The DOI matches its Crossref record; 35 of the 35 references it cites were found in a registry or an index.
Systematic Review of Therapeutic Physical Exercise in Patients with Amyotrophic Lateral Sclerosis over Time
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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.
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“These beneficial changes underscore the importance of exercise in preventing and slowing the progression of ageing as well as neurodegenerative diseases.504–508”
From Antiageing strategy for neurodegenerative diseases: from mechanisms to clinical advances (2025) · cites this paper as [505]
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Cites
Reliability of the PEDro Scale for Rating Quality of Randomized Controlled Trials
Maher, C. G., Sherrington, C., Herbert, R. D., Moseley, A. M., & Elkins, M. (2003) · Physical Therapy · doi:10.1093/ptj/83.8.713 · Cited by 4,808 · cited 2×
“, 1 point per item), thus points were obtained based on compliance with the requirements of each particular item [8].”
MethodLatimer‐Cheung, A. E., Pilutti, L. A., Hicks, A. L., Ginis, K. A. M., Fenuta, A. M., MacKibbon, K. A., & Motl, R. W. (2013) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2013.04.020 · Cited by 619 · cited 1×
“studied patients with ALS—moderate intensity, twice per week and aerobic skills combined with strength exercise [21].”
BackgroundMultidisciplinary rehabilitation for adults with multiple sclerosis
Khan, F., Turner‐Stokes, L. F., Ng, L., Kilpatrick, T. J., & Amatya, B. (2007) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006036.pub2 · Cited by 314
Stroud, N. M., & MINAHAN, C. L. (2009) · Health and Quality of Life Outcomes · doi:10.1186/1477-7525-7-68 · Cited by 164 · cited 1×
“Although, as has been seen in the case of multiple sclerosis, the mechanisms related to fatigue and corticospinal function are altered by the abnormalities in the CNS causing these neurological diseases, the response to exercise and fatigue seems to be different from that in healthy subjects [31].”
Ferreira, G. D., Costa, A. C. C., Plentz, R. D. M., Coronel, C. C., & Sbruzzi, G. (2016) · Physiotherapy · doi:10.1016/j.physio.2016.01.002 · Cited by 114 · cited 1×
“This shows the importance of cardiovascular training in these patients, since the respiratory muscles in more advanced stages of the disease are severely affected [30].”
BackgroundLunetta, C., Lizio, A., Sansone, V., Cellotto, N. M., Maestri, E., Bettinelli, M., Gatti, V., Melazzini, M. G., Meola, G., & Corbo, M. (2015) · Journal of Neurology · doi:10.1007/s00415-015-7924-z · Cited by 98
A randomized controlled trial of resistance and endurance exercise in amyotrophic lateral sclerosis
Clawson, L., Cudkowicz, M., Krivickas, L. S., Brooks, B. R., Sanjak, M., Allred, P., Atassi, N., Swartz, A., Steinhorn, G., Uchil, A., et al. (2017) · Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration · doi:10.1080/21678421.2017.1404108 · Cited by 77
Physical therapy for individuals with amyotrophic lateral sclerosis: current insights
Bello-Haas, V. P. M. D. (2018) · Degenerative Neurological and Neuromuscular Disease · doi:10.2147/dnnd.s146949 · Cited by 77 · cited 1×
“This fact supports the theory that training must be balanced between muscle overwork and underwork [22].”
BackgroundExercise and amyotrophic lateral sclerosis
de Almeida, J. P. L., Silvestre, R., Pinto, A. C., & de Carvalho, M. A. (2012) · Neurological Sciences · doi:10.1007/s10072-011-0921-9 · Cited by 69 · cited 1×
“It is even inferred that these two aspects could influence factors such as appetite, sleep or mood [29].”
BackgroundMerico, A., Cavinato, M., Gregorio, C., Lacatena, A., Gioia, E., Piccione, F., & Angelini, C. I. (2018) · European Journal of Translational Myology · doi:10.4081/ejtm.2018.7278 · Cited by 68 · cited 7×
“However, in both of the aforementioned studies, the distance in the 6MWT was greater after 1 month [11,16].”
BackgroundResultInfluentialMancuso, R., Martínez‐Muriana, A., Leiva-Rodríguez, T., Gregorio, D., Ariza, L., Morell, M., Esteban‐Pérez, J., García‐Redondo, A., Calvo, A. C., Atencia-Cibreiro, G., et al. (2016) · Neurobiology of Disease · doi:10.1016/j.nbd.2016.07.023 · Cited by 57 · cited 1×
“Prior to this, the so-called recruitment by collateral outbreak takes place, which is caused by muscle cells without neurological damage [20].”
