Introduction The efficacy of cardiopulmonary exercise testing (CPET) to determining exercise intensity has not been established in Amyotrophic Lateral Sclerosis (ALS). We studied this intervention. Methods We included 48 ALS patients randomized in 2 groups: G1 (n = 24), exercise intensity leveled by CPET; G2 (n = 24), standard care limited by fatigue, during 6 months. ALS functional scale (ALSFRS-R) and forced vital capacity (FVC) were performed every 3 months; CPET was done at admission (T1) and 6 months later (T2). We registered oxygen uptake, carbon dioxide output, and ventilation at anaerobic threshold and at peak effort. Primary outcome was functional change. We used parametric statistics for comparisons and multiple regression analyses to identify independent predictors of functional decline. Results At T1 both groups were identical, except for higher FVC in G1 (p = 0.02). At T2, ALSFRS-R was higher (p = 0.035) in G1. Gas exchange variables at T2 did not change in G1 but had significant differences in G2 (p < 0.05). Multiregression analyses showed the Spinal ALSFRS-R slope and Intervention group (p < 0.001) as significant predictors of ALSFRS-R at T2. Conclusion Aerobic exercise defined by CPET is feasible and can improve functional outcome in ALS. This trial is registered with Clinical trials.gov ID: NCT03326622.

Arquiteta e urbanista, mestranda do Programa de pós-graduação em Desenvolvimento Urbano da UFPE.

An optimized management of amyotrophic lateral sclerosis (ALS) is an added value of a follow-up by an interdisciplinary team. The aim of this study was to identify which professionals are involved in care of ALS patients at Portugal and their impact on quality of life (QoL). We divided the sample in Group 1 (G1; Southern) and Group 2 (G2; Northern) and used a semi-structured questionnaire, functional status scale (Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised [ALSFRS-R]), and QoL evaluation to perform the study. There were observed differences at admission in ALSFRS-R, higher in G1, presence of specialized professionals higher in G2; non-invasive ventilation equipment had higher use and compliance in G1. Multiple regression analysis shows gender, education level, and technical aids as predictors of QoL. The study showed that, despite regional differences, there were external factors common to both groups that influenced QoL.

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