What is the best way to approach exercise for those with HAE?

Jul 13, 2015

Dr. C:  This is an excellent topic to promote our new event this year at the Patient Summit—‘The HAE in motion 5K Walk/Run’. We hope to see you all in motion in Denver. Exercise is one of the most beneficial things that we can do for ourselves. A recent study confirmed that just doing something vs doing nothing reduced the risk of premature death by 20%. There was further benefit up to a point. Those engaged in 150 minutes per week had a reduction of 31% and individuals achieving 450 minutes per week had a 39% reduction. The benefit seemed to plateau from there. The important message here is—exercise, its good for you. As with all things pick something that engages your interest, gradually increase your time, enjoy yourself and you will make it part of your life. Marc perhaps you can give us your thoughts about exercise specifically for patients with HAE?

Dr. R: Unfortunately, there are no systematic studies looking at this excellent question.  Like a lot of things with HAE, the approach is highly variable and dependent on the individual person.  In some people, pressure or soft tissue impact will trigger swelling, so activities like contact sports (football, soccer) or those with repetitive impact or pressure (jogging, cycling) can be problematic. However, this isn’t true for everyone and I’ve seen some patients engage in these sports at a very high level with a good medical treatment plan. Some people report that “low-impact” activities work well for them: yoga, swimming, walking.  The numerous health benefits of exercise are very clear including a tremendous benefit in reducing psychological stress (another well recognized trigger for HAE attacks).   So I encourage patients to cautiously try out various forms of exercise to find something they enjoy.  Like most things, it’s important to ease into new activities and be prepared to treat an attack with medication.  It may take some trial and error, but physical activity is an important part of a healthy lifestyle. My view is that the HAE management plan developed with your health care team should ideally allow the pursuit of most activities, including various forms of exercise.  Sometimes we still hit limits, but hopefully those barriers will continue to fall away with new treatments and research.

Dr. C: Thank you, Marc. No matter what health condition we are struggling with exercise is a pathway to being the ‘best that we can be’. I am also a fan of incorporating activities with mind-body connection such as yoga and Tai chi—also wonderful stress diffusers. Bruce do you have any recommendations for our readers?

Dr. Z: We shouldn’t neglect a specific scenario where this issue is often overlooked. Parents of an affected child struggle with this question, and often end up restricting their child’s activities. There’s a natural tendency to want to “protect” children from possible harm. Surprisingly, children with HAE can usually participate in competitive sports without undue risk. Now that on-demand treatment is readily available, I would argue that the benefits of participating in sports far outweigh the risks. I encourage parents to allow their children to engage in all types of sports. Our mutual goal is to allow children with HAE to lead a normal life.

Dr. C: Thank you, hopefully everyone will now ‘get off the couch’. Grab your on demand treatment and start sweating. We look forward to your input, and will be back next ‘question of the week’.

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