Department of Rehabilitation, Murakami Karindoh Hospital, Fukuoka, Japan.
Department of Rehabilitation, Yoshino Neurology Clinic, Chiba, Japan.
Arch Phys Med Rehabil. 2018 Oct;99(10):2114-2117. doi: 10.1016/j.apmr.2018.02.015. Epub 2018 Mar 31.
To verify the effects of structured home-based exercises without supervision by a physical therapist in patients with early-stage amyotrophic lateral sclerosis (ALS).
A historical controlled study that is part of a multicenter collaborative study.
Rehabilitation departments at general hospitals and outpatient clinics with a neurology department.
Patients (N=21) with ALS were enrolled and designated as the home-based exercise (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.
The 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.
The 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, with a higher score indicating better function.
In the Home-EX group, 15 patients completed the home-based exercises for 6 months, and 6 patients dropped out because of medical reasons or disease progression. No adverse events were reported. The Home-EX group was found to have a significantly higher respiratory function subscore and total score on the ALSFRS-R than the control group at follow-up (P<.001 and P<.05, respectively).
Structured home-based exercises without supervision by a physical therapist could be used to alleviate functional deterioration in patients with early-stage ALS.
验证无物理治疗师监督的结构化家庭锻炼对早期肌萎缩侧索硬化症（ALS）患者的疗效。
历史对照研究，是多中心合作研究的一部分。
综合医院的康复科和有神经科的门诊。
纳入了 21 名 ALS 患者，并将其指定为家庭锻炼（Home-EX）组，他们进行无监督的家庭锻炼。作为对照组，从 ALS 患者数据库中提取了 84 名接受物理治疗师监督锻炼 6 个月的 ALS 患者，并在基本属性和临床特征方面与 Home-EX 组相匹配。
Home-EX 组接受了无物理治疗师监督的结构化家庭锻炼指导，包括肌肉拉伸、肌肉训练和功能训练，为期 6 个月。
主要结局指标是肌萎缩侧索硬化功能评定量表修订版（ALSFRS-R）评分，它由 3 个域组成：球部功能、肢体功能和呼吸功能。评分范围为 0 至 48 分，得分越高表示功能越好。
在 Home-EX 组中，有 15 名患者完成了 6 个月的家庭锻炼，有 6 名患者因医疗原因或疾病进展而退出。没有报告不良事件。随访时，Home-EX 组的呼吸功能亚评分和 ALSFRS-R 总评分均明显高于对照组（P<.001 和 P<.05）。
无物理治疗师监督的结构化家庭锻炼可用于减缓早期 ALS 患者的功能恶化。
