What is Energy, Exercise and Fatigue ?
Energy, Exercise and Fatigue is important for people living with the late effects of polio:
People living with the late effects of polio use a high percentage of their day to day energy just dealing with life’s norms
Energy management is the process of taking positive steps to reduce the effects of fatigue. Putting you in control of your energy
You can over exercise and under exercise. Finding the type and level of exercise that you can enjoy and maintain will allow you to improve fitness and health
Find other people you can work or play with to avoid isolation, give you regular encouragement, support and company
Energy, Exercise and Fatigue
No Pain No Gain? Conserve to preserve ? Use it or loose it ?
Many polio survivors have heard the saying “preserve to conserve” when dealing with increased fatigue and muscle pain. The big questions became, “to what level can you exercise without doing damage, below what level of no exercise does damage and, is there a middle ground?”
The good news is that a modified exercise program has been shown to be very beneficial to people living with the late effects of polio, with out any negative side effects, though this does require considerable resources, skill, sensitivity and determination to implement.
The skill and sensitivity is needed because we have learnt to ignore the signals telling us that we are tired or overstretched. We have become accustomed to giving 120% to a task , of running a marathon to do what others do in a average day, not only keep up with the able bodied, but to try to be better than them.
The resources and determination is needed because it is not enough to just know you have to something to get healthier, you have to really want to – hence the determinations. Doing something new always require new resources, weather it be a place to exercise, the equipment and clothing, the assessment and exercise prescription, the ability to monitor your progress and the social support behind your program.
A safe exercise program requires being able to keep within limits set by half our maximum capacity, get nowhere near our pain threshold and generally take it easy at a pace we are not used to. The benefits are not instant, so a long term program will provide the best payback for the time spent.
Common symptoms of Fatigue include:
Muscle fatigue: A short-term reduction in power is brought on by physical activity and relieved by rest
Muscle fatigue: A decline in muscle strength, which results in the need to work harder to perform everyday activities
Muscle fatigue: A sudden onset of exhaustion during or after activity, feelings of weakness and localized aching pain that can become worse in the cold
General Fatigue: A feeling of whole body exhaustion, “hitting a brick wall”, a feeling of being utterly drained, it can occur with physical (neuromuscular) fatigue, increased general fatigue is correlated with higher stress
Mental Fatigue: Fatigue which impacts on concentration, memory, mood, emotion and motivation, sometimes described as “Brain Fog”, increased mental fatigue is correlated with higher stress, depression and lower motivation
An increase in tremors, muscle twitching and decrease in hand control resulting in more accidents
Having (more) falls
Changes in Energy, Exercise and Fatigue Patterns
Polio survivors are extremely susceptible to muscle weakness and fatigue, therefore more caution should be taken with an exercise prescription. Polio affected muscles are more likely to fatigue and have a prolonged recovery time compared to unaffected muscles. The increasing workload on remaining muscles are compensating for lost motor units that were damaged or destroyed by polio.
The first step in an exercise prescription is the assessment and modification of any excessive demands on the body. This may include splinting, reduction of uneven stressors and reduction of workload. After modification of these factors, exercise forms the basis of self-management of people living with late effects of polio.
Polio survivors are extremely susceptible to muscle weakness and fatigue therefore more caution should be taken with an exercise prescription, more likely to fatigue and have a prolonged recovery time compared to unaffected muscles. This may be explained by the increasing workload on remaining motor units which are compensating for lost motor units that were destroyed by polio.
The first step in an exercise prescription is the assessment and modification of any excessive demands on the body. This may include splinting, reduction of uneven stressors and reduction of workload. After modification of these factors, exercise forms the basis of self-management of people living with late effects of polio.
Absolute bed rest can accelerate muscle mass loss and strength at a rate of 1.5% per day, particularly affecting the anti-gravity muscles that maintain posture in standing. Most polio survivors will benefit from appropriate physical activity, the more individually tailored specific muscle training the better. It is important that these activities are well paced, with sufficient rest time to help minimize local muscle fatigue and allow strength recovery.
In general, there are four reasons why people who had polio may have trouble with fatigue.
What can I do to improve my Energy, Exercise and Fatigue?
Keep Learning…
Try something new. Rediscover an old interest. Sign up for that course. Take on a different responsibility at work. Fix a bike. Learn to play an instrument or how to cook your favourite food. Set a challenge you will enjoy achieving. Learning new things will make you more confident, as well as being fun to do.
Be active…
Go for a walk. Step outside. Cycle. Play a game. Garden. Dance. Being active makes you feel good. Most importantly, discover a physical activity you enjoy; one that suits your level of mobility and fitness.
Take notice…
Be curious. Catch sight of the beautiful. Remark on the unusual. Notice the changing seasons. Savour the moment, whether you are on a train, eating lunch or talking to friends. Be aware of the world around you and what you are feeling. Reflecting on your experiences will help you appreciate what matters to you.
Give…
Do something nice for a friend, or a stranger. Thank someone. Smile. Volunteer your time. Join a community group. Look out, as well as in. Seeing yourself, and your happiness, linked to the wider community can be incredibly rewarding and will create connections with the people around you.
Connect…
With the people around you. With family, friends, colleagues and neighbours. At home, work, school or in your local community. Think of these as the cornerstones of your life and invest time in developing them. Building these connections will support and enrich you every day.
Strengthening and Aerobic Exercise.
Strengthening Exercise:
Muscle strengthening maybe performed in muscles with residual polio weakness, however strength gains may be slow or limited compared to muscles unaffected by polio.
Manual muscle testing must be performed before and during the exercise program to clearly monitor changes in muscle strength and the underlying cause of muscle weakness should be determined so that appropriate management strategies can be developed. General recommendations for strengthening exercise are: low resistance and high repetitions with frequent rest periods of sufficient duration to allow recovery from muscle fatigue.
Aerobic exercise :
Excessive cardiovascular exercise has been shown to increase levels of chronic fatigue however some amount of exercise is necessary for improving cardiovascular fitness.
The correct level of exercise must be determined in order to gain maximal cardiovascular fitness without worsening levels of chronic fatigue.
The major principles are to exercise at a moderate rather than maximal intensity and have short sessions with frequent rests and have adequate recovery time between session days
A typical program could include a 20 minute sessions with frequent short rests three times a week with at least one day off in between sessions.
The best exercise to help you lose weight is cardiovascular or aerobic exercise.
These exercises cause you to feel warm, perspire and breathe heavily without being out of breath and without any pain or burning sensations in your muscles.
Ongoing worry about Energy, Exercise and Fatigue
If you feel the fatigue is getting the better of you, and you can’t see things improving, it is time to get help. Our capacity to experience of fatigue will always be there, but we don’t have to be tired all the time. Register with the Duncan Foundation www.duncanfoundation.org and get an assessment and a range of option that you might follow.They offer a 6 week course on fatigue management online.
See you GP to check for any other possible causes of fatigue. Refer them to HealthPathways – Late Effects of Polio for the best guidance on the Late effects of polio.
Find out more
Resources, Links and Research Downloads
How to Exercise If You Are Living with Post Polio Syndrome
Q: Why people living with the late effect of polio should exercise.
W: How people living with the late effect of polio should exercise.
A: In depth material and well communicated.
