Exercise in ALS: The Disease That Made Doctors Fear Exertion - and the Trials That Found Moderate Training Slows the Decline

For decades, people with amyotrophic lateral sclerosis were told to conserve what they had. The reasoning seemed sound: the disease kills motor neurons, exertion stresses them, and the epidemiology hinted that a lifetime of hard exercise was associated with a higher risk of developing the condition. The trials of the last decade have complicated that story. Moderate, structured exercise does not accelerate ALS; in the randomised evidence it slows the loss of function and lung capacity over months, and the caution that survives is about intensity and frequency, not about movement itself.

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