A Physiotherapy Intervention Study in Patients With Amyotrophic Lateral Sclerosis (ALS)

Inclusion Criteria: * diagnosis of clinically probable, probable laboratory-supported, or definite ALS (revised El Escorial criteria) or upper motor neuron only (OPM classification \[onset, propagation, motoneuron involvement\]) * age ≥18 years; ability to understand study information and provide written informed consent * Willingness and ability to perform individualized exercise according to the study protocol (approximately three to five sessions of 30 minutes per week) for the duration of the intervention period * Individuals of all sexes and gender identities are eligible for inclusion Exclusion Criteria: * pregnancy, tracheostomy, continuous assisted ventilation, or other significant non-ALS pulmonary disease * other neurodegenerative or neuromuscular conditions that may confound assessments * concomitant life-threatening disease or impairment interfering with functional assessment