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European Journal of Epidemiology

, Volume 29, Issue 7, pp 459–475 | Cite as

Epidemiological evidence that physical activity is not a risk factor for ALS

  • Bello Hamidou
  • Philippe Couratier
  • Cyril Besançon
  • Marie Nicol
  • Pierre Marie Preux
  • Benoit MarinEmail author
Review

Abstract

To elucidate whether physical activity (PA) and sport increase the risk of developing amyotrophic lateral sclerosis (ALS), a literature review of epidemiological studies was conducted according to the Meta-analysis of Observational Studies in Epidemiology guidelines. Six databases (Pubmed, Scopus, ScienceDirect, IngentaConnect, Refdoc and the Cochrane database) were searched to April 2014. Experts were asked to identify studies in press. Studies of interest were examined for their level of evidence and synthetized using Armon’s classification for exogenous risk factors for ALS. Of 37 epidemiological works included in the review, two (5.5 %) provided class I evidence, and five (13.5 %) class II. Others offered evidence of class III (n = 8, 21.6 %), IV (n = 16, 43.2 %) and V (n = 6, 16.2 %). Results were stratified according to type of exposure: (1) PA related to sport and work (n = 14), (2) soccer and American football (n = 9), (3) occupation (n = 12), (4) proxies of PA (n = 2). Among articles which considered “PA related to sport and work”, two class I studies and one class II study concluded that PA is not a risk factor for ALS. This evidence establishes (level A) that PA is not a risk factor for ALS. As regards “occupational related activity” a level of evidence of U was obtained (it is unknown whether the professional category “physical worker” is a risk factor for ALS). Football/soccer may be considered as a possible risk factor for ALS (level C) and there is a need for further research taking into account the numerous confounding factors that may arise in this field.

Keywords

Amyotrophic lateral sclerosis Motor neuron disease Physical activity Sports American football Soccer players 

Abbreviations

ALS

Amyotrophic lateral sclerosis

EEDC

El escorial diagnostic criteria

MeSH

Medical subject headings

MET

Metabolic equivalents

PA

Physical activity

Notes

Acknowledgments

We thank Prof Ettore Beghi, Chairman of EURALS consortium (pan-European consortium for the epidemiological study of ALS) for his opinions as an expert in the field and for his comments on the manuscript. We thank William Françis for reviewing the manuscript in English. Hamidou Bello is sponsored by a scholarship from the Regional Council of Limousin Region and Inserm.

Conflict of interest

We confirm that there is no conflict of interest associated with this publication.

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Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  • Bello Hamidou
    • 1
    • 2
  • Philippe Couratier
    • 1
    • 2
    • 3
  • Cyril Besançon
    • 1
    • 2
  • Marie Nicol
    • 1
    • 3
  • Pierre Marie Preux
    • 1
    • 2
    • 4
  • Benoit Marin
    • 1
    • 2
    • 4
    Email author
  1. 1.INSERM UMR1094, Tropical Neuroepidemiology, Faculté de MédecineLimoges CedexFrance
  2. 2.Univ Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEISTLimogesFrance
  3. 3.CHU Limoges, Service de Neurologie, Centre SLALimogesFrance
  4. 4.CEBIMERCHU LimogesLimogesFrance

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