PHYSICAL ACTIVITY AND AMYOTROPHIC LATERAL SCLEROSIS

Abstract

Motor neuron diseases (MNDs) are a group of relatively rare, progressive neurodegenerative conditions (with amyotrophic lateral sclerosis/ALS being the most common) characterized by degeneration of upper and lower motor neurons leading to motor and extra motor symptoms. The etiology of MND is believed to involve complex interactions of environmental, lifestyle, and genetic factors, but so far only a few convincing risk factors have been established. Several putative risk factors associated with sporadic cases have been suggested, including repetitive blows to the head and traumatic brain injury. ALS is considered a sporadic disorder in 90% of cases. The incidence of ALS in the United States is 1.5 to 2.2 per 100.000, but varies significantly by age, sex, and race. The incidence of ALS generally increases with age and peaks during the seventh decade of life. There is not a large number of relevant studies for reliable conclusions about the connection between sports and BMN. However, there is increasing interest in the role of contact sports (eg, American football and rugby) following the diagnosis of BMN in several high-profile professional athletes. Several case-control studies have found an increased risk of MND among people who engage in strenuous physical activity, but other studies of this type did not find this risk (association) or the association was negative. Several other studies have shown an increased risk of BMN with traumatic brain injury, while others have found no association. The risk of MND varies depending on the type of sport played. For many individual sports, no increased risk of BMN was observed, including cricket, basketball, tennis, swimming, hockey, volleyball, badminton, field hockey, sailing, rowing, diving and skiing. However, several meta-analyses have shown a 1.3 to 1.7 times higher risk of MND in athletes who suffer a head injury, compared to the general population. Experience shows that exercise can be physically and psychologically important for people with ALS. Although the results so far do not provide clear conclusions regarding physical therapy or/and exrecise regimens to maintain function and quality of life in people with ALS, we can say, for sure, that moderate exercise is not harmful. Regarding the type of exercise, moderate intensity and not very high frequency (two sessions per week), combining strength and aerobic resistance, may be the best option to see improvements in ALS patients and prevent fatigue that further impairs their quality of life.