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Meta-Analysis
. 2024 Aug 25;14(8):e076541.
doi: 10.1136/bmjopen-2023-076541.

Physical therapy for the management of global function, fatigue and quality of life in amyotrophic lateral sclerosis: systematic review and meta-analyses

Stephano Tomaz Silva  1 , Isabela Macedo Costa  2 , Aline Alves Souza  2 , Karen Pondofe  2 , Luciana Protásio Melo  2 , Vanessa R Resqueti  3 , Ricardo Valentim  4 , Filipe Gonçalves  5 , Tatiana Souza Ribeiro  2
Affiliations
Meta-Analysis

Physical therapy for the management of global function, fatigue and quality of life in amyotrophic lateral sclerosis: systematic review and meta-analyses

Stephano Tomaz Silva et al. BMJ Open. .

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.

Keywords: motor neurone disease; rehabilitation medicine; systematic review.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1. Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram describing study selection.
Figure 2
Figure 2. Effects on global function.
Figure 3
Figure 3. Effects on quality of life.
Figure 4
Figure 4. Effects on fatigue.
Figure 5
Figure 5. Adverse events meta-analysis.
See this image and copyright information in PMC

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