Su Chien-Ling, Tam Ka-Wai, Fang Tien-Pei, Chiang Ling-Ling, Chen Hui-Chin
Department of Thoracic Internal Medicine, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan.
Department of Physical Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung City, Taiwan.
NeuroRehabilitation. 2021;48(3):255-265. doi: 10.3233/NRE-210052.
Patients with amyotrophic lateral sclerosis (ALS) develop respiratory failure and progressive muscle weakness. The effects of pulmonary rehabilitation on the lung function of patients with ALS are unclear.
Through this meta-analysis of randomized controlled trials (RCTs), we evaluated the effects of pulmonary rehabilitation, such as type of treatment, on patients with ALS and compared the effectiveness of this treatment.
PubMed, EMBASE, Web of Science, and Cochrane databases were searched until December 2020. The methodological quality of each study was assessed using the updated Cochrane Risk of Bias tool (RoB 2.0). Data were analyzed using Review Manager version 5.4 (Cochrane Collaboration, Oxford, England), and the meta-analysis was performed in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines.
Of 2168 articles, 10 trials were reviewed; among these trials, two focused on respiratory training and eight on physical exercise, three of which involved a combination of aerobic and resistance training. Our meta-analysis demonstrated no difference in the ALSFRS-R score and % FVC among patients with ALS.
Respiratory training or physical exercise did not significantly affect the ALSFRS-R score and % FVC of patients with ALS. At 12 months after intervention, the ALSFRS-R score in the physical exercise group was higher than that in the usual care group. Further clinical trials are warranted to develop approaches for improving the lung function of patients with ALS.
肌萎缩侧索硬化症（ALS）患者会出现呼吸衰竭和进行性肌肉无力。肺康复对ALS患者肺功能的影响尚不清楚。
通过对随机对照试验（RCT）的这项荟萃分析，我们评估了肺康复（如治疗类型）对ALS患者的影响，并比较了这种治疗的有效性。
检索了截至2020年12月的PubMed、EMBASE、Web of Science和Cochrane数据库。使用更新后的Cochrane偏倚风险工具（RoB 2.0）评估每项研究的方法学质量。使用Review Manager 5.4版本（Cochrane协作网，英国牛津）进行数据分析，并按照系统评价和荟萃分析的首选报告项目（PRISMA）指南进行荟萃分析。
在2168篇文章中，审查了10项试验；在这些试验中，两项侧重于呼吸训练，八项侧重于体育锻炼，其中三项涉及有氧训练和抗阻训练的组合。我们的荟萃分析表明，ALS患者的肌萎缩侧索硬化功能评分量表修订版（ALSFRS-R）得分和用力肺活量百分比（%FVC）没有差异。
呼吸训练或体育锻炼对ALS患者的ALSFRS-R得分和%FVC没有显著影响。干预12个月后，体育锻炼组的ALSFRS-R得分高于常规护理组。有必要进行进一步的临床试验，以开发改善ALS患者肺功能的方法。
