Low intensity exercise training in patients with amyotrophic lateral sclerosis - factors influencing eligibility and compliance to the clinical trial

Neurol Res. 2023 Aug;45(8):708-716. doi: 10.1080/01616412.2023.2194184. Epub 2023 Mar 28.

Abstract

Background: To date, there are no evidence-based recommendations for physical therapy in amyotrophic lateral sclerosis (ALS). The reason is a low number of related clinical trials (CTs), restricted sample sizes and a high dropout rate. It may influence the profile of the participants, while the final results might not translate to the general ALS population.

Objective: To analyze factors affecting the ALS patients' enrollment and retention to the study, and to describe a profile of participants as compared to the eligible group.

Methods: A total of 104 ALS patients were offered participation in a CT of low-intensity exercises at home. Forty-six patients were recruited. Demographic and clinical data (El Escorial criteria, site of onset, diagnosis delay, disease duration, amyotrophic lateral sclerosis functional rating scale - revised [ALSFRS-R], Medical Research Council [MRC], hand-held dynamometry) were analyzed every 3 months.

Results: Male gender, younger age and a higher ALSFRS predicted enrollment, while male gender, higher ALSFRS-R and MRC predicted retention in the study. A long commute to the study site and a fast disease progression were the main reasons influencing both enrollment and retention. Despite a high dropout rate, study participants were representative for the general ALS population.

Conclusion: The above demographic, clinical and logistic factors need to be considered when designing studies in ALS population.

Keywords: Exercise; amyotrophic lateral sclerosis; compliance; eligibility; physical therapy.

MeSH terms

  • Amyotrophic Lateral Sclerosis* / therapy
  • Disease Progression
  • Exercise
  • Exercise Therapy / methods
  • Humans
  • Male