Amyotrophic lateral sclerosis, physical exercise, trauma and sports: Results of a population-based pilot case-control study

Abstract

Our objective was to investigate exposure to physical exercise and trauma in patients with amyotrophic lateral sclerosis (ALS) compared to the general population. Previous studies in this area have yielded conflicting results. Using population-based ALS registries from Italy, the UK and Ireland, newly diagnosed patients with definite, probable or possible ALS were enrolled in a case-control study with two age- and sex-matched controls for each patient. Source, intensity and duration of physical activity and history of trauma were recorded. We here present the results of a pilot investigation. We studied 61 patients and 112 controls. Forty-one per cent of cases and 17.0% of controls (p = 0.001) had blue-collar occupations; 13.1% versus 3.6% reported strenuous physical activity at work (p = 0.05). Compared with controls, ALS patients had a longer exposure to work-related (10.7 vs. 7.3 years; p = 0.02) and sport-related physical exercise (9.6 vs. 5.2 years; p = 0.005). Three patients (0 controls) reported professional sports (p < 0.04). Traumatic events were similar. Blue collar occupation (OR 4.27; 95% CI 1.68–10.88) and duration of sport-related physical exercise (OR 1.03; 95% CI 1.00–1.05) were independent variables in multivariate analysis. We concluded that ALS is associated with physical exercise but not with traumatic events.

Clinical features and lifestyle of patients with amyotrophic lateral sclerosis in Campania: brief overview of an Italian database

“…Our preliminary data about sport further support previous evidences on correlation between ALS and physical activity, particularly for soccer [11,13,14], where an absolute increased risk of developing ALS or an anticipation effect have been reported.…”

“…The upper limbs onset was much more common in skilled agricultural and forestry workers (58.3%), indicating that probably a very intense manual labour might support the onset of the disease [11]. Although toxic etiopathogenesis has not yet been clarified in ALS, one might hypothesize a possible synergistic effect between the toxicity of various substances, such as pesticides [3,5,6], physical activity [11] or hypoxia [12], and the neurodegenerative process.…”

“…Although toxic etiopathogenesis has not yet been clarified in ALS, one might hypothesize a possible synergistic effect between the toxicity of various substances, such as pesticides [3,5,6], physical activity [11] or hypoxia [12], and the neurodegenerative process.…”

Prevalence of Amyotrophic Lateral Sclerosis — United States, 2012–2013

“…Military service continues to be a possible risk factor for ALS; however, no strong evidence has been found linking etiology with service (12)(13)(14)(15). Other possible risk factors such as nutritional intake, use of statins, exposure to viral agents, vigorous physical activity, and trauma also have been identified as possible risk factors (12,(16)(17)(18)(19)(20)(21).…”

The Role of Immune and Inflammatory Mechanisms in ALS

“…These have found somewhat differing results [24,52,53] but have found associations with genes for neurotransmitter release, genes associated with familial spastic paraparesis and genes associated with frontotemporal dementia. Environmental factors linked to ALS include cigarette smoking [54], occupational exposures particularly to toxins and metals, exercise [55,56] and education [57][58][59][60].…”