To understand knowledge, beliefs, activity level and barriers to exercise in PWE treated with neurostimulation.

Epilepsy is a common neurological condition, affecting approximately 1% of the worldwide population. In addition to increased morbidity and mortality, it is also associated with decreased educational/occupational achievement and increased incidence of cognitive and neuropsychiatric impairment. For people with epilepsy (PWE), these associated difficulties can be as burdensome as the medical comorbidities. Thus, there is interest in increasing awareness of the benefits of regular physical exercise in PWE, especially in those who are refractory to multiple treatment modalities, including surgery. There are misconceptions regarding its safety, resulting in many PWE to be unnecessarily restricted from physical activity. Prior studies have demonstrated that PWE who exercise have less seizures, score higher on cognitive functioning testing, and have less psychiatric comorbidity. Interestingly, no studies to date examine the effects of exercise in PWE after neurostimulation. 

We conducted a voluntary survey regarding exercise beliefs, barriers, activity level, and interest in a subset of our clinic’s PWE.  36 patients (20 with RNS only, 3 with DBS only, 9 with VNS only, and 2 with RNS and VNS) participated in the survey. Their responses were recorded and analyzed.

91% reported at least 1 barrier to regular exercise, primarily access to transportation. 19.4 % reported that they were told to avoid certain exercises and 25% reported avoiding certain exercises after device placement. 42.8 % of patients reported obtaining at least 75 minutes of physical activity per week. 69.5% was unaware that regular physical activity could reduce seizure frequency. Three patients were aware of exercise in epilepsy guidelines.

Our results suggest future education on epilepsy and exercise guidelines, along with support and resources for participation, could encourage physical activity and decrease seizure frequency and psychiatric comorbidities without an undue risk of harm.