Amyotrophic Lateral Sclerosis ALS

Question 1

ALS Health Condition and BSF Impairments

Answer 1

Neurodegenerative disease affecting upper and lower motor neurons

Signs may include spastic paralysis, hyperreflexia, pseudobulbar affects

Signs may include muscle wasting, flaccid paralysis, fasciculations

Bulbar-onset has a faster progression

Question 2

ALS Medications

Answer 2

Riluzole (Rilutek, Tiglutik)
Edaravone (Radicava)

Question 3

ALS Diagnosis specific T&M

Answer 3

ALS Functional Rating Scale
ALS Specific QOL Scale (ALSSQOL-R)

Question 4

ALS Interventions

Answer 4

Prevent falls
Respiratory complications
Compensate with equipment
Caregiver training
Energy conservation
Orthotics
Gait aids
Wheelchair
Remediation function and mobility

Question 5

ALS Special considerations

Answer 5

Diagnosed with El Escorial Criteria

Frontotemporal dementia is the more common type of dementia associated with this disease.

Riluzole increases median survival by 3-6 months

Question 6

ALS Movement System Diagnoses

Answer 6

Force Production Deficit

Question 7

ALS UMN Signs

Answer 7

Weakness
Spasticity
Hyperreflexia
Pathologic reflexes
Peudobulbar affect

Question 8

ALS LMN Signs

Answer 8

Weakness
Muscle Wasting
Muscle cramps
Fasciculations

Question 9

ALS Bulbar Onset Signs

Answer 9

Changes in speech
Difficulty swallowing
Involuntary tongue movement
More common in women
Progresses faster

Question 10

ALS Spinal Onset Signs

Answer 10

Fasciculations
Atrophy
Weakness
Spasticity

Question 11

ALS Respiratory Onset Signs

Answer 11

Shortness of breath
Orthopnea
Sleep-disorders breathing

Question 12

ALS Reported Symptoms

Answer 12

Fatigue
Muscle stiffness
Muscle cramps
SOB
Difficulty sleeping
Pain
Anxiety
Depression

Question 13

ALS Stages

Answer 13

Phase I
Stage I
- Mild weakness
- Clumsiness
- Ambulatory
- Independent in ADLs
Stage II
- Moderate, slective weakness
- Slightly decreased independence in ADLs
- Difficulty climbing stairs
- Difficulty raising arms
- Difficulty buttoning clothing
- Ambulatory
Phase II
Stage V
- Severe LE weakness
- Mod to severe UE weakness
- Wheelchair-dependent
Increasingly dependent in ADLs
- Possible skin breakdown
Phase III
Stage VI
- Bedridden
Completely dependent in ALDs

Question 14

ALS diagnosis

Answer 14

Evidence of LMN degeneration by clinical, EMG, or neuropathological exam (El escorial)
Evidence of UMN degeneration by clinical exam
Progression within a body region and to other regions

Question 15

ALS Prognosis

Answer 15

Death within 2-5 years of onset
Negative factors:
- Bulbar onset
- Weight loss
- Cognitive impairment
- Impaired respiratory function