ALS Rehabilitation Guide for Therapists

ALS Rehabilitation Guide for Therapists

ALS rehabilitation is key to maintain a patient’s current level of function and to improve the strength of the unaffected area to better support the weakened muscles or joints.

Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. The progressive degeneration of the motor neurons in ALS results in loss ability of the brain to initiate and control muscle movement. The degenerated area in the brain leads to scarring or hardening (“sclerosis”). The symptoms of ALS get worse over time. Currently, there is no cure for ALS and no effective treatment to halt or reverse the progression of the disease. However, rehabilitation for ALS patients can help maintain their current level of functioning. Learn More: What is ALS?

ALS Rehabilitation Treatment Approaches:

ALS rehabilitation includes physical, occupational, speech, and respiratory therapy. Rehab for ALS can help address following deficits:
  • Cognitive or linguistic impairments
  • Continence issues
  • Disturbance in gait or mobility
  • Involuntary movement
  • Muscle weakness and difficulty performing tasks of daily living
  • Muscle spasticity or tightness
  • Language impairments and swallowing difficulties
  • Respiratory issues
A physical therapist and occupational therapist can help the ALS patient by: 
  • Educating the patient about how ALS is affecting the muscles and daily activities.
  • Prescribing an exercise regime to help keep muscles as strong as possible. (Rehab professionals have a unique ability to teach patients how to perform the same activity with use of accessory muscles or adaptive equipment.)
  • Managing the ALS patient’s pain.
  • Aiding in posture control.
  • Suggesting use of adaptive equipment that can help when activities like walking become difficult. (The therapist should train on proper use of a cane, walker, wheelchair, power chairs, etc. to maintain functional independence.)
  • Helping with bracing options like AFO, KAFO, or wrist/elbow splints.
  • Training caregivers and family members how to assist the ALS patient with activities of daily living as well as prevent pressure sores.

A speech therapist can help the ALS patient by: A person with ALS may experience dysphagia or dysarthria. A speech therapist can teach both the patient and their caregivers strategies to aid in language/communication and swallowing function. A respiratory therapist can help the ALS patient by: When there is involvement of respiratory muscles, an ALS patient may have difficulty breathing. A respiratory therapist can help the ALS patient with breathing techniques and clearing out secretions.

Continuing Education Resources:

Therapy professionals can learn more about specific treatment techniques for ALS rehabilitation here:

ALS and Dysphagia: Disease Overview, Medications and Therapy Plan

Adult Dysphagia and Dysarthria Assessment and Treatment

Current Topics in Dysphagia Management

Maximizing the Team Approach for NeuroRehabilitation

Resources for Rehabilitation Professionals:

Les Turner ALS Foundation ALS Association: Including the Multidisciplinary Team Approach in Your Care

ALS Association: Tools for Healthcare Professionals

Talking with Your Patient’s Children About ALS

This article was written by Jami Cooley

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