Amyotrophic Lateral Sclerosis (ALS)

Amyotrophic lateral sclerosis (ALS) is a neurological disorder that may manifest with a wide range of symptoms. Research suggests that ALS may be related to a genetic mutation, but no known cause has yet to be identified. Diagnosis of ALS is achieved by eliminating other diseases with similar symptoms. Once ALS is determined, a patient can expect to experience six stages of disease progression. Physical therapist assistants must be aware of each stage so that they can best treat their patient. While there is no cure for ALS, quality of life may be improved and prolonged; physical therapy is a critical component in the treatment process. ALS, also called Lou Gehrig’s disease, is a condition that involves motor neurons. The upper motor

In this stage, the patient may need equipment and other devices to assist the weakened muscles. Active range of motion and stretching exercises in the muscles not associated with the aliment is still encouraged in this stage, s well as aerobic activities the patient is still capable of preforming. The patient also needs to preform passive range of motion and active assisted range of motion exercises to prevent contractures. As a Physical Therapist or Physical Therapist Assistant when designing a strengthening exercise plan for a patients with stage II ALS you need to take into consideration the energy level of the patient and avoid overusing the muscles.

During stage III the patient will start to experience severe weakness of the affected muscles. Due to this they may not be able to preform basic tasks, such as standing up without assistance and the patient may experience mild to moderate limitations of functional ability. However the goal is to allow the patient to still have as much independence as possible. Adaptive equipment may be needed to assist weakened muscles. Energy level and bouts of fatigue will be seen more often in this stage and; the necessity for a wheelchair may be

There is also a necessity to avoid venous stasis in the legs that may cause a pulmonary embolus. Head drop is more prevalent during this final stage of the disease and the patient’s ability to breath is also compromised. Breathing complications may require the use of a suction machine to assist the patient. Physical therapy techniques should be used to assist cardiopulmonary distress. Techniques include repositioning the patient so the body is able to exchange oxygen and blood adequately. Positioning is also important to avoid atelectasis and allow drainage to decrease retention of fluids and assist in the removal of excretions. If the patient is weak and unable to effectively cough up fluids or is unable clear their airway, manual assistances techniques including vibration and shaking can be preformed. The goal is this stage is to minimize pain and help the patient maintain the utmost quality of