Neuromuscular diseases (NMDs) encompass a diverse group of progressive disorders characterized by muscle weakness, fatigue, and functional impairments. This review highlights the critical role of physical training in managing disability in individuals with NMDs, focusing on evidence-based interventions tailored to specific conditions. Comprehensive assessment tools, including motor function tests and patient-reported outcome measures, guide the development of individualized exercise programs. Physical activity has been shown to improve muscular strength, functional mobility, and quality of life while mitigating the risk of secondary complications such as contractures, respiratory decline, and cardiovascular issues. For muscular dystrophies, including Duchenne muscular dystrophy, Becker muscular dystrophy, limb-girdle muscular dystrophy, and facioscapulohumeral muscular dystrophy, submaximal aerobic and resistance training, combined with stretching and respiratory exercises, have demonstrated benefits when appropriately supervised. In myotonic dystrophy, moderate-intensity strength training and aerobic exercise have improved muscle function without exacerbating symptoms. Spinal muscular atrophy management benefits from standing programs, respiratory muscle training, and aerobic conditioning tailored to the patient’s motor function level. In myasthenia gravis, resistance training and interval aerobic exercise have shown promising results in enhancing physical performance and reducing fatigue. Despite the demonstrated safety and efficacy of physical training, further research is needed to refine exercise protocols and establish long-term recommendations for various NMDs. A multidisciplinary approach, involving healthcare professionals, physiotherapists, and patients, remains essential to optimize the benefits of physical activity in managing disability associated with NMDs.