Exercise and movement for children with muscle wasting conditions

It’s important to speak to your child’s physiotherapy team about which exercises they recommend. They can help make a plan that suits your child’s condition and energy levels. The team will also monitor your child and adjust the plan based on any changes to their condition over time.

It’s important for your child to do some form of physical activity each day. Finding activities they enjoy means they’ll be more open to doing this.

Regular physical activity can help your child with:

• Slowing muscle weakness
• Joint range of movement (ROM)
• Heart and lung health
• Overall health
• Mood and confidence
• Sleep quality

There may be times when your child finds it difficult to exercise. This could be because of tiredness, illness, low motivation or other reasons. But try to avoid long periods of inactivity. This can lead to increased muscle weakness and heart problems, which make it harder to exercise. Even small daily activities can help your child stay active, such as travelling to school, playing, or moving around the house.

The UK government has physical activity guidelines for disabled children and young people aged 5-18 years. They recommend 20 minutes of physical activity a day. This can be broken down into several smaller chunks of activity. They also advise doing strength and balance exercises three times a week (where possible).

Getting advice

It’s safe for children with muscle wasting conditions to exercise, but in some cases, strenuous exercise is not recommended. Strengthening activities, like weight training, may need to be done carefully by children with certain conditions to avoid muscle damage. It’s important to get professional advice – your doctor or physiotherapist can let you know if there’s particular types of exercise your child should avoid.

If your child’s condition is linked to heart problems, they may need to see a heart specialist (cardiologist) first.

Before recommending an exercise programme, the physiotherapy team will consider your child’s:

• Muscle wasting condition
• Symptoms, such as fatigue or pain
• Range of movement (ROM)
• Heart and lung health
• Age
• Activity levels in the past
• Activity levels now

Pacing and safety

To help your child stay safe and avoid muscle damage or fatigue, it’s important they:

• Start with short sessions and slowly build up
• Rest when they need to
• Stop if they feel pain, shortness of breath, or excessive fatigue
• Avoid long sessions where their body is unbalanced — for example, using a scooter that puts more strain on one side
• Avoid certain high-impact activities, like trampolining, which work the muscles in a way that cause muscle damage
• Avoid exercises with heavy weights or high resistance that might strain muscles
• Have supervision if needed

Check with your doctor or physiotherapy team before starting any new form of exercise.

When exercise feels difficult

Exercise can feel difficult or frustrating for some children with muscle wasting conditions. They might get tired more easily, find some movements harder or feel self-conscious if they cannot keep up with others. Some days, they may not want to join in, and that’s okay.

It’s important to be patient and encouraging. Try to focus on what your child enjoys and what feels manageable for them. Even small movements or short bursts of activity can make a difference. Let them set the pace, celebrate their efforts, and reassure them.

If your child is finding their exercise plan too difficult, speak to their physiotherapy team. They may be able to suggest changes, adapt activities, or help find something that better suits your child’s current energy levels and what they enjoy. Exercise can be incorporated in play and should aim to be fun.

The physiotherapy team may recommend aerobic, strength, and stretching exercises. This will depend on what suits your child.

Aerobic exercises

Aerobic exercises make you breathe faster. They also make your heart and muscles work harder. They’re helpful for many children with muscle wasting conditions.
Low impact exercises are best because they do not put much stress on the joints. Examples include walking and swimming.

Taking part in PE lessons at school is a good way for your child to stay active with friends. The activities may need to be adapted to suit your child, so it’s important to discuss this with school staff. Some activities might not be possible, and an alternative should be found.

Strength exercises

These exercises can help prevent or slow the loss of muscle strength. If the physiotherapy team think strength exercises may benefit your child, they will keep the weights or resistance light. They may advise doing more repetitions as your child gets used to the exercises.

Stretching exercises

If your child has tight joints, the physiotherapy team may give them stretches to do at home. These may be self-stretches they do on their own, or active-assisted stretches where someone helps them. Only do stretches recommended by your physiotherapy team. Stretches need to be done regularly to work well.

The team may also recommend orthotics to help your child. These can include splints and spinal braces.

Children who are mobile

If your child can stand or walk, good exercises include:

• Cycling using a bike or trike
• Swimming
• Horse riding
• Gentle walks or short hikes
• Dancing
• Yoga
• Soft play

Children who are less mobile

If your child has limited mobility or uses a wheelchair, it’s important for them to keep active. They could try:

• Swimming
• Wheelchair sports such as football or basketball
• Boccia (a seated ball game similar to bowls)
• Exercise bands
• Chair-based or mat-based yoga or Pilates
• Seated exercises and games such as target throwing
• Self-propelling a manual wheelchair

Hydrotherapy (exercise in warm water) can also be helpful. Ask your physiotherapist or GP if it’s suitable for your child and available in your area.

The charity WheelPower has a list of wheelchair sports and events.

Every child can be active in their own way. Try to find activities that your child enjoys and that suit their ability. Regular movement, even small amounts, can have a big impact on health and confidence.

It’s also important to encourage your child to try everyday activities by themselves before helping them. This can include things like moving from lying down to sitting, transferring, or dressing. These are all active movements that help build independence – even if they take a little longer.