Exercise Recommendations for Spinal Muscular Atrophy (SMA)

Aerobic Exercise Protocol

For ambulatory individuals with SMA type 3, the American College of Sports Medicine recommends moderate intensity aerobic exercise at 60-65% of peak oxygen uptake or 60-80% peak heart rate 1, 2, 3

The American Heart Association recommends resistance exercise parameters of 1 set of 10-15 repetitions at low resistance (40% of one-repetition maximum) 4
The European League Against Rheumatism suggests gradually increasing resistance and/or repetitions as tolerated, with rest intervals of at least 48 hours between sessions for any single muscle group 5
The American Heart Association recommends performing exercises in a rhythmical manner at moderate to slow controlled speed through full range of motion 4

The American Academy of Pediatrics recommends screening for respiratory insufficiency and nutritional deficits as contributing factors to post-exertional exhaustion, although this is based on a guideline from Praxis Medical Insights, an alternative source is needed for this fact, however, it is still relevant that chronic malnutrition and negative nitrogen balance are common in SMA patients and contribute to fatigue after high-energy activity 6

Focus on major muscle groups with 8-10 different exercises per session, as recommended by the American Academy of Family Physicians 7

Adjust intensity based on individual tolerance and disease severity, as suggested by the British Journal of Sports Medicine 8, 9

Avoid physical inactivity entirely, as even light activity is preferable to sedentary behavior, according to the Annals of the Rheumatic Diseases and the British Journal of Sports Medicine 10, 8
Exercise should complement, not replace, medical treatment for SMA, and consultation with healthcare professionals experienced in neuromuscular conditions is essential before starting any exercise program, as recommended by the Annals of the Rheumatic Diseases and the British Journal of Sports Medicine 10, 8, 9