NDD-ALS Flashcards

1
Q

What is another name for ALS?

A

Lou Gehrig’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is ALS?

A

A progressive, degenerative disease in which the motor neurons in the brain, spinal cord and peripheral system are destroyed and replaced by scar tissue. The resulting plaques lead to progressive muscle atrophy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the exact cause of ALS?

A

It’s unknown but evidence has suggested a combination of genetic, viral, retro viral, autoimmune and neurotoxic factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which sex is affected by ALS more?

A

Males, (1.7:1 ratio)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

T or F: Signs and symptoms of ALS move proximal to distal

A

False, the move distal to proximal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

T or F: All symptoms are the same in patients with ALS

A

False, the symptoms depend on the part of the nervous system affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the most typical initial symptom of ALS?

A

Weakness of the small muscles of the hand or an asymmetrical foot drop with or without night ramps, usually in the calves.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some complaints a person who is showing initial symptoms of ALS would have?

A

Tripping or tumbling when walking or running or difficulty fastening clothes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the initial symptoms if the bulbar tract is affected?

A

Difficulty breathing, slurred speech, decreased volume in speech, or impaired swallowing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

T or F: People eventually develop all the symptoms of ALS, becoming progressively weak and immobile.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are LMN symptoms of ALS?

A

focal and multifocal weakness, muscle atrophy (progressing from distal to proximal musculature) and cramping and twitching of muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are corticospinal tract symptoms of ALS?

A

Spasticity (which contributes to muscle pain), and hyperreactive reflexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are corticobulbar tract symptoms of ALS?

A

dysphagia (difficulty swallowing) and dysarthria (difficulty with speech)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What word describes difficulty swallowing?

A

dysphagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What word describes difficulty wit speech?

A

dysarthria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some areas that are typically not affected in clients with ALS?

A

Cognition, sensation, vision and hearing and bowel and bladder control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How many stages are there for ALS?

A

6

18
Q

Which stage is when the person can walk, is independent with ADLS and has some weakness?

A

stage I

19
Q

What is stage II characterized as?

A

The person can walk and has moderate weakness

20
Q

Which stage is characterized as the person can walk but has severe weakness?

A

stage III

21
Q

What is stage IV characterized by?

A

The person requires a wheelchair for mobility, needs some assistance with ADLs and has severe weakness in the legs

22
Q

Which stage is characterized as the person requires a wheelchair for mobility, is dependent for ADLs and has severe weakness in the arms and legs

A

Stage V

23
Q

What is stage VI?

A

The person is confined to bed and dependent for ADLs and most self-care tasks.

24
Q

How long is the life expectancy for someone with ALS after diagnosis?

A

1 to 5 years, with a mean survival of 3 years (ALS progresses rapidly)

25
Q

Can the disease course potentially be affected by age?

A

Yes, it may be longer for younger people whose symptoms are milder.

26
Q

Death for individuals with ALS is usually secondary to what?

A

respiratory failure

27
Q

What surgical option can be used to help reduce drooling in patients with ALS?

A

low-dose radiation and botulinum toxin injections into salivary glands

28
Q

An OT should write goals focusing on what when working with a client with ALS?

A

Minimizing symptoms’ effect on occupational performance

29
Q

T or F: As the disease advances, interventions expand from the person with ALS and his/her performance to the physical and social environment.

A

True

30
Q

What are some appropriate tools for evaluation for a client with ALS?

A

ALS functional rating scale, purdue pegboard test, multidimensional fatigue inventory, dysphagia screening and testing

31
Q

T or F: Reevaluations should be completed as needed as the disease progresses

A

True

32
Q

T or F: Treatment approaches should focus on remediation

A

False, should be compensatory “focusing on adapting to disability and secondary complications”

33
Q

What should goals center on with clients with ALS?

A

Keeping the person as active and independent as possible for as long as possible.

34
Q

Should you conduct home evals and home safety assessments for clients with ALS?

A

yes

35
Q

Exercises should include?

A

Active, active-assisted and passive ROM, strengthening, endurance, stretching and home breathing exercise programs depending on the stage of ALS

36
Q

T or F: Clients should be instructed on ways to avoid overexertion and muscle spasms and monitor fatigue

A

true

37
Q

What adaptive equipment can be used for upper extremity stability during self care or fine motor tasks?

A

neck collar or universal cuff

38
Q

What would mobility aids such as foot-drop splints, cane and walkers help clients with ALS with?

A

minimize exertion during ambulation, compensate for LE weakness and reduce risks of falls.

39
Q

What is the ideal wheelchair for someone with ALS?

A

high backed and reclining, lightweight, turns in a small space, offers support for the head, trunk and extremities

40
Q

As ALS progress, what type of wheelchair would benefit the client?

A

A power wheelchair with adaptable controls that is easily maneuvered with tilt or recline and head, trunk, and extremity support.

41
Q

What are some techniques an OT should provide for a client with ALS to address dysphagia?

A

minimize distractions during mealtime, adapt food consistency (thicken liquids, downgrade diet to soft foods), use manual swallowing techniques, allow sufficient time for meals, and ensure that nutritional needs are met and use alternatives to feeding if issues arise.

42
Q

What are some things to be mindful of for a work environment for someone who has ALS?

A

physical demands should be minimal and sedentary and the environment should be wheelchair accessible.