Exercising With Amyotrophic Lateral Sclerosis: Prescription for Health

American College of Sports Medicine

April 01, 2010


Amyotrophic lateral sclerosis (ALS) is a progressive disease characterized by muscular weakness and atrophy that occurs at a steady rate without periods of remission. There is, however, great variability among individuals with regard to how quickly muscle strength is lost. Anecdotal evidence suggests that exercise can strengthen healthy muscle fibers, which may temporarily lead to stronger muscles and may permit an individual to maintain strength and a higher functional level for a longer time. Improving aerobic endurance and maintaining full range of motion of joints may also improve functional ability and minimize pain. If you have been diagnosed with ALS, a sensible exercise program may help you maintain your muscle strength and a higher functional level for a period of time.

Getting Started

  • Talk with your health care practitioner before starting an exercise program and ask for specific programming recommendations.

  • Take all medications as recommended by your physician.

  • The goals of the program should be to maximize the functional capacity of the innervated muscle fibers, prevent limitations in range of motion, and to maximize aerobic capacity, endurance, and functional level for as long as possible.

  • Depending on your balance, walk or use a recumbent cycle for up to 30 minutes without excessive fatigue at least 3 times per week. This may be accomplished by performing 10 minute bouts of exercise at one time, with rest periods interspersed if necessary.

  • Perform low to moderate resistance exercises with light weights three to five days per week, on the days you don’t walk or use the recumbent bicycle. Do one set of eight to 12 repetitions. Reduce resistance and the number of repetitions as weakness progresses.

  • Active and passive stretching exercises, done once or twice a day, will help maintain or increase your range of motion.

  • Pay attention to how you are feeling during exercise and take frequent breaks if needed.

  • Pay special attention to feelings of extreme fatigue or increased muscle cramps or muscle twitching (fasciculations). If these occur, stop exercising and check-in with your health care practitioner.

Exercise Cautions

  • Exercise is only beneficial when it does not cause excessive fatigue in the participant. Exercise is no longer appropriate if it becomes so tiring it keeps the individual from completing daily activities.

  • Adapted or support equipment may be needed due to muscle weakness and reduced balance.

Your exercise program should be designed to maximize the benefits with the fewest risks of aggravating your health or physical condition. Consider contacting a certified health and fitness professional* who can work with you and your health care provider to establish realistic goals and design a safe and effective program that addresses your specific needs.

For more information, visit www.exerciseismedicine.org or e-mail eim@acsm.org.

* If your health care provider has not cleared you for independent physical activity and would like you to be monitored in a hospital setting or a medical fitness facility, you should exercise only under the supervision of a certified professional. The American College of Sports Medicine (ACSM) has two groups of certified fitness professionals that could meet your needs. The ACSM Certified Clinical Exercise Specialist (CES) is certified to support those with heart disease, diabetes and lung disease. The ACSM Registered Clinical Exercise Physiologist (RCEP) is qualified to support patients with a wide range of health challenges. You may locate all ACSM-certified fitness professionals by using the ProFinder at www.acsm.org.

Sources: ACSM’s Guidelines for Exercise Testing and Prescription and other ACSM publications.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: