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A randomized controlled trial of resistance exercise in individuals with ALS

From the School of Physical Therapy (V.D.B.-H.), University of Saskatchewan, Saskatoon, Canada; and Department of Neurology (J.M.F., J.S., G.L.), Washington University School of Medicine, St. Louis, MO, Division of Physical Therapy (A.D.K.), Ohio State University, Columbus, Department of Neurology (S.M.H.) and Eleanor and Lou Gehrig MDA/ALS Research Center (H.M.), Neurological Institute, Columbia University, New York, and Department of Neurology (E.P.P.), Cleveland Clinic, OH.

Address correspondence and reprint requests to Dr. V. Dal Bello-Haas, School of Physical Therapy, University of Saskatchewan, 1121 College Dr., Saskatoon, SK, Canada S7N 0W3 vanina.dalbello-haas{at}usask.ca

Objective: To determine the effects of resistance exercise on function, fatigue, and quality of life in individuals with ALS.

Methods: Subjects with a diagnosis of clinically definite, probable, or laboratory-supported ALS, forced vital capacity (FVC) of 90% predicted or greater, and an ALS Functional Rating Scale (ALSFRS) score of 30 or greater were randomly assigned to a resistance exercise group that received a home exercise program consisting of daily stretching and resistance exercises three times weekly or to a usual care group, who performed only the daily stretching exercises. ALSFRS, the Fatigue Severity Scale (FSS), and Short Form-36 (SF-36) were completed at baseline and monthly for 6 months. FVC and maximum voluntary isometric contraction (MVIC) were monitored monthly throughout the study.

Results: Of 33 subjects screened, 27 were randomly assigned (resistance = 13; usual care = 14). Eight resistance exercise subjects and 10 usual care subjects completed the trial. At 6 months, the resistance exercise group had significantly higher ALSFRS and SF-36 physical function subscale scores. No adverse events related to the intervention occurred, MVIC and FVC indicated no negative effects, and less decline in leg strength measured by MVIC was found in the resistance exercise group.

Conclusion: Our study, although small, showed that the resistance exercise group had significantly better function, as measured by total ALS Functional Rating Scale and upper and lower extremity subscale scores, and quality of life without adverse effects as compared with subjects receiving usual care.

Supplemental data at www.neurology.org

Funded in part by the Amyotrophic Lateral Sclerosis Association (Clinical Management Research Grant Program), Calabasas Hills, CA.

Disclosure: The authors report no conflicts of interest.

Received September 7, 2006. Accepted in final form February 2, 2007.

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