ALS pt. 3 Flashcards
stage 1 ALS
early disease, mild focal weakness, asymmetrical distribution, symptoms of hand cramping and fasciculations
stage 2 ALS
mod weakness in groups of muscles, some wasting of muscles, mod I with AD
stage 3 ALS
severe weakness of specific muscles, increasing fatigue, mild to mod fxn limitations, ambulatory
stage 4 ALS
severe weakness and wasting LEs, mild weakness of UEs, modA and AD/WC user
stage 5 ALS
progressive weakness with deterioration of mobility and endurance, increased fatigue, mod-severe weakness of limbs/trunk, spasticity, hyperreflexia, loss of head control, maxA
stage 6 ALS
bedridden, dependent, FMS; progressive respiratory distress
ALS functioning rating scale (ALSFRS-R)
measures ADL and global fxn across 12 functional categories
assess response to treatment or disease progression
ALSFRS-R score
max 48
low score reflects worse performance
ALSFRS-R 12 items
speech
salivation
swallowing
hand writing
cutting food
dressing/hygiene
turning in bed
walking
climbing stairs
dyspnea
orthopnea
respiratory insufficiency
avg mortality rate
2-5 years
some 15-20
negative prognostic indicators
bulbar onset
early respiratory signs
positive prognositc indicators
participation in multidisciplinary clinics
PT considerations for stage 1
independent of mobility and ADLs
continue normal activities
stretching of affected joints
AROM, resistive exercises to unaffected muscles
aerobic activities - mod intensity
PT considerations for stage 2
mod weakness in group
muscle weakness in extremities could lead to difficulties with ADLs such as bathing, dressing
use of AD
stage 1 activities but incorporate more conservative
increase caregiver assistance
exercise 2-3x week w/ rest btw
airway clearance
PT considerations for stage 3
cont ambulation but severe weakness in muscle gro
ups, SOB with exertion and/or sleep disordered breathing
keep pt physically independent
energy conservation techniques
splints, orthotics, AD
