EFFECTS OF A HOME-BASED MOTOR PROGRAM WITH REMOTE AND PRESENTIAL FOLLOW-UP OF INDIVIDUALS WITH AMIOTROPHIC LATERAL SCLEROSIS: A RANDOMIZED CLINICAL TRIAL
Neuromuscular diseases; Telerehabilitation; Physiotherapy
Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative disease, with varied and complex clinical manifestations, so treatment with a multidisciplinary approach is necessary, with the presence of a physiotherapist. However, in pearson physical therapy in this population may encounter barriers such as the difficulty in moving individuals to urban centers and complications in the population's access to these professionals. In view of these weaknesses, new strategies emerge, such as remote monitoring through telerehabilitation, which aims to implement treatment and physical therapy monitoring at a distance. The literature suggests that this type of rehabilitation is a viable alternative for the population with ALS, however there is no evidence regarding its comparison with the form in pearson follow-up. Objectives: To evaluate the effects of a home exercise protocol with face-to-face and remote monitoring on clinical outcomes in ALS patients. Methodology: Randomized, blinded clinical trial, with a sample of 44 adult individuals with a clinical diagnosis of ALS at any stage of the disease. After initial face-to-face assessment, participants will be randomized into two groups, who will perform a home exercise protocol (according to the stage of the disease), three times a week for six months. The execution of the exercise program will be monitored weekly (1x / week), remotely (via phone calls) for the control group (CG) and in person (with team visits) for the experimental group (GE). Outcome measures will be: functional physical capacity (Amyotrophic Lateral Sclerosis Functional Rating Scale - Revised - ALSFRS-r), disease severity (Severity scale in Amyotrophic lateral sclerosis - Egela), fatigue (Fatigue severity scale - FHS) and pain (Visual Analogue Scale and body diagram). The reevaluations of the outcomes will be carried out remotely every 2 months, during the intervention period, and one month after the end of the interventions. In the statistical analysis, the analysis of variance (ANOVA) mixed with repeated measures will be used to compare the outcome measures between the groups and between the moments of evaluation, with α = 5%. Expected results: Understand the impacts of motor rehabilitation on the population of patients seen, after the implementation of the individualized protocol that addresses all types of exercises for each clinical phase of ALS. In addition, the monitoring modalities offered, remote and face-to-face, will be compared to determine their effectiveness and impact on participants' adherence to treatment.