Physical Activity in People With Motor Neuron Disease: Validity of the Physical Activity Scale for the Elderly as a Measuring Tool

Published:September 27, 2022DOI:



      This study aimed to investigate whether the physical activity scale for the elderly (PASE) is a valid tool in measuring physical activity (PA) in people with motor neuron disease (MND) and to identify the demographic and clinical factors that predict PA participation in this population.


      A prospective, observational study involving 100 ambulant participants with MND.


      This study was conducted at a multidisciplinary specialist MND clinic. The clinic is fully funded by the local public health system and patients receiving care here are not expected to pay for their consultation.


      190 patients with MND who had a physiotherapy appointment at the specialist clinic between July and October 2018 were screened. Of these, 100 participants (mean age 67 years [SD=12], 64% [n=64] men) who were ambulant (with or without assistance) were recruited (N=100).


      Not applicable.

      Main Outcome Measures

      PASE questionnaire, amyotrophic lateral sclerosis functional rating scale—Revised (ALSFRS-r), forced vital capacity (FVC).


      The results showed that engagement in PA is generally low, with median PASE score of 57. The PASE had fair-moderate correlation with ALSFRS-R total scores (rho=0.607; P<.000) and FVC (rho=0.250; P=.030). Standard multiple regression analyses showed that disease severity (ALSFRS-R total score) was the strongest predictor of PA levels (β= 0.54; 95% confidence interval 0.02,0.06). The most frequently selected physical activities of choice for people with MND were activities around their homes and the biggest barrier to participation is fatigue.


      Present findings suggest that the PASE can be used to measure PA participation in people with MND. Details about activity of choice and barriers to participation present important considerations in designing exercise programs in this population to maximize compliance and therefore effectiveness.


      List of abbreviations:

      ALSFRS -R (amyotrophic lateral sclerosis functional rating scale—revised), FVC (forced vital capacity), MND (motor neuron disease), NICE (National Institute for Health and Care Excellence), PA (physical activity), PASE (physical activity scale for the elderly), PD (Parkinson's disease)
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        • Orrell RW
        • Guiloff RJ.
        Clinical aspects of motor neurone disease.
        Medicine. 2020; 48: 607-611
        • Ng L
        • Khan F
        • Young CA
        • Galea M.
        Symptomatic treatments for amyotrophic lateral sclerosis/motor neuron disease.
        Cochrane Database Syst Rev. 2017; 1CD011776
        • Hassett L
        • Shields N
        • Cole J
        • Owen K
        • Sherrington C.
        Comparisons of leisure-time physical activity participation by adults with and without a disability: results of an Australian cross-sectional national survey.
        BMJ Open Sport Exerc Med. 2021; 7: e00091
        • Durstine JL
        • Gordon B
        • Wang Z
        • Luo X.
        Chronic disease and the link to physical activity.
        J Sport Health Sci. 2013; 2: 3-11
        • Lui AJ
        • Byl NN.
        A systematic review of the effects of moderate intensity exercise on function and disease progression in amyotrophic lateral sclerosis.
        JNPT. 2009; 33: 68-87
        • Dal Bello-Haas V
        • Florence JM
        Therapeutic exercise for people with amyotrophic lateral sclerosis or motor neuron disease.
        Cochrane Database Syst Rev. 2013; 5CD005229
        • Meng L
        • Li X
        • Li C
        • et al.
        Effects of exercise in patients with amyotrophic lateral sclerosis a systematic review and meta-analysis.
        Am J Phys Med Rehabil. 2020; 99: 801-810
        • Tsitkanou S
        • Della Gatta P
        • Foletta V
        • Russell A
        The role of exercise as a non-pharmacological therapeutic approach for amyotrophic lateral sclerosis: beneficial or detrimental?.
        Front Neurol. 2019; 10: 783
      1. National Institute for Health and Care Excellence. Motor eurone isease: assessment and management (NICE Guideline NG42). Available at: Accessed May 14, 2019.

        • Mantri S
        • Fullard ME
        • Duda JE
        • Morley JF.
        Physical activity in early Parkinson disease.
        J Parkinsons Dis. 2018; 8: 107-111
        • Lindahl M
        • Hansen L
        • Pedersen A
        • et al.
        Self-reported physical activity after ischemic stroke correlates with physical capacity.
        Adv Physiother. 2008; 10: 188-194
        • Washburn RA
        • Smith KW
        • Jette AM
        • Janney CA.
        The physical activity scale for the elderly (PASE): development and evaluation.
        J Clin Epidemiol. 1993; 1: 153-162
        • Hagiwara A
        • Ito N
        • Sawai K
        • Kazuma K.
        Validity and reliability of the physical activity scale for the elderly (PASE) in Japanese elderly people.
        Geriatr Gerontol Int. 2008; 8: 143-151
        • Franchignoni F
        • Mora G
        • Giordano A
        • et al.
        Evidence of multidimensionality in the ALSFRS-R Scale: a critical appraisal on its measurement properties using Rasch analysis.
        J Neurol Neurosurg Psychiatry. 2013; 84: 1340-1345
        • Czaplinski A
        • Yen AA
        • Appel SH.
        Forced vital capacity (FVC) as an indicator of survival and disease progression an ALS clinic population.
        J Neurol NEurosurg Psychiatry. 2006; 77: 390-392
        • Mousavi SJ
        • Zamani B
        • Shahmiri SS
        • et al.
        Pulmonary function tests in patients with amyotrophic lateral sclerosis and the association between these tests and survival.
        Iran J Neurol. 2014; 13: 131-137
        • Cohen JW.
        Statistical power analysis for the behavioural sciences.
        2nd ed. Lawrence Erlbaum Associates, Hillsdale, NJ1988: 79-81
        • Tsukita K
        • Sakamaki-Tsukita H
        • Takahashi R.
        Long-term effects of regular physical activity and exercise habits in patients with early Parkinson disease.
        Neurology. 2022; 98: e859-e871
        • Dharmadasa T
        • Matamala JM
        • Huynh W
        • Zoing MC
        • Kiernan MC.
        Motor neurone disease.
        Handb Clin Neurol. 2018; 159: 345-357
        • Galvin M
        • Corr B
        • Madden C
        • et al.
        Caregiving in ALS – a mixed methods approach to the study of burden.
        BMC Paliative Care. 2016; 15: 81
        • De Wit J
        • Bakker LA
        • van Groenestijn AC
        • et al.
        Caregiver burden in amyotrophic lateral sclerosis: a systematic review.
        Palliat Med. 2018; 32: 231-245
        • Ramirez C
        • Piemonte MEP
        • Callegaro D
        • DaSilva HCA.
        Fatigue in amyotrophic lateral sclerosis: frequency and associated factors.
        Amyotroph Lateral Scler. 2009; 9: 75-80
        • Vogt S
        • Habil M
        • Schreiber S
        • et al.
        Dyspnoea as a fatigue promoting factor in ALS and the role of objective indicators of respiratory impairment.
        J Pain Symptom Manage. 2020; 60: 2
        • Talman P
        • Duong T
        • Vucic S
        • et al.
        Identification and outcomes of clinical phenotypes in amyotrophic lateral sclerosis/motor neuron disease observational cohort.
        BMJ Open. 2016; 6e012054