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PHYSDYS
NEURODEGENERATIVE DISORDERS (AMYOTROPHIC LATERAL SCLEROSIS)
| Term | Definition |
|---|---|
| AMYOTROPHIC LATERAL SCLEROSIS (ALS) 1 | ● Progressive neurodegenerative disease that affects nerve cells in the brain and spinal cord, leading to muscle weakness, loss of mobility, and, eventually, respiratory failure." ● Also known as Lou Gehrig's Disease |
| AMYOTROPHIC LATERAL SCLEROSIS (ALS) 2 | ● A progressive neurodegenerative disease affecting the motor neurons in the brain and spinal cord ● Leads to loss of voluntary muscle control, causing paralysis over time. |
| AMYOTROPHIC LATERAL SCLEROSIS (ALS) 3 | ● Affects both upper and lower motor neurons, leading to muscle weakness, atrophy, and spasticity. ● Does not affect cognition, sensation, or autonomic functions in most cases. ○ Malala because there is a potential to be paralyzed |
| ALS CLASSIC MANIFESTATION: | motor problems |
| ALS EARLY SYMPTOMS | ● Muscle weakness and stiffness (often asymmetrical). ● Difficulty with fine motor tasks (eg. buttoning a shirt, writing). ● Slurred speech (dysarthria) and swallowing difficulties (dysphagia) |
| ALS PROGRESSIVE SYMPTOMS 1 | ● Muscle wasting (atrophy) and twitching (fasciculations). ● Loss of mobility, leading to complete paralysis in later stages. ● Respiratory failure, requiring ventilatory support in advanced stages. |
| ALS PROGRESSIVE SYMPTOMS 2 | ● Cognitive impairment may occur in some cases (linked to frontotemporal dementia). ○ VERY UNCOMMON |
| ALS COURSE AND PROGNOSIS 1 | ● ALS progresses rapidly, with an average survival of 2-5 years post-diagnosis. ● Affects men more often than women, typically diagnosed between ages 40-70. |
| ALS COURSE AND PROGNOSIS 2 | ● No cure, but treatments like riluzole and edaravone may slow progression. ● Fatal due to ventilatory problems |
| OT EVALUATIONS FOR ALS | ● ASSESSMENT AREAS ● STANDARDIZED OT ASSESSMENTS |
| ASSESSMENT AREAS | ● Activities of Daily Living (ADLs) And instrumental ADLa (IADLs) ● Muscle Strength and Endurance ● Speech and Swallowing Function ● Respiratory Function ● Cognitive and Psychosocial Function |
| Activities of Daily Living (ADLs) And instrumental ADLa (IADLs) | ○ Identify functional limitations in dressing, grooming, eating, and home tasks |
| Muscle Strength and Endurance | ○ Assess loss of fine/gross motor skills. |
| Speech and Swallowing Function | ○ Dysphagia evaluation |
| Respiratory Function | ○ Assess for breathlessness during activities. |
| Cognitive and Psychosocial Function | ○ Screen for emotional impact and coping strategies |
| STANDARDIZED OT ASSESSMENTS | ● ALS Functional Rating Scale (ALSERS-R) ● Modified Fatigue Impact Scale (MFIS) ● Home Safety Evaluation |
| ALS Functional Rating Scale (ALSERS-R | ○ Measures physical function and disease progression. |
| Modified Fatigue Impact Scale (MFIS) | ○ Evaluates fatigue levels. |
| Home Safety Evaluation | ○ Assesses for accessibility modifications. |
| OT INTERVENTIONS FOR ALS | ● Energy conservation & Adaptive techniques ● Mobility and Positioning Support ● Assistive Technology & Communication Devices ● Respiratory Support & Swallowing Management ● Psychosocial and Caregiver Support |
| Energy conservation & Adaptive techniques | ○ Teach pacing strategies and activity modification. ○ Provide adaptive equipment leg, long-handled reachers, Lightweight utensils) |
| Mobility and Positioning Support | ○ Recommend wheelchairs, power chairs, and seating systems. ○ Use orthotic supports for weak limbs (eg, ankle-foot orthoses). |
| Assistive Technology & Communication Devices | ○ Introduce voice-to-text software and speech-generating devices ○ Recommend environmental control units (ECUs) for home automation |
| Respiratory Support & Swallowing Management | ○ Collaborate with respiratory therapists for breathing exercises. ○ Work with speech-language pathologists on safe swallowing strategies. |
| Psychosocial and Caregiver Support | ○ Address emotional well-being, including anxiety and depression. ○ Provide caregiver training on transfers, feeding, and safety. |
| STAGES for ALS | 1-6 |
| Stage I | - Ambulatory, no problems with ADL, mild weakness |
| Stage II | - Ambulatory, moderate weakness in certain muscles, increased fatigue |
| Stage III | - Ambulatory, severe weakness in certain muscles, increased difficulty with ADL; marked fatigue |
| Stage IV | - Wheelchair confined, almost independent, severe weakness in legs |
| Stage V | - Wheelchair confined, dependent, marked leg and arm weakness |
| Stage VI | - Bedridden, unable to perform ADL, maximal assistance required |
Created by:
avemaria