Park Donghwi, Kwak Sang Gyu, Park Jin-Sung, Choo Yoo Jin, Chang Min Cheol
Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea.
Department of Medical Statistics, College of Medicine, Catholic University of Daegu, Daegu, South Korea.
Front Neurol. 2020 Aug 13;11:853. doi: 10.3389/fneur.2020.00853. eCollection 2020.
Despite the high incidence of muscle weakness in patients with amyotrophic lateral sclerosis (ALS), the effects of therapeutic exercise on these individuals have not been clearly determined. A comprehensive database search was conducted on PubMed, Embase, Cochrane Library, and SCOPUS. We included studies published up to December 31, 2019 that fulfilled our inclusion and exclusion criteria. Functional status was determined as the Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS) score (previous and revised versions) before and after a therapeutic exercise program for the meta-analysis. The Cochrane Collaboration's tool for assessing risk of bias in randomized trials was used for the methodological quality assessments of included studies. The meta-analysis was performed using the RevMan v.5.3. A total of 94 patients in the experimental group (who received therapeutic exercise) and 159 patients in the control group (who received conventional exercise or therapy) were included from five randomized controlled trials. The decrement of ALSFRS (previous version), ALSFRS-R (revised version), and ALSFRS-R-Respiratory scores at the 6-month evaluation were less for the therapeutic exercise group as compared to the control group. However, at the 6-month evaluation, the ALSFRS-R-Limb scores did not significantly differ between the two groups. Therapeutic exercise appears beneficial for patients with ALS. Further, it appears to exert more of a cardiopulmonary benefit, as opposed to preventing the progression of limb weakness. However, as the therapeutic exercises applied in each included study were not uniform, the result of our meta-analysis should be considered cautiously.
尽管肌萎缩侧索硬化症（ALS）患者中肌肉无力的发生率很高，但治疗性运动对这些个体的影响尚未明确确定。我们在PubMed、Embase、Cochrane图书馆和SCOPUS上进行了全面的数据库搜索。我们纳入了截至2019年12月31日发表的符合我们纳入和排除标准的研究。在进行荟萃分析时，将功能状态确定为治疗性运动计划前后的肌萎缩侧索硬化症功能评定量表（ALSFRS）评分（先前版本和修订版本）。采用Cochrane协作网评估随机试验偏倚风险的工具对纳入研究进行方法学质量评估。使用RevMan v.5.3进行荟萃分析。五项随机对照试验共纳入了94例实验组患者（接受治疗性运动）和159例对照组患者（接受传统运动或治疗）。与对照组相比，治疗性运动组在6个月评估时ALSFRS（先前版本）、ALSFRS-R（修订版本）和ALSFRS-R-呼吸评分的下降幅度较小。然而，在6个月评估时，两组之间的ALSFRS-R-肢体评分没有显著差异。治疗性运动似乎对ALS患者有益。此外，它似乎更多地发挥心肺益处，而不是防止肢体无力的进展。然而由于每项纳入研究中应用的治疗性运动并不统一，我们的荟萃分析结果应谨慎考虑。
