Effectiveness of home-based exercises without supervision by physical therapists for patients with early-stage amyotrophic lateral sclerosis: A pilot study

Publication date: Available online 31 March 2018
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Kosuke Kitano, Takashi Asakawa, Naoto Kamide, Keisuke Yorimoto, Masaki Yoneda, Yutaka Kikuchi, Makoto Sawada, Tetsuo Komori
ObjectiveThis study aimed to verify the effects of structured home-based exercises without supervision by a physical therapist on patients with early-stage amyotrophic lateral sclerosis (ALS).DesignThis is a historical controlled study that is part of a multicenter collaborative study.SettingRehabilitation departments at general hospitals and outpatient clinics with a neurology department in Japan.ParticipantsTwenty-one patients with ALS were enrolled and designated as the Home-EX group, and they performed unsupervised home-based exercises. As a control group, 84 patients with ALS who underwent supervised exercise with a physical therapist for 6 months were extracted from a database of patients with ALS and matched with the Home-EX group in terms of their basic attributes and clinical features.InterventionThe Home-EX group was instructed to perform structured home-based exercises without supervision by a physical therapist that consisted of muscle stretching, muscle training, and functional training for 6 months.Main outcome measureThe primary outcome was the score on the ALS Functional Rating Scale-Revised (ALSFRS-R), which is composed of 3 domains: bulbar function, limb function, and respiratory function. The score ranges from 0 to 48 points, and a higher score indicates better function.ResultsIn the Home-EX group, 15 patients completed the home-based exercises for 6 months, and 6 patients dropped out due to medical reasons or disease progression. No adverse events were reported. The Home-EX group was found to have a significantly higher respiratory function sub-score and total score on ALSFRS-R than the control group at follow-up (p < 0.001 and p < 0.05, respectively).ConclusionStructured home-based exercises without supervision by a physical therapist could be used to alleviate functional deterioration in patients with early-stage ALS.



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