Can Therapeutic Exercise Slow Down Progressive Functional Decline in Patients With Amyotrophic Lateral Sclerosis? A Meta-Analysis

Park, Donghwi; Kwak, Sang Gyu; Park, Jin-Sung; Choo, Yoo Jin; Lee, Hee Jin

doi:10.3389/fneur.2020.00853

Cited by 17 publications

(14 citation statements)

References 28 publications

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“…Firstly, the poor functional status evidenced by ALSFRS-R testified that an appropriate rehabilitative intervention should be prescribed by a PRM physician in order to counteract muscle impairment. A recent meta-analysis performed by Park et al demonstrated that therapeutic exercise exerted benefic effects in patients with ALS in terms of preventing the progression of limb weakness and improving cardiopulmonary benefit (Park et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

“…In light of these considerations, a multidimensional approach that includes neurologists, physical medicine and rehabilitation (PRM) physicians, and oral care specialists is strongly recommended for patients affected by ALS (Miller et al, 2009;Norris et al, 2020;Park D, et al, 2020;Plowman et al, 2019); however, oral hygiene screening is mandatory in these patients. However, albeit the current practice takes into account a multidisciplinary team, there is still a lack of clear indications regarding oral health care and rehabilitation needs patients with ALS.…”

Section: Introductionmentioning

confidence: 99%

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Functional status and oral health in patients with amyotrophic lateral sclerosis: A cross-sectional study

Sire

Invernizzi

Ferrillo

et al. 2021

NRE

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BACKGROUND: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease affecting upper and lower motor neurons. The current practice of caring for patients affected by ALS involves a multidisciplinary team without any indication about oral health care. OBJECTIVE: We sought to investigate the functional status and oral health in patients with ALS to define a specific multidisciplinary management. METHODS: In this cross-sectional study, we included patients affected by ALS, evaluating their functional status, using the Revised ALS Functional Rating Scale (ALSFRS-R) and their oral health status through specific parameters, including Brief Oral Health Status Examination (BOHSE), Winkel Tongue Coating Index (WTCI), and Oral Food Debris Index (OFDI). RESULTS: All 37 patients (mean age: 61.19±11.56 years) showed a poor oral status, independent from the functional status and strictly correlated to the severity of sialorrhea (p = 0.01). OFDI index was negatively correlated with the ALSFRS-R upper limb (p = 0.03). Patients with bulbar onset had significantly lower ability to perform adequate tongue movements in terms of protrusion (p = 0.006) and lateralization (p < 0.001). Significant negative correlations between survival rate and BOHSE (p = 0.03) was found. CONCLUSIONS: Taken together, our findings showed that a poor oral health status might be correlated to a worse functional status and survival time. Thus, an adequate oral health care and rehabilitation should be considered as crucial in the multidisciplinary management of patients with ALS.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Functional status and oral health in patients with amyotrophic lateral sclerosis: A cross-sectional study

Sire

Invernizzi

Ferrillo

et al. 2021

NRE

View full text Add to dashboard Cite

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“…Overall, preclinical studies have shown that mild-to-moderate aerobic training improves the phenotype of ALS animal models. A recent meta-analysis assessed the impact of exercise on ALS patients by comparing 94 patients that underwent therapeutic exercise with 159 patients treated with conventional therapy [ 214 ]. The authors concluded that exercise could positively affect the rate of weakening of physical functions; however, these results should be interpreted with caution due to the limited number of studies and the different protocols used [ 214 ].…”

Section: Physical Exercise As a Therapeutic Approachmentioning

confidence: 99%

Skeletal Muscle in ALS: An Unappreciated Therapeutic Opportunity?

Scaricamazza

Salvatori

Ferri

et al. 2021

Cells

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Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder characterized by the selective degeneration of upper and lower motor neurons and by the progressive weakness and paralysis of voluntary muscles. Despite intense research efforts and numerous clinical trials, it is still an incurable disease. ALS had long been considered a pure motor neuron disease; however, recent studies have shown that motor neuron protection is not sufficient to prevent the course of the disease since the dismantlement of neuromuscular junctions occurs before motor neuron degeneration. Skeletal muscle alterations have been described in the early stages of the disease, and they seem to be mainly involved in the “dying back” phenomenon of motor neurons and metabolic dysfunctions. In recent years, skeletal muscles have been considered crucial not only for the etiology of ALS but also for its treatment. Here, we review clinical and preclinical studies that targeted skeletal muscles and discuss the different approaches, including pharmacological interventions, supplements or diets, genetic modifications, and training programs.

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“…It is well assessed that miRNA expression responds to exercise [ 179 ]. On the other hand, therapeutic training appears to be beneficial to ALS patients’ health [ 180 ]. On these bases, emphasis is placed on establishing whether these two issues are linked.…”

Section: Noncoding Rna Landscapementioning

confidence: 99%

RNA Deregulation in Amyotrophic Lateral Sclerosis: The Noncoding Perspective

Laneve

Tollis

Caffarelli

2021

IJMS

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RNA metabolism is central to cellular physiopathology. Almost all the molecular pathways underpinning biological processes are affected by the events governing the RNA life cycle, ranging from transcription to degradation. The deregulation of these processes contributes to the onset and progression of human diseases. In recent decades, considerable efforts have been devoted to the characterization of noncoding RNAs (ncRNAs) and to the study of their role in the homeostasis of the nervous system (NS), where they are highly enriched. Acting as major regulators of gene expression, ncRNAs orchestrate all the steps of the differentiation programs, participate in the mechanisms underlying neural functions, and are crucially implicated in the development of neuronal pathologies, among which are neurodegenerative diseases. This review aims to explore the link between ncRNA dysregulation and amyotrophic lateral sclerosis (ALS), the most frequent motoneuron (MN) disorder in adults. Notably, defective RNA metabolism is known to be largely associated with this pathology, which is often regarded as an RNA disease. We also discuss the potential role that these transcripts may play as diagnostic biomarkers and therapeutic targets.

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Can Therapeutic Exercise Slow Down Progressive Functional Decline in Patients With Amyotrophic Lateral Sclerosis? A Meta-Analysis

Cited by 17 publications

References 28 publications

Functional status and oral health in patients with amyotrophic lateral sclerosis: A cross-sectional study

Functional status and oral health in patients with amyotrophic lateral sclerosis: A cross-sectional study

Skeletal Muscle in ALS: An Unappreciated Therapeutic Opportunity?

RNA Deregulation in Amyotrophic Lateral Sclerosis: The Noncoding Perspective

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