Amyotrophic lateral sclerosis (ALS) is the most common type of adult- onset motor neuron disease. Neurological disorders are characterized primarily by progressive degeneration and loss of motor neurons. ALS involves upper and lower motor neurons and presents as an idiopathic , progressive degeneration of anterior horn cells and their associated neurons, resulting in progressive muscle weakness, atrophy, and fasciluations.
ALS is a gradual onset disease. The first initial symptoms of ALS varies person to person. One person may have trouble with their grip, such as holding a cup or pen, while another person may experience change in pitch in their voice while speaking. The rate at which ALS develops also varies person to person, with the mean survival time ranging three to five years. Although there are cases in which people have lived five, and ten or more years. Onset symptoms can begin in the muscles that control speech and swallowing, or in the hands, arms, legs or feet. Not all people who suffer from ALS experience the same symptoms as others or the same sequences or patterns of progression. Although, universally progressive muscle weakness and paralysis is experienced.
ALS is a somewhat difficult disease to diagnose. There is not one test or procedure to instantly establish the diagnosis of ALS. Through the use of clinical examination, and a series of diagnostic tests, often ruling out other diseases that mimic ALS, that a diagnosis can be established. A comprehensive diagnostic check-list includes most, if not all, of all the following procedures:
- Electrodiagnostic tests- Electomyography (EMG) and Nerve conduction velocity (NCV)
- Blood & Urine studies
- Spinal tap
- X-rays including MRI
- Myleogram of cervical spine
- Muscle and/or nerve biopsy
- A thorough neurological examination
These tests are done at the discretion of the physician, usually based on the results of other diagnostic tests and the physical examination. There are several diseases that have some of the same symptoms as ALS, and most of these conditions are treatable.
Treatment of ALS can be done with physiotherapy, focusing on stretching and daily range of motion (ROM) exercises. Our physiotherapists at Triangle will focus on the emphasis of energy conservation and teach patients and caregivers methods for performing safe, efficient transfers. Our therapists at Triangle can also provide instruction for strengthening exercise programs. In one study, individualized, moderate-intensity, endurance-type exercises for the trunk and limbs performed 15 minutes twice daily was shown to significantly reduce spasticity as measured by the Ashworth scale. At Triangle, we may have to recommend wheel chairs to anticipate the patients future needs. Initially, a lightweight wheelchair should be rented, with future plans to purchase a heavier chair when the patient is no longer able to ambulate. Modifications will be recommended on the basis of the patients condition and tolerance for gadgets.
