Efficacy of Different Physical Therapy Regimen for Amyotrophic Lateral Sclerosis: A Systematic Review

Abstract

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder characterised by the degeneration of upper and lower motor neurones, which results in progressive muscle weakness, functional decline, and ultimately respiratory failure. There is presently no cure for ALS; however, rehabilitation strategies have been investigated to enhance functional capacity and quality of life in affected individuals.
Objective: The objective of this narrative review is to evaluate the effectiveness of different exercise interventions and determine which forms of exercise are beneficial across the stages of amyotrophic lateral sclerosis.
Method: Articles were sourced from online databases including PubMed, Google Scholar, and Cochrane. The systematic review was conducted in accordance with the PRISMA 2020 Statement guidelines. All studies included in the review were randomised, controlled trials evaluating physiotherapy-based exercise programs, including aerobics, resistance, stretching, endurance, strengthening, and balance exercises. They were reviewed. Findings from the included studies were synthesised narratively to identify trends in exercise prescription and clinical outcomes.
Result: 30 articles were found; out of these, six randomised controlled trials examining interventions in individuals with ALS were included. The PEDro assessment indicated that the included studies demonstrated moderate methodological quality. Overall, moderate-intensity exercise programmes were reported as safe and beneficial for maintaining physical function, respiratory capacity, and quality of life in individuals with ALS.
Conclusion: Although ALS is a progressive neurodegenerative disease, evidence suggests that appropriately prescribed physiotherapy interventions may help maintain functional ability and improve quality of life. Moderate-intensity exercise appears to be beneficial across different stages of the disease when carefully monitored. However, larger randomized controlled trials are required to establish Standardised exercise guidelines should be established to determine the long-term safety and effectiveness of rehabilitation interventions in ALS.