Scand J Med Sci Sports 2016: 26: 856–857
doi: 10.1111/sms.12708
Letter to the Editor
Exercise as medicine for people with epilepsy
We read with great interest the review paper entitled
“Exercise as medicine – evidence for prescribing exer-
cise as therapy in 26 different chronic diseases” by
Pedersen and Saltin (2015) recently published in the
Scandinavian Journal of Medicine & Science in Sports.
The authors conducted a review study in order to
discuss the impact of exercise in the treatment of dif-
ferent chronic diseases including psychiatric, neuro-
logical, metabolic, cardiovascular, pulmonary,
musculo-skeletal, and cancer conditions.
We applaud the authors for this outstanding
paper; however, we would also like to address several
points particularly with regard to neurological dis-
eases. The authors explored the effect of physical
exercise in the treatment of dementia, Parkinson’s,
and multiple sclerosis. In our view, based on the cur-
rent scientific evidence and topic relevance, epilepsy
is a disease that should also be addressed in manu-
scripts of this nature.
Epilepsy is a common and prevalent neurologic
disease found in 2% of the population, affecting peo-
ple of all ages and characterized by a predisposition
to promote seizures as well as neurobiological, psy-
chological, cognitive, and social consequences
(Fisher et al., 2005; Arida et al., 2008). Due to their
condition, patients with epilepsy may develop other
medical problems such as heart disease, dementia,
insulin resistance, obesity, and atherosclerosis
(Hamed, 2014; Keezer et al., 2016).
Commonly, individuals with epilepsy have a
sedentary lifestyle which leads to poor physical fit-
ness (Nakken et al., 1990; Eriksen et al., 1994;
McAuley et al., 2001; Heise et al., 2002; Duncan
et al., 2006). Consequently, individuals with epilepsy
have low levels of maximal oxygen uptake and car-
diorespiratory fitness (Nakken et al., 1990; Eriksen
et al., 1994; Heise et al., 2002; Vancini et al., 2010a)
and poor levels of strength and flexibility (McAuley
et al., 2001; Heise et al., 2002). For example, Vancini
et al. (2010a) demonstrated that the lower aerobic
fitness observed in people with epilepsy may be asso-
ciated with their sedentary habits.
Physical activity should be encouraged in this
group, as previous studies have reported a number of
856
ª 2016 John Wiley & Sons A/S.
Published by John Wiley & Sons Ltd
positive effects of physical exercise in people with epi-
lepsy (Nakken et al., 1990; Eriksen et al., 1994;
McAuley et al., 2001; Heise et al., 2002; Arida et al.,
2008, 2010; Vancini et al., 2010a, 2013; de Lima et al.,
2011; Capovilla et al., 2016). However, the correct
management and prescription of physical exercise pro-
grams in epilepsy patients depends on health profes-
sionals’ knowledge (Vancini et al., 2010b, 2012, 2015).
Regular physical exercise, when prescribed at the
correct dose and type, can promote quality of life and
well-being (Capovilla et al., 2016), improve cardiovas-
cular fitness and strength, increase maximal aerobic
capacity, elevate work capacity, promote weight and
body fat reduction, and help in the management of sei-
zure frequency (for review see Arida et al., 2010;
Capovilla et al., 2016). Taken together, this broad
body of evidence indicates that patients with epilepsy
should be encouraged to practice regular physical exer-
cise, as this is beneficial for their health and does not
exacerbate seizure frequency (Arida et al., 2008).
Finally, we would like to congratulate Pedersen
and Saltin (2015) on their interesting and relevant
paper and to emphasize the importance of the prac-
tice of physical exercise by those with epilepsy.
Acknowledgements
English review of this manuscript was carried out by an Eng-
lish native speaker and supported by Fundacß~ao de Amparo a
Pesquisa do Estado de Goi as (FAPEG, Chamada no. 10/
2013, CAPES-Programa de Apoio  os-Graduacß~
a P ao-PPGS-
FAPEG).
R. L. Vancini1, M. S. Andrade2, C. A. B. de Lira3
1
Centro de Educacßa~o Fısica e Desportos, Universi-
dade Federal do Espırito Santo, Vitoria, ES, Brazil,
2
Departamento de Fisiologia, Universidade Federal de
S~
ao Paulo, S~ao Paulo, SP, Brazil, 3Setor de Fisiologia
Humana e do Exercıcio, Faculdade de Educacßa~o Fısica e
Dancßa, Universidade Federal de Goi as, Goi^
ania, GO,
Brazil
E-mail: andre.claudio@gmail.com

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