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Objective To verify the effects of structured home-based exercises without supervision by a physical therapist in patients with early-stage amyotrophic lateral sclerosis (ALS). Design A historical controlled study that is part of a multicenter collaborative study. Setting Rehabilitation departments at general hospitals and outpatient clinics with a neurology department. Participants 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. Intervention 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. Main Outcome Measures 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. Results 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 Conclusions Structured home-based exercises without supervision by a physical therapist could be used to alleviate functional deterioration in patients with early-stage ALS.

Background The types of exercise therapy that have an effect on functioning in early-stage amyotrophic lateral sclerosis patients are not well-known. Aim To investigate the types of exercise therapy that have an effect on functioning in early-stage amyotrophic lateral sclerosis patients. Methods The participants were consecutive amyotrophic lateral sclerosis patients who were prescribed exercise therapy at six institutions in Japan. All data (age, sex, site of onset and disease duration) were collected retrospectively from the patients' medical records. The amyotrophic lateral sclerosis functional rating scale-revised scores were collected to assess patients' functioning at two time-points, at baseline and during exercise therapy. Furthermore, details of the types of exercise therapy were investigated. The change in the amyotrophic lateral sclerosis functional rating scale-revised score was calculated using the score at two time-points. A multiple regression analysis was used to determine the effect of type of exercise therapy on the change in amyotrophic lateral sclerosis functional rating scale-revised scores. Results The analysis included 156 participants. The interaction term of performance factor (walking training, standing training, and activities of daily living task training) was significantly associated with the change in the amyotrophic lateral sclerosis functional rating scale-revised score, but the interaction term of the muscle function factor (resistance training and cycle ergometer training) was not. Conclusion The combination of performance task training appears to alleviate functional decline in early-stage amyotrophic lateral sclerosis patients.