BackgroundBrown, D. G., Shorter, J., & Wobst, H. J. (2019) · Bioorganic & Medicinal Chemistry Letters · doi:10.1016/j.bmcl.2019.126942 · Cited by 53 · cited 1×
“Amyotrophic lateral sclerosis (ALS) is a disease of the central nervous system (CNS) and is characterized by a progressive involution of motor neurons in the cortex of the brain (upper motor neurons) [1].”
BackgroundThe Role of Moderate Aerobic Exercise as Determined by Cardiopulmonary Exercise Testing in ALS
Braga, A. C., Pinto, A. C., Pinto, S., & de Carvalho, M. A. (2018) · Neurology Research International · doi:10.1155/2018/8218697 · Cited by 48 · cited 5×
“Some of the therapeutic physical exercise interventions consisted of aerobic exercise [9,10], moderate-high-intensity strength and endurance exercises [5,11–13], functional training or stretching [14,15].”
BackgroundResultInfluentialMultidisciplinary rehabilitation for adults with multiple sclerosis
Khan, F., Turner‐Stokes, L. F., Ng, L., Abrahamson, S. J., & Kilpatrick, T. J. (2006) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006036 · Cited by 45
Spanish adaptation of the revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R)
Campos, T. S., Rodríguez-Santos, F., Esteban‐Pérez, J., Cordero-Vázquez, P., Pardina, J. S. M., & Carmona, A. C. (2010) · Amyotrophic Lateral Sclerosis · doi:10.3109/17482968.2010.489115 · Cited by 43
Ferri, A., Lanfranconi, F., Corna, G., Bonazzi, R., Marchese, S., Magnoni, A., & Tremolizzo, L. (2019) · Frontiers in Physiology · doi:10.3389/fphys.2019.01537 · Cited by 41 · cited 5×
“It seems that, within 3 months, significant differences begin to appear between the groups treated with therapeutic exercise and those treated with passive conventional treatment [12,15,17] (Tables 3 and 4).”
BackgroundResultInfluentialAerobic Exercise Therapy in Ambulatory Patients With ALS: A Randomized Controlled Trial
van Groenestijn, A. C., Schröder, C. D., van Eijk, R. P. A., Veldink, J. H., Reenen, E. T. K., Groothuis, J. T., Grupstra, H. F., Tepper, M., van Vliet, R. O., Visser‐Meily, J. M. A., et al. (2019) · Neurorehabilitation and neural repair · doi:10.1177/1545968319826051 · Cited by 38 · cited 3×
“, (2019) [17] 57 (32) G1 = AET: 27 (10) G2 = UC: 30 (22) G1: 60.”
BackgroundMethodEvolución de pacientes con esclerosis lateral amiotrófica atendidos en una unidad multidisciplinar
Garrido, F. J. R. D. R., Guevara, C. O., Gallego, I. S., Valiente, B. S. J., Recuerda, A. S., Mendieta, M. A. G., Arpa, J., & Tejedor, E. D. (2011) · Neurología · doi:10.1016/j.nrl.2011.01.021 · Cited by 33 · cited 1×
“This fact did not occur in the rest of the patients and it may indicate that the behavior of the pathology, which decreased at 1 month, could return to the normal level of affectation in the medium term, since it is difficult to maintain such high score levels in a disease that is characterized by the early degenerati…”
BackgroundKristensen, R., Bostock, H., Tan, S. V., Witt, A. H., Fuglsang‐Frederiksen, A., Qerama, E., Andersen, H., & Tankişi, H. (2019) · Clinical Neurophysiology · doi:10.1016/j.clinph.2019.04.713 · Cited by 33 · cited 1×
“In fact, there are studies that focus precisely on the recovery cycles of muscle speed in relation to the number of motor units and the changes that occur in sickness [33].”
BackgroundKitano, K., Asakawa, T., Kamide, N., Yorimoto, K., Yoneda, M., Kikuchi, Y., Sawada, M., & Komori, T. (2018) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2018.02.015 · Cited by 31 · cited 5×
“, (2018) [14] 105 G1 = Home-ex: 21 (15) G2 = Control: 84 G1: 62.”
