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Physical exercise: Potential candidate as coping strategy for people with epilepsy

2013; Elsevier BV; Volume: 28; Issue: 1 Linguagem: Inglês

10.1016/j.yebeh.2013.04.004

1525-5069

Rodrigo Luiz Vancini, Claudio André Barbosa de Lira, Ricardo Mário Arida,

Child and Adolescent Psychosocial and Emotional Development

We read with great interest the original article entitled “Determining the coping strategies of individuals with epilepsy” by Bautista et al. that has appeared recently in Epilepsy & Behavior [ [1] Bautista R.E. Rundle-Gonzalez V. Awad R.G. Erwin P.A. Determining the coping strategies of individuals with epilepsy. Epilepsy Behav. 2013; 27: 286-291 Abstract Full Text Full Text PDF PubMed Scopus (24) Google Scholar ]. The authors reported whether the coping styles and strategies (positive and/or negative) – substance abuse, religion, humor, instrumental support, acceptance, denial, emotional support, positive reframing, planning, active coping, self-blame, behavioral disengagement, venting, and self-distraction – of people with epilepsy are associated with certain demographic, clinical, and psychosocial variables. They notably highlighted that strategies cited in their manuscript should be considered as alternative emotional and stress coping techniques used by people with epilepsy. We applaud the authors for approaching this topic, but we are also interested in addressing some considerations for this paper. Coping is described as cognitive and behavioral efforts utilized to deal with difficult situations and as a problem-solving technique that is utilized to reduce a person's psycho-emotional burden [ [2] Folkman S. Lazarus R.S. An analysis of coping in a middle-aged community sample. J Health Soc Behav. 1980; 21: 219-239 Crossref PubMed Scopus (3712) Google Scholar ]. Positive coping strategies employed by people with epilepsy may incorporate spirituality, emotional support, and meditative techniques. In this sense, negative strategies may include denial, self-blame, or even alcohol and/or drug use [ [3] Livneh H. Wilson L.M. Duchesneau A. Antonak R.F. Psychosocial adaptation to epilepsy: the role of coping strategies. Epilepsy Behav. 2001; 2: 533-544 Abstract Full Text PDF PubMed Scopus (50) Google Scholar ]. A large number of people with epilepsy use nonpharmacological therapies along with their conventional medicine. Programs of physical exercise have an important role in this picture. It is interesting to note that individuals with epilepsy have only recently included physical exercise programs as a complementary therapy (for review, see Arida et al. [ 4 Arida R.M. Scorza F.A. Gomes da Silva S. Schachter S.C. Cavalheiro E.A. The potential role of physical exercise in the treatment of epilepsy. Epilepsy Behav. 2010; 17: 432-435 Abstract Full Text Full Text PDF PubMed Scopus (49) Google Scholar , 5 Arida R.M. Cavalheiro E.A. da Silva A.C. Scorza F.A. Physical activity and epilepsy: proven and predicted benefits. Sports Med. 2008; 38: 607-615 Crossref PubMed Scopus (88) Google Scholar ]). In accordance with this reasoning, positive effects of exercise to people with epilepsy have been increasingly reported in the literature. Studies have generally shown that physical activity can decrease seizure frequency as well as lead to improved psychological and general health in people with epilepsy [ 6 Nakken K.O. Bjorholt P.G. Johannessen S.I. Loyning T. Lind E. Effect of physical training on aerobic capacity, seizure occurrence, and serum level of antiepileptic drugs in adults with epilepsy. Epilepsia. 1990; 31: 88-94 Crossref PubMed Scopus (142) Google Scholar , 7 Nakken K.O. Loyning A. Loyning T. Gløersen G. Larsson P.G. Does physical exercise influence the occurrence of epileptiform EEG discharges in children?. Epilepsia. 1997; 38: 279-284 Crossref PubMed Scopus (57) Google Scholar , 8 Eriksen H.R. Ellertsen B. Gronningsaeter H. Nakken K.O. Løyning Y. Ursin H. Physical exercise in women with intractable epilepsy. Epilepsy. 1994; 35: 1256-1264 Crossref PubMed Scopus (129) Google Scholar , 9 McAuley J.W. Long L. Heise J. Kirby T. Buckworth J. Pitt C. et al. A Prospective Evaluation of the effects of a 12-week outpatient exercise program on clinical and behavioral outcomes in patients with epilepsy. Epilepsy Behav. 2001; 2: 592-600 Abstract Full Text PDF PubMed Scopus (116) Google Scholar ]. In this sense, we proposed that physical exercise can be a coping strategy in the treatment of psychological disorders of people with epilepsy. Cairney et al. [ [10] Cairney J. Kwan M. Veldhuizen S. Faulkner G.E.J. Who uses exercise as a coping strategy for stress? Results from a National Survey of Canadians. J Phys Act Health. 2013; (in press) PubMed Google Scholar ] reported that the practice of physical exercise for coping with stress is common in the general population. However, it is less used compared with several other behaviors. For this reason, engaging in physical exercise as a strategy for stress and emotional coping could potentially reduce overall stress levels and improve general health and well-being of people with epilepsy. Considering the influence of physical exercise on brain function and its positive impact in seizure control and psychological state, it seems reasonable to include programs of exercise as complementary treatment modality and a stress coping strategy in epilepsy, since emotional stress is a factor that can trigger seizures in people with epilepsy. Health professionals should bear in mind the therapeutic use of regular physical exercise when advising their patients to undergo nonpharmacological treatment of epilepsy. They should stimulate patients to engage in regular physical activities not only for seizure control but also for the improvement of general health and quality of life. Overall, we would like to express our congratulations to Bautista et al. [ [1] Bautista R.E. Rundle-Gonzalez V. Awad R.G. Erwin P.A. Determining the coping strategies of individuals with epilepsy. Epilepsy Behav. 2013; 27: 286-291 Abstract Full Text Full Text PDF PubMed Scopus (24) Google Scholar ] for their interesting paper and for emphasizing the possible role of physical exercise as a positive coping strategy for people with epilepsy.