Neurological Sciences

, Volume 33, Issue 1, pp 9–15 | Cite as

Exercise and amyotrophic lateral sclerosis

  • J. P. Lopes de Almeida
  • R. Silvestre
  • A. C. Pinto
  • M. de Carvalho
Review Article


Amyotrophic Lateral Sclerosis (ALS) is a progressive and fatal neurodegenerative disease in which much burden is geared towards end-of-life care. Particularly in the earlier stages of ALS, many people have found both physiological and psychological boosts from various types of physical exercise for disused muscles. Proper exercise is important for preventing atrophy of muscles from disuse—a key for remaining mobile for as long as possible—and as long as it is possible to exercise comfortably and safely, for preserving cardiovascular fitness. However, the typical neuromuscular patient features a great physical inactivity and disuse weakness, and for that reason many controversial authors have contested exercise in these patients during years, especially in ALS which is rapidly progressive. There is an urgent need for dissecting in detail the real risks or benefits of exercise in controlled clinical trials to demystify this ancient paradigm. Yet, recent research studies document significant benefits in terms of survival and quality of life in ALS, poor cooperation, small sample size, uncontrolled and short-duration trials, remain the main handicaps. Sedentary barriers such as early fatigue and inherent muscle misuse should be overcome, for instance with body-weight supporting systems or non-invasive ventilation, and exercise should be faced as a potential non-monotonous way for contributing to better health-related quality of life.


Amyotrophic lateral sclerosis Non-invasive ventilation Exercise 



Amyotrophic lateral sclerosis


Amyotrophic lateral sclerosis functional rate score


Non-invasive ventilation


Conflict of interest

No competing personal and financial interests exist to declare.


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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • J. P. Lopes de Almeida
    • 1
    • 2
    • 5
  • R. Silvestre
    • 3
  • A. C. Pinto
    • 1
    • 2
  • M. de Carvalho
    • 2
    • 4
  1. 1.Department of Physical Medicine and RehabilitationUniversity of Lisbon Medical School, Santa Maria HospitalLisbonPortugal
  2. 2.Neuromuscular Unit, Institute of Molecular MedicineUniversity of Lisbon Medical SchoolLisbonPortugal
  3. 3.Faculty of Physical Education and SportUniversidade Lusófona de Humanidades e TecnologiasLisbonPortugal
  4. 4.Department of NeurosciencesUniversity of Lisbon Medical School, Santa Maria HospitalLisbonPortugal
  5. 5.Clínica Universitária de Medicina Física e de Reabilitação, Faculdade de Medicina de LisboaHospital de Santa MariaLisboaPortugal

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