BackgroundInfluentialExercise Interventions for Individuals With Neurological Disorders
Lai, C., Chen, H., Liou, T., Li, W., & Chen, S.-C. (2019) · American Journal of Physical Medicine & Rehabilitation · doi:10.1097/phm.0000000000001247 · Cited by 30 · cited 1×
“Both the number and frequency of falls decreased in other neurodegenerative pathologies (such as Parkinson’s disease) thanks to a programme of therapeutic physical exercise [27].”
BackgroundHigh‐frequency motor rehabilitation in amyotrophic lateral sclerosis: a randomized clinical trial
Zucchi, E., Vinceti, M., Malagoli, C., Fini, N., Gessani, A., Fasano, A., Rizzi, R., Sette, E., Cavazza, S., Fiocchi, A., et al. (2019) · Annals of Clinical and Translational Neurology · doi:10.1002/acn3.765 · Cited by 28
Lisle, S. J., & Tennison, M. (2015) · Current Sports Medicine Reports · doi:10.1249/jsr.0000000000000122 · Cited by 26 · cited 1×
“Even sedentary patients can show better progress than those who excessively reach fatigue [28].”
BackgroundAlves, W. M. G. D. C., Alves, T. G. G., Ferreira, R. M., de Lima, T. A., Pimentel, C. P., de Sousa, E. C., Abrahin, O., & Alves, E. A. C. (2019) · The Journal of Sports Medicine and Physical Fitness · doi:10.23736/s0022-4707.19.09509-4 · Cited by 24 · cited 1×
“The result was that the older people who underwent active neurorehabilitation looked significantly better [26].”
BackgroundRecumbent stepping aerobic exercise in amyotrophic lateral sclerosis: a pilot study
Sivaramakrishnan, A., & Madhavan, S. (2019) · Neurological Sciences · doi:10.1007/s10072-019-03736-3 · Cited by 19 · cited 6×
“However, in both of the aforementioned studies, the distance in the 6MWT was greater after 1 month [11,16].”
BackgroundResultInfluentialKato, N., Hashida, G., & Konaka, K. (2018) · Medicine · doi:10.1097/md.0000000000011145 · Cited by 18 · cited 2×
“In this sense, having a tool that allows studying the status and evolution of the patient with ALS is very important [6,7]: The Revised Amyotrophic Lateral Sclerosis Functional Scale (ALSFRS-R) is a measure used to assess the status and progression of patients with ALS.”
BackgroundMethodEl deporte para atender la diversidad: deporte adaptado y deporte inclusivo
Vázquez, F. J. H. (2000) · Apunts Educación Física y Deportes · Cited by 17
Dimensiones de la condición física saludable: evolución según edad y género
Casterad, J. Z., Ostaríz, E. S., & Lanaspa, E. G. (2005) · Revista Internacional de Medicina y Ciencias de la Actividad Física y del Deporte · Cited by 16
Tratamiento neurorrehabilitador de la esclerosis lateral amiotrófica
López, F. O., Terré, R., Espinosa, D. G., & Bernabeu, M. (2006) · Revista de Neurología · doi:10.33588/rn.4309.2005668 · Cited by 13 · cited 1×
“sensitivity and intellect are not altered [2].”
Vargas, A. I. C., White, M., González‐Sánchez, M., & Kuisma, R. (2014) · Disability and Rehabilitation · doi:10.3109/09638288.2014.918191 · Cited by 13 · cited 1×
“Therefore, the costs of resources and treatments could be saved without apparently affecting these results [24].”
BackgroundSelf-citationEnfermedades neurodegenerativas
Carreres, M. A. A., Falguera, N. T., & Figuera, R. G. (2004) · Rehabilitación · doi:10.1016/s0048-7120(04)73487-8 · Cited by 13
Kato, N., Hashida, G., Kobayashi, M., & Konaka, K. (2017) · Annals of Physical and Rehabilitation Medicine · doi:10.1016/j.rehab.2017.09.007 · Cited by 12 · cited 4×
“In fact, there are claims about possible ineffectiveness in improving function in patients with ALS through moderate- to high-intensity strength exercise therapy according to the Borg Scale [18].”
BackgroundMethodResultInfluentialEffects of Strength Training in Amyotrophic Lateral Sclerosis: How Much Do We Know?
Shefner, J. M. (2018) · Muscle & Nerve · doi:10.1002/mus.26347 · Cited by 9
Neuromuscular diseases: revisiting the "overtraining"
Orsini, M., Hasue, R. H., Leite, M. A. A., de Menezes, S. L. S., Silva, J. G., & Oliveira, A. B. (2014) · Fisioterapia e Pesquisa · doi:10.1590/1809-2950/00121022014 · Cited by 4 · cited 1×
“Thus, it seems that, with passive patient care, fatigue can be controlled more safely than with strength exercises, which can lead to a feeling of exhaustion [32].”
