This is inevitable. Only the most minor neurological changes would leave this undisturbed. The dysfunction of normal movement necessitates uneconomical substitute movements which undermine exercise tolerance. If this is not apparent because the patient is relatively immobile due to his disorder, his exercise tolerance will be reduced because of lack of exercise.
The chair bound patient who is wheeled about by relatives, quickly loses such exercise tolerance as he had because his circulatory and respiratory mechanisms are not put to any stress. Added to this he may be inclined to overeat and will put on unnecessary fat which will further reduce his condition of tolerance. Any patient whose respiratory capacity is reduced must have diminished exercise tolerance. Since there are many reasons for this problem they should be noted by the physiotherapist who may be able to minimise them in…
