brain in a knot

Exercise can benefit the epileptic client. Over 2.5 million Americans are currently living with epilepsy and need exercise just like everyone else.

Epilepsy is a neurological disorder characterized by frequent seizures, believed to originate from abnormal spurts of electrical activity in the brain.

While the majority of cases have unknown etiology, epilepsy can be brought on by genetic factors, head trauma, stroke, tumors or an infection within the nervous system.

While a potential new client with epilepsy may present a challenge to many personal trainers, or at the very least a situation they have not previously encountered, it is good to be as informed as possible should such an opportunity present itself. There is much that we can do to improve the quality of life in such individuals.

Benefits of Physical Activity for Epilepsy

Many of the diseases typically linked to a sedentary lifestyle — cardiovascular disease, type 2 diabetes, hypertension, and osteoporosis— are comorbid conditions among individuals affected by epilepsy. Despite a shift in medical recommendations toward encouraging rather than restricting participation in exercise, this demographic remains less active than the general population.

Both clinical and experimental studies have analyzed the effect of physical exercise on epilepsy. A study conducted in Norway examined the physical activity patterns of a group of women with uncontrolled epilepsy.

Data revealed that 60-minute sessions of aerobic exercise, engaged in twice weekly, resulted in a significant reduction in the number of seizures experienced.

The subjects also reported/demonstrated:

Decrease Anxiety and Enhance Mood

Aberrations in brain substances known as neurotransmitters are commonly associated with mood disorders and epilepsy. Some of the more familiar neurotransmitters include serotonin (the “feel good” substance), noradrenaline (known as the “fight-or-flight” hormone), dopamine (responsible for sensations of pleasure and pain), and GABA (helps control fear and anxiety).

Since a regular exercise program can affect the mechanism of these substances, many individuals living with epilepsy experience improvements in mood as well as a decrease in levels of anxiety.

Can Exercise Cause a Seizure?

Although there are rare cases of exercise-induced epileptic seizures, studies have shown that physical activity generally decreases seizure frequency while also leading to improved health. While this is all positive, it is equally important for a trainer to fully understand the limitations of an epileptic client, directing him toward the safest and most effective workouts.

Modes of Exercise and accompanying Risks

Exercise can be broken down into three general categories of physical endeavors, based upon potential risk of injury or death to the participant. When training a client with epilepsy, keep this in mind before suggesting he engage in an advanced-level sport.

The first group encompasses sports with no significant additional risk.

The second category includes physical activities that potentially pose a moderate risk to epileptic clients. Many contact sports — football, hockey and rugby, for example – are associated with increased risk of head injuries, which have the potential to trigger or adversely affect epileptic seizures. Clients may be cautioned against participation in the absence of appropriate safety headgear.

The third group consists of sports that involve a significant risk should a seizure happen during participation. Hang gliding, scuba diving, skiing and rock climbing fall into this last category.

It is prudent for trainers to explain all potential risks to new clients, especially those who have never undertaken serious physical activity and may be significantly deconditioned. Assessing and determining each individual’s attitude toward risk-taking and personal responsibility may help prior to starting a training program.

Program Design And Implementation

When preparing a workout for an epileptic client, consider choosing activities that fall into the first aforementioned category, especially with those new to exercise. Supervised strength training, using dumbbells, resistance bands, and weight machines, is a great starting point. Body-weight-only strengthening moves, such as push-ups, pull-ups, and abdominal exercises, are also ideal.

Offering Options

Clients often ask for appropriate exercise formats in which to engage when they are not with their personal trainer. Yoga is among the most popular in terms of group exercise. This discipline offers a combination of flexibility and strength, and also functions as an anxiety reducer, a common trigger for many living with epilepsy.

Walking and biking are also healthy and relatively safe activities to encourage for epileptic clients, particularly when done with a workout buddy who knows how to recognize and respond to a seizure.  Swimming and water aerobics are also great modes of exercise.

Stress to your client the importance of alerting the lifeguard to his condition prior to entering the pool; seizures that occur in the water pose a unique and potentially dangerous situation.

General Safety Considerations

Even if an epileptic client assures his trainer that the frequency of his seizure rate is extremely low, trainers and gym owners can protect themselves – and their clients – by adhering to some basic safety tenets.

Inquire about any known triggers; then have a client describe how his body typically reacts in the midst of a seizure. By learning the best ways to help in the throes of a seizure, both you and the client can be kept safe should this occur.

Trainers often find that a client’s motivation and energy are contagious, and may unknowingly push an epileptic client too far. Pay attention to unusual signs of physical exhaustion, dehydration and overheating. It is also a good idea to have an emergency phone number on hand, either a family member or the client’s physician, in the event of a serious seizure.

The Nutrition Nuance

A balanced diet from different food groups helps the body and brain to function. This may reduce the risk of seizures for some people with epilepsy, knowing that both dehydration and hypoglycemia can exacerbate a seizure risk.

Although there is little evidence that a balanced diet has a direct effect on seizures, it provides essential nutrients and maintains a steady energy level. A prudent nutritional plan may help clients feel positive and more in control of their lives and decisions about managing their epilepsy.

Special Considerations For Seniors

Epilepsy is not always the first possibility that comes to mind when an older client suffers a seizure or related episode. Its clinical presentation can resemble other more common conditions, such as the aftermath of a stroke, head injury, brain tumor/surgery, chronic alcoholism or dementia.

By inquiring about and discussing any pre-existing comorbid health conditions during that all-important client screening and assessment, trainers can make informed decisions in case of an emergency.

Clients living with unique health situations will value trainers who take the time to listen, understand, and work within their challenges. A little knowledge, a little empathy, and a lot of empowerment can make for a strong and successful working relationship.

How have unique health issues impacted your business?

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Cathleen Kronemer

Cathleen Kronemer is an NFPT CEC writer and a member of the NFPT Certification Council Board. Cathleen is an AFAA-Certified Group Exercise Instructor, NSCA-Certified Personal Trainer, ACE-Certified Health Coach, former competitive bodybuilder and freelance writer. She is employed at the Jewish Community Center in St. Louis, MO. Cathleen has been involved in the fitness industry for over three decades. Feel free to contact her at She welcomes your feedback and your comments!