BackgroundTratamiento – rehabilitación y manejo global de las enfermedades neuromusculares
Barros, G., Moreira, I., & Ríos, R. (2018) · Revista Médica Clínica Las Condes · doi:10.1016/j.rmclc.2018.07.005 · Cited by 4 · cited 1×
“Therefore, it is suggested that perhaps submaximal aerobic activity in patients with neuromuscular diseases, allowing for adequate rest, prevents overexertion [34], and that this is not effective for the achievement of greater lung capacity, although all treatments or physical exercise programmes must be adapted to th…”
Background
Cited by
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Antiageing strategy for neurodegenerative diseases: from mechanisms to clinical advances
Jiang, Q., Liu, J., Huang, S., Wang, X.-Y., Chen, X., Liu, G.-H., Ye, K., Song, W., Masters, C. L., Wang, J., et al. (2025) · Signal Transduction and Targeted Therapy · doi:10.1038/s41392-025-02145-7 · Cited by 165
Current State and Future Directions in the Therapy of ALS
Tzeplaeff, L., Wilfling, S., Requardt, M. V., & Herdick, M. L. (2023) · Cells · doi:10.3390/cells12111523 · Cited by 171
“Moderate active physical therapy has been shown to have a positive impact on the stabilization and maintenance of physical activity and ALSFRS-R levels when compared to passive therapy [16,65].”
BackgroundUnderstanding Amyotrophic Lateral Sclerosis: Pathophysiology, Diagnosis, and Therapeutic Advances
Rizea, R. E., Corlatescu, A.-D., Costin, H. P., Dumitru, A. V., & Ciurea, A. V. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms25189966 · Cited by 76
“Finally, Riluzole appears to reduce gamma-aminobutyric acid (GABA) reuptake and enhance GABA receptors [110].”
BackgroundThe panoramic view of amyotrophic lateral sclerosis: A fatal intricate neurological disorder
Dhasmana, S., Dhasmana, A., Narula, A. S., Jaggi, M., Yallapu, M. M., & Chauhan, S. C. (2021) · Life Sciences · doi:10.1016/j.lfs.2021.120156 · Cited by 54
Convergent pathways of the gut microbiota–brain axis and neurodegenerative disorders
Gubert, C., Gasparotto, J., & Morais, L. H. (2022) · Gastroenterology report · doi:10.1093/gastro/goac017 · Cited by 40
“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].”
Metadata
- Authors
- Ortega-Hombrados, L., Molina-Torres, G., Galán-Mercant, A., Sánchez-Guerrero, E., González-Sánchez, M., & Ruiz-Muñoz, M.
- Affiliations
- Universidad de Cádiz (ES)
- Department of Nursing Sciences, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almería, 04120 Almería, Spain
- Department of Physiotherapy, Faculty of Health Sciences, University of Málaga, 29071 Málaga, Spain
- Institute of Biomedicine of Málaga (IBIMA), 29010 Málaga, Spain
- ORCID
- Venue
- International Journal of Environmental Research and Public Health
- Publisher
- MDPI AG
- Published
- 2021-01-26
- Volume
- 18
- Issue
- 3
- Pages
- 1074
- ISSN
- 1660-4601 (ISSN-L)
- PMC
- PMC7908444
- OpenAlex
- W3124148958
- Cited by
- 62
- References
- 35
- Citations by year
- 2026: 10 · 2025: 12 · 2024: 21 · 2023: 12 · 2022: 5 · 2021: 2
- FWCI
- 1.28
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
- Preprints.org (acceptedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RISalud Institutional Health Repository of Andalucía (submittedVersion, cc-by)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by-nc-nd)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Repositorio de Patentes de la Universidad de Almería (Universidad de Almería) (submittedVersion, cc-by-nc-nd)
- RODIN (Universidad de Cádiz) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Amyotrophic Lateral Sclerosis Research
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Health Sciences › Medicine › Clinical Neurology › Spinal Cord Injury Research
- Keywords
- amyotrophic lateral sclerosis, exercise therapy, ALSFRS-R, functional capacity, activities of daily living, long-term outcomes, rehabilitation
- MeSH terms
- Activities of Daily Living, Amyotrophic Lateral Sclerosis, Exercise Therapy, Humans, Exercise, Physical Therapy Modalities
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