Tailored Home Exercises May Improve Daily Living of Early-stage ALS Patients, Small Study Suggests

Researchers suggest that patients in the early stage of amyotrophic lateral sclerosis (ALS) may benefit from a personalized program of home-based exercises without a physical therapist’s supervision.

The small Japanese study, “Effectiveness of home-based exercises without supervision by physical therapists for patients with early-stage amyotrophic lateral sclerosis: A pilot study” was published in the journal Archives of Physical Medicine and Rehabilitation.

Researchers evaluated the effects of structured home-based exercises, performed without the supervision of a physical therapist, in patients with early ALS.

The study enrolled 21 patients diagnosed with early-stage disease recruited at clinical facilities throughout Japan who underwent tailored but unsupervised home-based exercises. The group was called Home-EX.

The exercises included in the program targeted upper limbs, lower limbs, and trunk muscles, along with functional training for activities of daily living such as turning over and standing from a chair.

Patients performed the exercises on their own over a six-month period and recorded each exercise type, frequency, and number of repetitions.

Physical therapists regularly assessed the patients’ reports and evaluated their muscle weakness via manual muscle testing (MMT). They also monitored patient fatigue each month during a face-to-face interview and readjusted the exercise program anytime there was a marked increase in fatigue or a decline in muscle strength.

The study also included data from 84 patients with ALS (matching the characteristics of the Home-Ex patients) who underwent supervised exercise with a physical therapist for six months. These were the controls.

Researchers assessed patients’ Home-Ex outcomes using the ALS Functional Rating Scale-Revised (ALSFRS-R), which ranges from a score of 0 to 48. Higher scores indicate better function.

A total of 15 patients out of 21 completed the six-month study period of home-based exercises. The results showed that patients in the Home-EX group had significant improvements in the total score of ALSFRS-R compared to controls – 38.1 vs. 33.1, respectively.

The improvements were significant for the sub-parameter related to respiratory function, with Home-Ex patients scoring 11.8, compared to 10.5 in the control group.

Also, the Home-EX group needed significantly fewer physical therapy sessions than the control group.

These results suggest that “structured home-based exercises without supervision by a physical therapist could be used to alleviate functional deterioration in patients with early-stage ALS,” the study concluded.