NDD-ALS

Question 1

What is another name for ALS?

Answer 1

Lou Gehrig’s disease

Question 2

What is ALS?

Answer 2

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.

Question 3

What is the exact cause of ALS?

Answer 3

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

Question 4

Which sex is affected by ALS more?

Answer 4

Males, (1.7:1 ratio)

Question 5

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

Answer 5

False, the move distal to proximal

Question 6

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

Answer 6

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

Question 7

What is the most typical initial symptom of ALS?

Answer 7

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

Question 8

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

Answer 8

Tripping or tumbling when walking or running or difficulty fastening clothes

Question 9

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

Answer 9

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

Question 10

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

Answer 10

True

Question 11

What are LMN symptoms of ALS?

Answer 11

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

Question 12

What are corticospinal tract symptoms of ALS?

Answer 12

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

Question 13

What are corticobulbar tract symptoms of ALS?

Answer 13

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

Question 14

What word describes difficulty swallowing?

Answer 14

dysphagia

Question 15

What word describes difficulty wit speech?

Answer 15

dysarthria

Question 16

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

Answer 16

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

Question 17

How many stages are there for ALS?

Answer 17

6

Question 18

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

Answer 18

stage I

Question 19

What is stage II characterized as?

Answer 19

The person can walk and has moderate weakness

Question 20

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

Answer 20

stage III

Question 21

What is stage IV characterized by?

Answer 21

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

Question 22

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

Answer 22

Stage V

Question 23

What is stage VI?

Answer 23

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

Question 24

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

Answer 24

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

Question 25

Can the disease course potentially be affected by age?

Answer 25

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

Question 26

Death for individuals with ALS is usually secondary to what?

Answer 26

respiratory failure

Question 27

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

Answer 27

low-dose radiation and botulinum toxin injections into salivary glands

Question 28

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

Answer 28

Minimizing symptoms' effect on occupational performance

Question 29

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

Answer 29

True

Question 30

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

Answer 30

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

Question 31

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

Answer 31

True

Question 32

T or F: Treatment approaches should focus on remediation

Answer 32

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

Question 33

What should goals center on with clients with ALS?

Answer 33

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

Question 34

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

Answer 34

yes

Question 35

Exercises should include?

Answer 35

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

Question 36

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

Answer 36

true

Question 37

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

Answer 37

neck collar or universal cuff

Question 38

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

Answer 38

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

Question 39

What is the ideal wheelchair for someone with ALS?

Answer 39

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

Question 40

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

Answer 40

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

Question 41

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

Answer 41

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.

Question 42

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

Answer 42

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