The Effect of Exercise Therapy on Amyotrophic Lateral Sclerosis Patients: A Literature Review
DOI:
https://doi.org/10.35451/7sd4k345Keywords:
physical activity, Aerobic, Exercise therapyAbstract
Weakness caused by motor neuron degeneration in Amyotrophic lateral sclerosis (ALS) can result in avoidance of physical activity, resulting in deconditioning and decreased health-related quality of life. The literature review that the author obtained from previous research has a role in shaping the character of thinking in this study. The articles used in this study were obtained from three databases, namely PubMed, Science Direct and Google Scholar. The keywords used during the search were ALS, Exercise, Therapy, Exercise Therapy, Amyotrophic Lateral Sclerosis, carried out a maximum of 2019. Out of 10 articles, there are 7 articles stated that aerobic exercise therapy and strength training had a positive effect on ALS. While 3 other articles showed changes but were not significant. The results of this preliminary ALSFRS-R study support the safety and feasibility of 12 sessions of supine whole-body stepping in individuals with ALS. This respiratory EMST training program was well tolerated and resulted in positive changes in respiratory and bulbar function in ALS. Our prospective CPET study measured significantly reduced exercise capacity in ALS via non-invasive CPET. Genetically predicted physical activity was not significantly associated with risk of neurodegenerative disorders. A 12-week combined aerobic and strength training program was significantly superior to freezing alone in improving respiratory function, mobility, and well-being in ambulatory ALS patients.
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[1]. Genge A, Wainwright S, Vande Velde C. Amyotrophic lateral sclerosis: exploring pathophysiology in the context of treatment. Vol. 25, Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration. Taylor and Francis Ltd.; 2024. p. 225–36.
[2]. Wolfson C, Gauvin D, Ishola F, Oskoui M. The Global Prevalence and Incidence of Amyotrophic Lateral Sclerosis: A Systematic Review (P2-5.023). Neurology [Internet]. 2023 Apr 25 [cited 2025 Jul 12];100(17_supplement_2):3346. Available from: https://www.neurology.org/doi/abs/10.1212/WNL.0000000000203202
[3]. Xu R. Overview of nomenclature and diagnosis of amyotrophic lateral sclerosis. Ann Med [Internet]. 2024 Dec 31 [cited 2025 Jul 12];56(1). Available from: https://www.tandfonline.com/doi/full/10.1080/07853890.2024.2422572
[4]. Barberio J, Lally C, Kupelian V, Hardiman O, Flanders WD. Estimated Familial Amyotrophic Lateral Sclerosis Proportion: A Literature Review and Meta-analysis. Neurol Genet. 2023 Nov 30;9(6).
[5]. Wolfson C, Gauvin D, Ishola F, Oskoui M. The Global Prevalence and Incidence of Amyotrophic Lateral Sclerosis: A Systematic Review (P2-5.023). Neurology. 2023 Apr 25;100(17_supplement_2).
[6]. Longinetti E, Fang F. Epidemiology of amyotrophic lateral sclerosis: an update of recent literature. Curr Opin Neurol [Internet]. 2019 Oct 1 [cited 2025 Jan 12];32(5):771. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6735526/
[7]. Faried A, Saputra PAE, Dhuha A, Arifin MZ. Amyotrophic Lateral Sclerosis: First Case Report in Department of Neurosurgery, Faculty of Medicine, Universitas Padjadjaran, Bandung. International Journal of Integrated Health Sciences [Internet]. 2019 May 23 [cited 2025 Jul 12];7(1):56–60. Available from: https://journal.fk.unpad.ac.id/index.php/ijihs/article/view/1237
[8]. Brotman RG, Moreno-Escobar MC, Joseph J, Munakomi S, Pawar G. Amyotrophic Lateral Sclerosis. StatPearls [Internet]. 2024 Feb 12 [cited 2025 Jan 25]; Available from: https://www.ncbi.nlm.nih.gov/books/NBK556151/
[9]. Ortega-Hombrados L, Molina-Torres G, Galán-Mercant A, Sánchez-Guerrero E, González-Sánchez M, Ruiz-Muñoz M. Systematic review of therapeutic physical exercise in patients with amyotrophic lateral sclerosis over time. Int J Environ Res Public Health. 2021 Feb 1;18(3):1–15.
[10]. Meng L, Li X, Li C, Tsang RCC, Chen Y, Ge Y, et al. Effects of exercise in patients with amyotrophic lateral sclerosis: A systematic review and meta-analysis. Am J Phys Med Rehabil. 2020 Sep 1;99(9):801–10.
[11]. Plowman EK, Tabor‐Gray L, Rosado KM, Vasilopoulos T, Robison R, Chapin JL, et al. Impact of expiratory strength training in amyotrophic lateral sclerosis: Results of a randomized, sham‐controlled trial. Muscle Nerve [Internet]. 2019 Jan 29 [cited 2025 Jul 12];59(1):40–6. Available from: https://onlinelibrary.wiley.com/doi/10.1002/mus.26292
[12]. Casal-Moldes Á, Campo-Prieto P, Rodríguez-Fuentes G, Cancela-Carral JM. Multisensory Stimulation in Amyotrophic Lateral Sclerosis Disease: Case Report of an Innovative Proposal through Immersive Virtual Reality. Applied Sciences 2024, Vol 14, Page 9238 [Internet]. 2024 Oct 11 [cited 2025 Jul 12];14(20):9238. Available from: https://www.mdpi.com/2076-3417/14/20/9238/htm
[13]. Sivaramakrishnan A, Madhavan S. Recumbent stepping aerobic exercise in amyotrophic lateral sclerosis: a pilot study. Neurological Sciences. 2019 May 1;40(5):971–8.
