Moderate-level resistance exercise significantly improved the Sickness Impact Profile ALS-19 and muscle transcriptome of the early-stage ALS patients.
Amyotrophic lateral sclerosis (ALS) patients lose motor and neuromuscular function but lack effective treatments. The objective of this study was to evaluate the effect of moderate-level exercise on ALS scores, neuromuscular function, and transcriptome in ALS patients. Methods: A pilot open-label, non-randomized clinical trial was conducted in seven individuals with early-stage ALS. Participants were given three months of moderate-level home-based resistance exercise focusing on the quadriceps muscles. Before and after the exercise program, participants were evaluated by quantifiable outcome measures using bilateral quadriceps strength with manual muscle testing and handheld dynamometers and functional outcome measures using five times sit-to-stand and Timed-Up-and-Go. In addition, changes in the transcriptome and mitochondrial respiration of exercised muscles were compared before and after the exercise. Results: The exercise program significantly improved the Sickness Impact Profile ALS-19 (SIP/ALS-19) and did not cause serious adverse events to the patients. ALSFRS-R, quantifiable outcome measures, functional outcome measures, and muscle respiration values did not change by the exercise program. Transcriptome analysis revealed that exercise reverted the expression level of genes decreased in ALS, including PVALB. Conclusions: Three months of moderate-level resistance exercise is not detrimental for the patients and may have a positive effect on patients' QOL. Overall design: To evaluate the effect of moderate-level exercise on ALS scores, neuromuscular function, and transcriptome in ALS patients.