NDD-ALS Flashcards
What is another name for ALS?
Lou Gehrig’s disease
What is ALS?
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.
What is the exact cause of ALS?
It’s unknown but evidence has suggested a combination of genetic, viral, retro viral, autoimmune and neurotoxic factors
Which sex is affected by ALS more?
Males, (1.7:1 ratio)
T or F: Signs and symptoms of ALS move proximal to distal
False, the move distal to proximal
T or F: All symptoms are the same in patients with ALS
False, the symptoms depend on the part of the nervous system affected
What is the most typical initial symptom of ALS?
Weakness of the small muscles of the hand or an asymmetrical foot drop with or without night ramps, usually in the calves.
What are some complaints a person who is showing initial symptoms of ALS would have?
Tripping or tumbling when walking or running or difficulty fastening clothes
What are the initial symptoms if the bulbar tract is affected?
Difficulty breathing, slurred speech, decreased volume in speech, or impaired swallowing.
T or F: People eventually develop all the symptoms of ALS, becoming progressively weak and immobile.
True
What are LMN symptoms of ALS?
focal and multifocal weakness, muscle atrophy (progressing from distal to proximal musculature) and cramping and twitching of muscles
What are corticospinal tract symptoms of ALS?
Spasticity (which contributes to muscle pain), and hyperreactive reflexes
What are corticobulbar tract symptoms of ALS?
dysphagia (difficulty swallowing) and dysarthria (difficulty with speech)
What word describes difficulty swallowing?
dysphagia
What word describes difficulty wit speech?
dysarthria
What are some areas that are typically not affected in clients with ALS?
Cognition, sensation, vision and hearing and bowel and bladder control
How many stages are there for ALS?
6
Which stage is when the person can walk, is independent with ADLS and has some weakness?
stage I
What is stage II characterized as?
The person can walk and has moderate weakness
Which stage is characterized as the person can walk but has severe weakness?
stage III
What is stage IV characterized by?
The person requires a wheelchair for mobility, needs some assistance with ADLs and has severe weakness in the legs
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
Stage V
What is stage VI?
The person is confined to bed and dependent for ADLs and most self-care tasks.
How long is the life expectancy for someone with ALS after diagnosis?
1 to 5 years, with a mean survival of 3 years (ALS progresses rapidly)
Can the disease course potentially be affected by age?
Yes, it may be longer for younger people whose symptoms are milder.
Death for individuals with ALS is usually secondary to what?
respiratory failure
What surgical option can be used to help reduce drooling in patients with ALS?
low-dose radiation and botulinum toxin injections into salivary glands
An OT should write goals focusing on what when working with a client with ALS?
Minimizing symptoms’ effect on occupational performance
T or F: As the disease advances, interventions expand from the person with ALS and his/her performance to the physical and social environment.
True
What are some appropriate tools for evaluation for a client with ALS?
ALS functional rating scale, purdue pegboard test, multidimensional fatigue inventory, dysphagia screening and testing
T or F: Reevaluations should be completed as needed as the disease progresses
True
T or F: Treatment approaches should focus on remediation
False, should be compensatory “focusing on adapting to disability and secondary complications”
What should goals center on with clients with ALS?
Keeping the person as active and independent as possible for as long as possible.
Should you conduct home evals and home safety assessments for clients with ALS?
yes
Exercises should include?
Active, active-assisted and passive ROM, strengthening, endurance, stretching and home breathing exercise programs depending on the stage of ALS
T or F: Clients should be instructed on ways to avoid overexertion and muscle spasms and monitor fatigue
true
What adaptive equipment can be used for upper extremity stability during self care or fine motor tasks?
neck collar or universal cuff
What would mobility aids such as foot-drop splints, cane and walkers help clients with ALS with?
minimize exertion during ambulation, compensate for LE weakness and reduce risks of falls.
What is the ideal wheelchair for someone with ALS?
high backed and reclining, lightweight, turns in a small space, offers support for the head, trunk and extremities
As ALS progress, what type of wheelchair would benefit the client?
A power wheelchair with adaptable controls that is easily maneuvered with tilt or recline and head, trunk, and extremity support.
What are some techniques an OT should provide for a client with ALS to address dysphagia?
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.
What are some things to be mindful of for a work environment for someone who has ALS?
physical demands should be minimal and sedentary and the environment should be wheelchair accessible.
