When evaluating the effect of a modality such as exercise, maturation in children, the rate of progression of the disease, and the degree of weakness should be considered. The two major factors critical in producing overwork weakness are the degree of weakness at the time the exercise program is started and the intensity of the exercise training program. Exercise therapy is apparently not harmful and may be beneficial in patients with motor unit diseases if it is started early in the course of the diseases when muscle fiber degeneration is minimal, and is carried out at submaximal levels.

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