Brain Plasticity Lab, Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, 1919 West Taylor Street, Chicago, IL, 60612, USA.
Graduate Program in Rehabilitation Sciences, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA.
Neurol Sci. 2019 May;40(5):971-978. doi: 10.1007/s10072-019-03736-3. Epub 2019 Feb 4.
Aerobic exercise can promote neuroplastic responses in the healthy and injured brain. Although the role of exercise in amyotrophic lateral sclerosis (ALS) is debated, new evidence suggests that exercise may reduce disease progression. While common exercise modalities such as the treadmill and cycle ergometer have been explored in ALS, the safety and feasibility of a total body recumbent stepper have not been investigated. Additionally, the functional and neurophysiological effects of recumbent stepping in ALS are still unknown. Here, we investigated the safety and feasibility of a 4-week recumbent stepping program to slow disease progression in ALS and possibly facilitate neuroplasticity.
Nine individuals with ALS performed moderate intensity recumbent stepping for four weeks. Outcomes included participation satisfaction questionnaire, ALS Functional Rating Scale Revised (ALSFRS-R), clinical tests of walking and endurance, fatigue severity scale, Beck depression inventory, SF-12, and transcranial magnetic stimulation-induced motor evoked potentials (MEPs). All measurements were collected at baseline, post-intervention, and at the 1-month follow-up.
Eight participants completed the study without any adverse events. The ALSFRS-R scores were similar at the end of the study and at follow-up. No significant differences were noted for any of the clinical outcomes. MEPs were present only in two participants and changes in corticomotor excitability after exercise were minimal.
Results from this preliminary study support the safety and feasibility of 12 sessions of total body recumbent stepping in individuals with ALS.
有氧运动可以促进健康和受损大脑的神经可塑性反应。尽管运动在肌萎缩侧索硬化症（ALS）中的作用存在争议，但新的证据表明，运动可能会减缓疾病进展。虽然已经探索了跑步机和循环测力计等常见运动方式在 ALS 中的应用，但全身卧式踏步器的安全性和可行性尚未得到研究。此外，ALS 中卧式踏步的功能和神经生理学效应仍不清楚。在这里，我们研究了为期 4 周的卧式踏步计划的安全性和可行性，以减缓 ALS 疾病进展并可能促进神经可塑性。
9 名 ALS 患者进行了 4 周的中等强度卧式踏步运动。结果包括参与满意度问卷、肌萎缩侧索硬化功能评定量表修订版（ALSFRS-R）、步行和耐力临床测试、疲劳严重程度量表、贝克抑郁量表、SF-12 和经颅磁刺激诱导的运动诱发电位（MEPs）。所有测量均在基线、干预后和 1 个月随访时进行。
8 名参与者完成了研究，没有任何不良事件。研究结束时和随访时的 ALSFRS-R 评分相似。临床结果均无显著差异。只有两名参与者出现 MEP，并且运动后皮质运动兴奋性的变化很小。
这项初步研究的结果支持在 ALS 患者中进行 12 次全身卧式踏步的安全性和可行性。
