Medications and Exercise Participation at the Centre of Movement

Children with chronic conditions often require the use of medications, in conjunction with other supports to help effectively manage their symptoms. These medications, whether prescribed or over the counter, can be game changers in terms of outcomes, quality of life and overall routine. Such medications all have their primary area of impact (what they are meant to treat), but often also have other side effects across their systems.

Clinical exercise also creates systematic changes. Adaptations to chronic exercise include (but are not limited to) increased muscle and bone mass, improved synthesis and release of neurotransmitters like dopamine, enhanced organ functioning, lower inflammation, supported immune function and better mental health (McGee & Hargreaves, 2020).

It boosts academic performance, attention, brain-derived neurotrophic factor, cognition, executive function, gene expression and working memory (Valkenborghs et al., 2019). All whilst simultaneously reducing the risk of developing certain cancers, diabetes mellitus, high blood pressure, depression, osteoporosis and fractures, obesity and lower back pain (Bushman, 2020).

Often the side effects of common medications overlap with the expected response the body has to exercise. For example, when a child participates in moderate to vigorous exercise, they will have a predictable increase in blood pressure as their body manages the added demands of the activity.

The drug Baclofen (commonly used to assist with spasticity) also elevates blood pressure. Without knowing this drug is being taken, it would be easy for the exercise physiologist to be confused or even alarmed by the blood pressure reading they are seeing in the clinic. The same drug also makes many children drowsy, and activities that may have been very safe prior to taking Baclofen may now need a little extra supervision or support as the child adjusts.

Baclofen is known to impact bladder function and stomach tolerance in some children. Knowing this, their exercise physiologist can easily make positions and tasks more tolerable and avoid pressure on their stomach. If one of a child’s therapy goals is related to toilet training, this also informs the way they may go about setting a timeline for this goal or understanding how to better support the changes in urgency many will report after starting the drug.

Just like in the example above, we ask about your child’s medications and medical clearance so we can:

• Assist with attainable goal setting.
• Help notice if a new medication may be interfering with their therapy outcomes.
• Know what modalities may be most beneficial.
• Plan the level of monitoring that is appropriate for different kinds of exercise.
• Understand their “normal” and tailor sessions to keep them safe.

Below are some of the more common drug classes seen in our clinic and how they typically interact with normal exercise responses: