Resistance exercise slows functional decline in amyotrophic lateral sclerosis

Supervised Resistance Exercise Slowed Functional Loss in Small Study
by Amy Labbe
People with early-stage ALS who engaged in a supervised resistance exercise program had better muscle function after six months than a similar group that participated only in a stretching program, say U.S. and Canadian researchers who recently conducted a 27-person study.
Although the debate persists over whether or not exercise is beneficial or detrimental in ALS, these latest study results represent a potential first step toward resolving the long-standing controversy.
The research team, which included a physician and physical therapists associated with MDA/ALS Centers in New York and St. Louis, found that, even though exercise may not have any ultimate influence on disease progression, it may temporarily slow loss of strength and function and minimize muscle wasting that results from lack of movement.
In a paper published in the June 5 issue of Neurology, the investigators say they randomly assigned 13 out of 27 subjects with mild to moderate weakness to a regimen of stretching and resistance exercise. They assigned the other 14 to a control group that performed only stretching exercises. Eight people in the stretching-plus-resistance exercise group and 10 in the stretching group completed the trial.
Physical therapist Jeanine Schierbecker assesses the strength of a man with ALS.
The stretching routine was the same for both groups and was performed daily, while those in the resistance exercise group added individualized exercises using cuff weights three times a week.
After initial instruction, all exercises were performed at home, with telephone monitoring every two weeks and physical assessments every month.
After six months, those in the resistance exercise program had a smaller decline in muscle strength than those performing only stretching exercises.
"Our study, although small, showed that the resistance exercise group had significantly better function, measured by the ALS Functional Rating Scale and upper and lower extremity subscale scores, and quality of life without adverse effects as compared to subjects receiving usual care," said study author Julaine Florence, a physical therapist at Washington University in St. Louis.
Physical therapist Jeanine Schierbecker, also a study author and physical therapist at Washington University, said her "best recommendation is that, if a patient with ALS is interested in pursuing an exercise program, they should discuss it with their physician and be evaluated by a knowledgeable, ALS-savvy physical therapist."