ALS Flashcards
ALS
Chronic degenerative disease o the MOTOR neurons in the brain, brain stem and spinal cord
Results in UMN and LMN impairments
What areas are commonly sparred
Sensory, occular
Characteristics
UMN and LMN
Asymmetrical distribution (bilateral but not mirrored)
Distal - proximal progression
Caudal - rostral in the spinal cord
Impairments
Weakness (cardinal sign of ALS)
Fasciculations
Atrophy
Muscle cramps
Hyporeflexia
Hypotonicity
Impairments related to bulbar pathology
Mixed palsy
Bulbar muscle weakness
Dysphagia
Dysarthria
Sialorrhea
Pseudobulbar affect
Other impairments
Respiratory impairments
Cognitive impairments
- frontotemporal dementia
Diagnosis
LMN signs
UMN signs
Progression of disease within a region or to other regions
Absence of other diseases
Interventions- restorative/perventative early stage
Strengthening
Endurance
AROM, AAROM, PROM
Interventions- compensatory early stage
Energy conservative techniques
Education and support groups
Adaptive or assistive devices
Ergonomic modifications
Interventions- restorative/perventative middle stage
Same as early
Interventions- compensator middle stage
Support weak muscles with adaptive equipment slings, neck collars, orthoses
Modifications to home or workplace
Prescribe wheelchair
Educating family and caregivers regarding functional training
Late stage ALS interventions
Preventative
- PROM
- pulmonary rehab
- prescribe pressure relieving devices
- prevent skin breakdown
Compensatory
- educating caregivers regarding transfers, positioning and skin care
- mechanical lifts
The hallmark signs of ALS
are “heavy-headedness,” LE>UE weakness, bulbar pathologies, and difficulty with distal muscle activities (buttoning, pinching, writing, etc.)
