Exercise pressor reflex in Amyotrophic lateral sclerosis patients

Amyotrophic lateral sclerosis (ALS) is an incurable neurodegenerative disease characterized by progressive loss of motor neurons that leads to a decrease in muscle strength and motor performance. It is still unclear whether acute exercise evokes circulatory responses in late-stage ALS patients, although it is well known that in healthy people, there is an increase in heart rate (HR) and blood pressure (BP). Therefore, we examined whether the sensory and autonomic nervous systems respond greatly sufficiently to evoke circulatory responses to acute movement in late-stage ALS patients. Late-stage ALS patients (age:55–92 yrs, five males, two females) on ventilators performed static passive forearm stretching and passive leg pedaling exercises. The intensity of stretching was lower than individual pain thresholds. The beat-to-beat BP was continuously recorded. HR, systolic blood pressure, diastolic blood pressure, and the mean arterial pressure significantly increased from rest with passive forearm stretching (p < 0.05), while no significant circulatory changes were observed during passive leg pedaling.These results are similar responses to those reported in healthy people, suggesting that the functions of sensory and autonomic nervous systems are intact to evoke circulatory responses in late-stage ALS patients. Clinical trial registration : This study was registered at UMIN-CTR (R000069509) on February 25, 2026.