Systematic Review of Therapeutic Physical Exercise in Patients with Amyotrophic Lateral Sclerosis over Time

Abstract

Background: the main objective of this study was to analyze the potential short-, medium- and long-term effects of a therapeutic physical exercise (TFE) programme on the functionality of amyotrophic lateral sclerosis (ALS) patients, measured with the Revised Amyotrophic Lateral Sclerosis Functional Scale (ALSFRS-R) scale. Methods: a systematic review of the PubMed, SCOPUS, Cochrane, Scientific Electronic Library Online (Scielo), Physiotherapy Evidence Database (PEDro), Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Medical Literature Analysis and Retrieval System Online (MEDline) databases was carried out. The information was filtered using the following Medical Subjects Heading (MeSH) terms: “Amyotrophic lateral sclerosis”, “Physical Therapy”, and “Physical and Rehabilitation Medicine”. The internal validity of the selected documents was evaluated using the PEDro scale. The study included clinical trials published in the last 5 years in which one of the interventions was therapeutic physical exercise in patients with ALS, using the ALSFRS-R as the main outcome variable and functional variables as secondary variables. Results: 10 clinical trials were analyzed, with an internal validity of 5–7 points. The TFE groups showed significant short-, medium- and long-term differences, obtaining a mean difference of 5.8 points compared to the 7.6 points obtained by the control groups, at six months, measured with ALSFRS-R. In addition, the participants showed significant improvements in functional abilities in the short, medium and long terms. Conclusions: Therapeutic physical exercise could contribute to slowing down the deterioration of the musculature of patients with ALS, thus facilitating their performance in activities of daily living, based on the significant differences shown by these individuals in the short, medium and long term both in subjective perception, measured with ALSFRS-R, and functional capacities.

Convergent pathways of the gut microbiota–brain axis and neurodegenerative disorders

“…In ALS, a systematic review and meta-analysis including 322 patients showed increased functionality and vital capacity with no effect on muscle strength or quality of life [ 195 ]. A more recent systematic review corroborated the effect of exercise on functional abilities in patients with MS in the short, medium and long terms [ 201 ]. In the context of HD, a preclinical model of HD exercise was able to delay the onset of the disease and cognitive impairment [ 202 ].…”

Metabolic Remodeling in Skeletal Muscle Atrophy as a Therapeutic Target

“…However, in humans, research data are less clear. Overall, it seems that the best option to prevent the onset of fatigue and see improvements in ALS patients is an exercise of moderate intensity and not very high frequency, combining strength and aerobic endurance [ 121 ].…”

Mixed Comparison of Different Exercise Interventions for Function, Respiratory, Fatigue, and Quality of Life in Adults With Amyotrophic Lateral Sclerosis: Systematic Review and Network Meta-Analysis

“…For example, in 2018, a randomized controlled trial conducted by Clawson's team demonstrated that exercise programs contained resistance, endurance, and stretching (or range of motion) exercises are safe to be performed with the specified regimen without any worsening of outcomes as related to ALS function and can be tolerated showing high compliance over a long term (Clawson et al, 2018 ). A systematic review published in 2021 identified that therapeutic physical exercise could contribute to slowing down the deterioration of the musculature of patients with ALS and facilitating the performance in daily life activities in the short-, medium, and long term (Ortega-Hombrados et al, 2021 ). In addition, an improved overall functional score, muscle strength, and quality of life in ALS patients had been reported following a period of exercise intervention (Jensen et al, 2017 ).…”