Physical activity in patients with amyotrophic lateral sclerosis: Prevalence, patients’ perspectives and relation to the motor performance

Article type: Research Article

Authors: Sznajder, Jan^{a; b} | Barć, Krzysztof^b | Kuźma-Kozakiewicz, Magdalena^{b; c; d; *}

Affiliations: [a] Department of Rehabilitation, Józef Piłsudski University of Physical Education inWarsaw, Warsaw, Poland | [b] Department of Neurology, University Clinical Centre of Medical University of Warsaw, Warsaw, Poland | [c] Department of Neurology, Medical University of Warsaw, Warsaw, Poland | [d] Neurodegenerative Diseases Research Group, Medical University of Warsaw, Warsaw, Poland

Correspondence: [*] Address for correspondence: Prof. Magdalena Kuzma-Kozakiewicz, MD, PhD, Department of Neurology, Medical University of Warsaw, Zwirki I Wigury Str. 61, 02-091 Warsaw, Poland. E-mail: mkuzma@wum.edu.pl.

Abstract: BACKGROUND:There are no recommendations for physical activity in amyotrophic lateral sclerosis (ALS) patients. OBJECTIVE:(i) To describe the prevalence and pattern of physical activity (PA) in ALS patients; (ii) to explore patients’ attitude towards PA; and (iii) to investigate the relationship between PA at home environment and the rate of functional decline. METHODS:96 ALS patients were followed for 6 months at 3-month intervals and assessed by site of disease onset, disease duration, diagnosis delay, functional status, muscle strength, fatigue and prevalence of PA. RESULTS:Over 70% of patients performed regular exercise and reported a positive effect of PA on functional status and mood. Regularly exercising individuals showed a higher ALSFRS-R bulbar score (11.0 vs 9.0, p = 0.011) and a lower decline of respiratory sub-score of ALSFRS-R compared to non-regularly exercising patients (0 vs 1.0, p = 0.026). Bulbar onset was a negative prognostic factor for regular exercise (odds ratio [OR]: 5.2, p = 0.004). CONCLUSION:The majority of ALS patients perform regular PA and find it positively influence their motor performance and mood. Bulbar disease onset, but not functional status, is a negative prognostic factor for regular exercise in ALS patients. Regular mild PA may result in a slower deterioration of functional status, especially the respiratory function.

Keywords: Physical activity, amyotrophic lateral sclerosis, exercise, functional status

DOI: 10.3233/NRE-210312

Journal: NeuroRehabilitation, vol. 50, no. 4, pp. 433-443, 2022