CoChat
Sign Up
Cited by 178Amyotrophic Lateral Sclerosis ResearchSpinal Cord Injury ResearchNeurogenetic and Muscular Disorders Research

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

Open access
Dal Bello-Haas, Vanina, Florence, Julaine M·2013·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd005229.pub3PMC PMC6769061
Open this paper in CoChat — free accountOpen PDF

Abstract

BACKGROUND: Despite the high incidence of muscle weakness in individuals with amyotrophic lateral sclerosis (ALS) or motor neuron disease (MND), the effects of exercise in this population are not well understood. This is an update of a review first published in 2008. OBJECTIVES: To systematically review randomised and quasi-randomised studies of exercise for people with ALS or MND. SEARCH METHODS: We searched The Cochrane Neuromuscular Disease Group Specialized Register (2 July 2012), CENTRAL (2012, Issue 6 in The Cochrane Library), MEDLINE (January 1966 to June 2012), EMBASE (January 1980 to June 2012), AMED (January 1985 to June 2012), CINAHL Plus (January 1938 to June 2012), LILACS (January 1982 to June 2012), Ovid HealthSTAR (January 1975 to December 2012). We also searched ProQuest Dissertations & Theses A&I (2007 to 2012), inspected the reference lists of all papers selected for review and contacted authors with expertise in the field. SELECTION CRITERIA: We included randomised or quasi-randomised controlled trials of people with a diagnosis of definite, probable, probable with laboratory support, or possible ALS, as defined by the El Escorial criteria. We included progressive resistance or strengthening exercise, and endurance or aerobic exercise. The control condition was no exercise or standard rehabilitation management. Our primary outcome measure was improvement in functional ability, decrease in disability or reduction in rate of decline as measured by a validated outcome tool at three months. Our secondary outcome measures were improvement in psychological status or quality of life, decrease in fatigue, increase in, or reduction in rate of decline of muscle strength (strengthening or resistance studies), increase in, or reduction in rate of decline of aerobic endurance (aerobic or endurance studies) at three months and frequency of adverse effects. We did not exclude studies on the basis of measurement of outcomes. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trial quality and extracted the data. We collected adverse event data from included trials. The review authors contacted the authors of the included studies to obtain information not available in the published articles. MAIN RESULTS: We identified two randomised controlled trials that met our inclusion criteria, and we found no new trials when we updated the searches in 2012. The first, a study with overall unclear risk of bias, examined the effects of a twice-daily exercise program of moderate load endurance exercise versus "usual activities" in 25 people with ALS. The second, a study with overall low risk of bias, examined the effects of thrice weekly moderate load and moderate intensity resistance exercises compared to usual care (stretching exercises) in 27 people with ALS. After three months, when the results of the two trials were combined (43 participants), there was a significant mean improvement in the Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS) measure of function in favour of the exercise groups (mean difference 3.21, 95% confidence interval 0.46 to 5.96). No statistically significant differences in quality of life, fatigue or muscle strength were found. In both trials adverse effects, investigators reported no adverse effects such as increased muscle cramping, muscle soreness or fatigue AUTHORS' CONCLUSIONS: The included studies were too small to determine to what extent strengthening exercises for people with ALS are beneficial, or whether exercise is harmful. There is a complete lack of randomised or quasi-randomised clinical trials examining aerobic exercise in this population. More research is needed.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1002/14651858.cd005229.pub3

Cites

70 of 70 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Exercise improves motor performance in individuals with Parkinson's disease, lowers disability in multiple sclerosis, improves functionality in individuals with motor neuron disease, and improves cognitive, mood and motor recovery from TBI.

    “exercise also improves motor performance in individuals with Parkinson’s disease [153], lowers disability in multiple sclerosis [161], improves functionality in individuals with motor neuron disease [46], and improves cognitive, mood and motor recovery from TBI, although the precise timing and intensity of the beneficial exercise after TBI remain to be determined [62, 197].”

    From The neuropathology of sport (2014) · cites this paper as [46]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

5 of the 75 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. Cochrane Library Trusted evidence. Informed decisions. Better health. Cochrane Database of Systematic Reviews 5 exp Clinical Trials/ (3193) 6 (clin$ adj25 trial$).tw. (5421) 7 ((singl$ or doubl$ or treb$ or trip$) adj25 (blind$ or mask$ or dummy)).tw. (2228) 8 placebos/ (518) 9 placebo$.tw. (2496) 10 random$.tw. (12741) 11 research design/ (1676) 12 Prospective Studies/ (463) 13 meta analysis/ (108) 14 (meta?analys$ or systematic review$).tw. (1843) 15 control$.tw. (27490)

Cited by

Sorted by citations

Related

Authors
Dal Bello-Haas, V., & Florence, J. M.
Affiliations
  • McMaster University; School of Rehabilitation Science; 1400 Main Street West, 403/E Hamilton Ontario Canada L8S 1C7
  • Washington University in St. Louis (US)
Venue
Cochrane Database of Systematic Reviews
Publisher
Wiley
Published
2013-05-31
Volume
2013
Issue
5
Pages
CD005229-CD005229
ISSN
  • 1361-6137 (ISSN-L)
  • 1465-1858
DOI
10.1002/14651858.cd005229.pub3
PMC
PMC6769061
OpenAlex
W1948683193
Cited by
178
References
75
Citations by year
2026: 3 · 2025: 6 · 2024: 14 · 2023: 8 · 2022: 16 · 2021: 11 · 2020: 15 · 2019: 11 · 2018: 11 · 2017: 13 · 2016: 8 · 2015: 12 · 2014: 11 · 2013: 13 · 2012: 11
FWCI
1.91
Type
journal article
Language
en
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Neurology › Amyotrophic Lateral Sclerosis Research
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Spinal Cord Injury Research
  • Health Sciences › Medicine › Genetics › Neurogenetic and Muscular Disorders Research
Keywords
amyotrophic lateral sclerosis, motor neuron disease, exercise therapy, resistance training, aerobic exercise, functional capacity, disability, muscle strength, fatigue, quality of life, adverse effects, decline rate, El Escorial criteria, patient satisfaction
MeSH terms
Amyotrophic Lateral Sclerosis, Exercise Therapy, Humans, Physical Endurance, Quality of Life, Randomized Controlled Trials as Topic, Motor Neuron Disease, Exercise Tolerance, Muscle Weakness

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review