What guidance is available for people with epilepsy wanting to participate in sport and exercise? A narrative review

Background: This narrative review aimed to explore publicly available documents and policies that provide recommendations regarding safe sport and exercise participation for people with epilepsy. It also considered whether these documents addressed the needs of individuals with intellectual disability and other neurological conditions who have a co-occurring diagnosis of epilepsy. Method: A literature search was conducted across four electronic databases including PubMED, Embase, SPORTDiscus and Web of Science, accompanied by a hand search through Google Advanced Search. Documents were included if they were: 1) publicly available 2) produced by national and international government organisation, 3) published after 2016, 4) available in English, and 5) consisted of a full-text document. Results: A total of 11 papers were included. From the recommendations provided to the public four themes emerged, 1) general epilepsy advice, 2) guidance on what to do during participation, 3) considerations to avoid, and 4) activity specific recommendations. Eight of the papers provided recommendations to sport and exercise professionals, falling under three themes, 1) general epilepsy advice, 2) recommendations for sport and exercise professionals, and 3) key knowledge required to safely work with people with epilepsy. Of the 11 included papers, only four provided recommendations specific to people with disability. Conclusion: Findings revealed that whilst documents acknowledged risks, they did not provide strategies for risk mitigation or management to support participation in a variety of physical activity contexts. Additionally, the specific and often more complex needs of people with disability who have a co-occurring diagnosis of epilepsy were often overlooked.