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Abstract
Objectives To critically evaluate the effectiveness of physical therapy interventions in improving global function, quality of life and fatigue in individuals with amyotrophic lateral sclerosis (ALS).
Design Systematic review and meta-analyses.
Data sources MEDLINE, EMBASE, Cochrane Library (CENTRAL) and Physiotherapy Evidence Database (PEDro) were searched through 31 January 2023.
Eligibility criteria We included randomised clinical trials (RCTs) that compared physical therapy interventions that act on global function, fatigue and quality of life in individuals with ALS with any other non-physiotherapeutic methods and techniques, placebo or non-intervention. The primary outcome measure was the evaluation of global function. Secondary outcomes were quality of life, fatigue and adverse events.
Data extraction and synthesis Two independent authors used a researcher-developed extraction form and the Rayyan software to search, screen and code included studies. The risk of bias was assessed using the PEDro scale. Meta-analyses were conducted employing random effects. Outcomes were succinctly presented in Grading of Recommendations, Assessment, Development and Evaluation evidence profiles.
Results Our searches identified 39 415 references. After study selection, three studies were included in the review. Such studies involved 62 participants with a mean age of 54.6 years. In the evaluated trials, 40 were male, while 22 participants were female. Regarding the type of onset of the disease, 58 participants had spinal onset of ALS, and four had bulbar.
Conclusions Physical therapy intervention may improve the global function of individuals with ALS in the short term; however, clinically, it was inconclusive. In terms of quality of life and fatigue, physical therapy intervention is not more effective than control in the short term. Adverse events are not increased by physical therapy intervention in the short term. Due to significant methodological flaws, small sample sizes, wide CIs and clinical interpretation, our confidence in the effect estimate is limited.
PROSPERO registration number CRD42021251350.
- systematic review
- rehabilitation medicine
- motor neurone disease
Data availability statement
Data are available upon reasonable request.
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
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Data availability statement
Data are available upon reasonable request.
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Footnotes
X @luprotasio, @vanessaresqueti, @ricvalentim
Contributors STS: guarantor, conceptualisation, data extraction, risk of bias assessment, statistical analysis, methodology, project administration, writing and editing. IMC: study selection and data extraction. AAS: study selection. KP: risk of bias assessment. LPM: research concept and reviewing. VRR: research concept and reviewing. RV: funding acquisition. FG: review. TSR: conceptualisation, statistical analysis, methodology, project administration and reviewing.
Funding This study was partially supported by the Coordination for the Improvement of Higher Education Personnel, Brazil (CAPES), Finance Code 001, the National Council for Scientific and Technological Development and the Ministry of Health through a Decentralised Execution Term (TED132/2018).
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
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