Exercises and Brain Stimulation to Preserve Function in Amyotrophic Lateral Sclerosis

Background and Objectives: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease leading to the loss of motor function and muscle strength. Nonpharmacologic neuromodulative therapeutic approaches such as active exercise may contribute to preserve motor functions in ALS, but this hypothesis remains debated. The present meta-analysis first aimed to evaluate the effect of active exercise on function and muscle strength preservation. Moreover, since the responsiveness to induced neuroplasticity of patients with ALS is being discussed, the second objective was to review the analogous effects of noninvasive brain stimulation (NIBS). Methods: ) were calculated with Revman software, and evidence quality was estimated by the GRADE quality scale. Only 1 NIBS study revealed neuroplastic changes in the brain. Discussion: Active exercise likely slows functional loss in ALS, but the effects of NIBS need further investigation to support their neuroprotective effectiveness. Moreover, both interventions require further neurophysiologic investigation to elucidate ALS neuroplasticity. Trial Registration Information: This review has been registered in PROSPERO (CRD42023408121).