A Systematic Review of the Effect of Moderate Intensity Exercise on Function and Disease Progression in Amyotrophic Lateral Sclerosis

  title={A Systematic Review of the Effect of Moderate Intensity Exercise on Function and Disease Progression in Amyotrophic Lateral Sclerosis},
  author={Andrew Lui and Nancy Byl},
  journal={Journal of Neurologic Physical Therapy},
  • A. LuiN. Byl
  • Published 1 June 2009
  • Medicine
  • Journal of Neurologic Physical Therapy
Background and Purpose: Amyotrophic lateral sclerosis (ALS) is an idiopathic disease of adults affecting upper and lower motor neurons. In one to four years, progressive weakness, spasticity, and respiratory insufficiency compromise independence and survival. Current medical treatment is limited to medication and supportive care. The benefit and harm of moderate physical exercise are controversial. This review examined current research related to moderate exercise for maintaining independence… 

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Exercise training seems to be safe and feasible in HD patients, however, current knowledge is mainly based on short, small-scale studies and it cannot be transferred to all HD patients so longer-term interventions with larger HD patient cohorts are necessary to draw firm conclusions about the potentially positive effects of exercise training.

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The current results suggest that the positive effect of muscle strengthening exercise is greater at the early stage and may be maintained in patients with bulbar type ALS, and improvement can be achieved approximately 1 year after onset and in Patients with an ALSFRS-R score of 40 points or more.

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A single trial performed was too small to determine whether individualised moderate intensity endurance type exercises for the trunk and limbs are beneficial or harmful and no other medical, surgical or alternative treatment and therapy has been evaluated in a randomized fashion in this patient population.

Therapeutic exercise for people with amyotrophic lateral sclerosis or motor neuron disease.

There is a complete lack of randomised or quasi-randomised clinical trials examining aerobic exercise in this population and more research is needed to determine to what extent strengthening exercises for people with ALS are beneficial, or whether exercise is harmful.

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The current literature on exercise and motor neuron disease is reviewed, focusing on rodent and human studies to define the proper type, intensity, and duration of exercise necessary to enhance neuron survival as well discuss current mechanistic studies to further define the exercise-mediated pathways of neuroprotection.

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