#ALS
#PhysicalExercise #AerobicExercise
Amyotrophic lateral sclerosis (ALS) is a
rare,
incurable, and rapidly progressive
neurodegenerative disease, characterized by
the
degeneration of motor neurons. It leads to the
progressive paralysis of
voluntary muscles, including the
respiratory muscles, with an average life
expectancy of 3 to 5 years. While drug treatments, assisted ventilation or
artificial nutrition help alleviate certain symptoms, they
do not reverse the
overall progression of the disease. Furthermore, their
side effects (nausea, functional
limitations, dependency) often limit adherence.
In this context, physical exercise is being considered as a promising
non-pharmacological co-treatment. It could help preserve muscle function,
improve the ability to carry out daily living activities, and enhance quality
of life. However, recommendations remain cautious due to the potential risk of
muscle overuse. This study was initiated to evaluate the effectiveness of
different forms of exercise (aerobic, resistance, combined, respiratory) on
function, breathing, fatigue, and quality of life in patients with ALS.
Which exercise to slow ALS?
Twelve randomized controlled trials including 430 patients with ALS, from 8
countries, were selected. The exercises tested included aerobic, resistance,
combined, and respiratory muscle training. The analysis of effects focused on
overall function (ALSFRS), fatigue, walking test distance (WT), respiratory
strength (MIP, MEP), forced vital capacity (FVC), and peak expiratory flow
(PEF).
The results show a significant improvement in overall function, an increase in
walking distance, and an improvement in maximal expiratory pressure. On the
other hand, no significant effect was observed on fatigue, maximal inspiratory
pressure (MIP), FVC, or PEF. Subgroup analysis reveals that resistance exercise
is the most effective in improving overall function, while aerobic exercise
shows a positive impact on FVC. Respiratory training and combined programs did
not show any significant effect. No serious adverse effects were reported.
Read next: ALS: strengthening to withstand
Moving without exhaustion: a successful bet?
Amyotrophic lateral sclerosis is a progressive neurodegenerative disease,
marked by motor neuron damage and progressive loss of motor function. Given the
absence of a curative treatment, one of the current major challenges is to
identify non-pharmacological approaches capable of preserving functional
autonomy without worsening fatigue, a pervasive and disabling symptom in ALS.
This study aimed to evaluate the impact of various types of physical exercise —
aerobic, resistance, combined, and respiratory — on motor function, breathing,
and quality of life in patients with ALS. The objective was to identify
concrete and tailored approaches to improve their overall management.
The results confirm that physical exercise, when well-adjusted and moderate,
can improve certain dimensions of ALS. Resistance exercise appears particularly
effective in preserving motor function, while aerobic exercise shows specific
effects on respiratory function. These benefits are achieved without increasing
fatigue, which supports the idea of a personalized exercise program, supervised
by a multidisciplinary team, as a safe and useful component of overall
treatment.
However, several limitations must be considered and justify the need for
further research. Future, more robust studies with better follow-up and larger
samples are needed. They will have to adapt recommendations according to the
type of exercise, patient profile, and tolerance, to reliably guide clinical
practice.
Read next: Clinical stratification of patients with ALS
