effective and enjoyable – and safe – activity for clients with epilepsy.
Reflecting on this experience led to questioning how other fit pros might respond in similar situations. Newcomers, particularly if they don’t have the experience that builds knowledge and confidence, may reject a client, or conversely may ‘give it a go’ and cause damage.
Searching for specific training courses that would provide knowledge and support for both sport and fitness professionals drew a blank. This lack of training is surprising, as one percent of the UK population lives with epilepsy – that’s as many as live with rheumatoid arthritis, which is covered on many courses. Further research into dedicated books and manuals aimed at those working with different conditions found little to no mention of considerations for people living with epilepsy. Epilepsy isn’t even mentioned in the professional standards for long-term or neurological conditions!
Considering the many courses and qualifications out there to equip fit pros with the knowledge to support people with myriad medical conditions, this is a gap that needs filling.
People with epilepsy, a condition that can massively benefit from the health benefits of exercise, are being underserved, because of a lack of access to specialist education for sports and fitness professionals. This is also concerning, as people living with epilepsy are at a higher risk of other long-term conditions such as heart disease, obesity, depression, migraine and arthritis. Additionally, epilepsy occurs in between 15% and 50% of people living with cerebral palsy, and up to 32% of those with intellectual disability, so a broader knowledge of potential comorbidity and multimorbidity for people with epilepsy is strongly advised.
What are the main things you need to know?
The basics of programme planning are the same as for anyone else. What does the client want to gain, what are their fears and limitations, and what is their current fitness level? As professionals we do this daily, and epilepsy is no different – we just need the condition-specific information to ensure it is a safe and effective programme.
As mentioned earlier, one of the barriers to opportunities for sport and exercise is the professional’s fear of triggering a seizure. Yes, there is a risk but with appropriate condition management, seizures are less common and professionals can receive basic training in what to do. While there may be triggers, they can happen anywhere, any time, so if it happens in front of you, training means you will be prepared! Know your client’s triggers, check at each session and adapt accordingly. For example, if lack of sleep is a trigger, change the planned session if your client has had a restless night or two. Discuss with your client what do to if a seizure does happen. This is basic duty of care and with this information you can be confident in supporting your client well.
While there are condition- and client-specific considerations, overall, an appropriately planned exercise programme is just as safe for people with epilepsy as it is for others. Focus on the client and their aims while being aware of the condition – and remember, the physical and psychological benefits of participation far outweigh the risks.
Other than knowledge of the condition and potential comorbidities, it is also important that sport and fitness professionals have the confidence in their understanding and ability to create an individual and flexible approach, so they can fully and safely support people with epilepsy and help them enjoy all of the benefits of a physically active lifestyle.
It is also important for people with epilepsy to have confidence in knowing they can turn to a dedicated qualified professional with the specialist knowledge to support and help them in becoming more physically active and enjoying a healthy, active lifestyle.
To promote and support sport and fitness professionals in working with people with epilepsy, we are developing a course in exercise and epilepsy. To ensure it is of the highest quality and standard, we are working with the charity Epilepsy Action (EA), which has been supportive and enthusiastic. EA is providing and endorsing learning materials to help people understand epilepsy and how it affects people they may work with. This will provide both sport and fitness professionals with the key information and knowledge to work with clients with epilepsy and promote active lifestyles to improve health.
Find out more about working with clients with long term conditions in this FitPro blog post.
For further information, contact Sarah at admin@sarahbolitho.com or Steve at steve@shreevehandf.com
Bios
Sarah Bolitho helps fitness and healthcare professionals to develop their careers through training in specialist fields. With 35+ years in the health-related fitness industry, she is ideally placed to train, support and mentor people who want to work with clients with a range of disabilities, mental health conditions and long-term conditions.
Steve Shreeve helps clients to keep their minds and bodies feeling physically young through a range of tailored programmes. With over 20 years in sport and fitness, he has a reputation for truly caring for his clients and is massively passionate about the potential and importance of exercise, particularly resistance training.
