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Abstract
Amyotrophic lateral sclerosis (ALS) patients lack effective treatments to maintain motor and neuromuscular function. This study aimed to evaluate the effect of a home-based exercise program on muscle strength, ALS scores, and transcriptome in ALS patients, Clinical Trials.gov #NCT03201991 (28/06/2017). An open-label, non-randomized pilot clinical trial was conducted in seven individuals with early-stage ALS. Participants were given 3 months of home-based resistance exercise focusing on the quadriceps muscles. The strength of exercised muscle was evaluated using bilateral quadriceps strength with manual muscle testing, handheld dynamometers, five times sit-to-stand, and Timed-Up-and-Go before and after the exercise program. In addition, changes in the Sickness Impact Profile ALS-19 (SIP/ALS-19) as the functional outcome measure and the transcriptome of exercised muscles were compared before and after the exercise. The primary outcome of muscle strength did not change significantly by the exercise program. The exercise program maintained the SIP/ALS-19 and the ALS Functional Rating Scale-Revised (ALSFRS-R). Transcriptome analysis revealed that exercise reverted the expression level of genes decreased in ALS, including parvalbumin. Three months of moderately intense strength and conditioning exercise maintained muscle strength of the exercised muscle and ALSFRS-R scores and had a positive effect on patients’ muscle transcriptome.
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1 University of Kansas Medical Center, Department of Neurology, Kansas City, USA (GRID:grid.412016.0) (ISNI:0000 0001 2177 6375)
2 University of Kansas Medical Center, Department of Physical Therapy, Rehabilitation Science, and Athletic Training, Kansas City, USA (GRID:grid.412016.0) (ISNI:0000 0001 2177 6375)
3 Tokyo Metropolitan Institute for Geriatrics and Gerontology, Laboratory of Neurobiology of Aging, Tokyo, Japan (GRID:grid.412016.0); Tokyo University of Agriculture and Technology, Department of Applied Biological Science, Fuchu-shi, Japan (GRID:grid.136594.c) (ISNI:0000 0001 0689 5974)
4 Tokyo Metropolitan Institute for Geriatrics and Gerontology, Laboratory of Neurobiology of Aging, Tokyo, Japan (GRID:grid.136594.c)
5 University of Kansas Medical Center, Department of Physical Therapy, Rehabilitation Science, and Athletic Training, Kansas City, USA (GRID:grid.412016.0) (ISNI:0000 0001 2177 6375); Tufts University School of Medicine, Department of Rehabilitation Science, Boston, USA (GRID:grid.67033.31) (ISNI:0000 0000 8934 4045)
6 University of Kansas Medical Center, Department of Anatomy and Cell Biology, Kansas City, USA (GRID:grid.412016.0) (ISNI:0000 0001 2177 6375); University of Pittsburgh, Department of Neuroscience, Pittsburgh, USA (GRID:grid.21925.3d) (ISNI:0000 0004 1936 9000)
7 University of Kansas Medical Center, Department of Neurology, Kansas City, USA (GRID:grid.412016.0) (ISNI:0000 0001 2177 6375); University of Kansas Medical Center, Department of Biostatistics and Data Science, Kansas City, USA (GRID:grid.412016.0) (ISNI:0000 0001 2177 6375)
8 Tokyo Metropolitan Institute for Geriatrics and Gerontology, Laboratory of Neurobiology of Aging, Tokyo, Japan (GRID:grid.412016.0)
9 University of Kansas Medical Center, Department of Molecular and Integrative Physiology, Kansas City, USA (GRID:grid.412016.0) (ISNI:0000 0001 2177 6375)
10 University of Kansas Medical Center, Genome Sequencing Facility, Kansas City, USA (GRID:grid.412016.0) (ISNI:0000 0001 2177 6375)
11 University of Kansas Medical Center, Department of Neurology, Kansas City, USA (GRID:grid.412016.0) (ISNI:0000 0001 2177 6375); University of Missouri, School of Medicine, Department of Neurology, Columbia, USA (GRID:grid.134936.a) (ISNI:0000 0001 2162 3504)
12 Tokyo Metropolitan Institute for Geriatrics and Gerontology, Laboratory of Neurobiology of Aging, Tokyo, Japan (GRID:grid.134936.a); Tokyo University of Agriculture and Technology, Department of Applied Biological Science, Fuchu-shi, Japan (GRID:grid.136594.c) (ISNI:0000 0001 0689 5974); University of Kansas Medical Center, Department of Anatomy and Cell Biology, Kansas City, USA (GRID:grid.412016.0) (ISNI:0000 0001 2177 6375)