[14]. Plowman EK, Gray LT, Chapin J, Anderson A, Vasilopoulos T, Gooch C, et al. Respiratory Strength Training in Amyotrophic Lateral Sclerosis: A Double-Blind, Randomized, Multicenter, Sham-Controlled Trial. Neurology. 2023 Apr 11;100(15):E1634–42.
[15]. He J, Fu J, Zhao W, Ren C, Liu P, Chen L, et al. Exercise Physiology Impairments of Patients With Amyotrophic Lateral Sclerosis: Cardiopulmonary Exercise Testing Findings. Front Physiol [Internet]. 2022 Mar 14 [cited 2025 Jul 12];13:792660. Available from: www.frontiersin.org
[16]. Lakkadsha TM, Timothy R, Saifee SSH, Lalwani SS. Assorted ways for gait rehabilitation for a patient with amyotrophic lateral sclerosis. Med Sci. 2022 Jun 3;26(124):1–7.
[17]. Wu PF, Lu H, Zhou X, Liang X, Li R, Zhang W, et al. Assessment of causal effects of physical activity on neurodegenerative diseases: A Mendelian randomization study. J Sport Health Sci [Internet]. 2021 Jul 1 [cited 2025 Jul 12];10(4):454–61. Available from: https://www.sciencedirect.com/science/article/pii/S2095254621000089?via%3Dihub
[18]. Kalron A, Mahameed I, Weiss I, Rosengarten D, Balmor GR, Heching M, et al. Effects of a 12-week combined aerobic and strength training program in ambulatory patients with amyotrophic lateral sclerosis: a randomized controlled trial. J Neurol [Internet]. 2021 May 1 [cited 2025 Jul 12];268(5):1857–66. Available from: https://link.springer.com/article/10.1007/s00415-020-10354-z
[19]. Souza AA De, Silva ST Da, Pondofe KDM, Resqueti VR, Melo LP De, Valentim RADM, et al. Remote versus face-to-face home-based exercise programme in people with amyotrophic lateral sclerosis: protocol for a randomised clinical trial. BMJ Open [Internet]. 2022 May 1 [cited 2025 Jul 12];12(5):e056323. Available from: https://bmjopen.bmj.com/content/12/5/e056323
[20]. Zucchi E, Vinceti M, Malagoli C, Fini N, Gessani A, Fasano A, et al. High-frequency motor rehabilitation in amyotrophic lateral sclerosis: a randomized clinical trial. Ann Clin Transl Neurol. 2019 May 1;6(5):893–901.
[21]. van Groenestijn AC, Schröder CD, van Eijk RPA, Veldink JH, Kruitwagen-van Reenen ET, Groothuis JT, et al. Aerobic exercise therapy in ambulatory patients with ALS: a randomized controlled trial. Neurorehabil Neural Repair. 2019 Feb 1;33(2):153–64.
[22]. Steyn FJ, Li R, Kirk SE, Tefera TW, Xie TY, Tracey TJ, et al. Altered skeletal muscle glucose-fatty acid flux in amyotrophic lateral sclerosis Running title: Altered glucose-fatty acid flux in ALS. Brain Commun [Internet]. 2020;2:154. Available from: https://academic.oup.com/braincomms/advance-article/doi/10.1093/braincomms/fcaa154/5911097
[23]. Huang C, Yan S, Zhang Z. Maintaining the balance of TDP-43, mitochondria, and autophagy: a promising therapeutic strategy for neurodegenerative diseases. Transl Neurodegener. 2020 Dec 1;9(1).
[24]. Obrador E, Salvador-Palmer R, López-Blanch R, Jihad-Jebbar A, Vallés SL, Estrela JM. The link between oxidative stress, redox status, bioenergetics and mitochondria in the pathophysiology of als. Vol. 22, International Journal of Molecular Sciences. MDPI; 2021.
[25]. Fenili G, Scaricamazza S, Ferri A, Valle C, Paronetto MP. Physical exercise in amyotrophic lateral sclerosis: a potential co-adjuvant therapeutic option to counteract disease progression. Front Cell Dev Biol [Internet]. 2024 [cited 2025 Jul 12];12. Available from: https://pubmed.ncbi.nlm.nih.gov/39156974/
[26]. Tsitkanou S, Gatta P Della, Foletta V, Russell A. The Role of Exercise as a Non-pharmacological Therapeutic Approach for Amyotrophic Lateral Sclerosis: Beneficial or detrimental? Vol. 10, Frontiers in Neurology. Frontiers Media S.A.; 2019.
[27]. Ren S, Che X, Hu S, Feng X, Zhang J, Shi P. The effect of exercise intervention on amyotrophic lateral sclerosis: a systematic review and meta-analysis. Vol. 16, Frontiers in Neurology. Frontiers Media SA; 2025.
[28]. Rahmati M, Malakoutinia F. Aerobic, resistance and combined exercise training for patients with amyotrophic lateral sclerosis: a systematic review and meta-analysis. Vol. 113, Physiotherapy (United Kingdom). Elsevier Ltd; 2021. p. 12–28.
[29]. Jawdat O, Rucker J, Nakano T, Takeno K, Statland J, Pasnoor M, et al. Resistance exercise in early-stage ALS patients, ALSFRS-R, Sickness Impact Profile ALS-19, and muscle transcriptome: a pilot study. Sci Rep. 2024 Dec 1;14(1).
[30]. Laura Ritchie KJL hampton, NBALMETGGWANONC and MT. Amyotrophic Lateral Sclerosis [Internet]. 2019 [cited 2025 Jan 25]. Available from: https://www.physio-pedia.com/Amyotrophic_Lateral_Sclerosis
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