Therapies for ALS patients
Because ALS affects communication between the brain and the body's muscles, people
who have ALS may find that simple tasks – from physical movement to speech to breathing
– can cause fatigue. To compensate for muscle weakness, people in the early stages
of ALS can benefit from many types of therapy.
Physical therapy
Occupational therapy
Speech therapy
Respiratory therapy
Physical therapy
A physical therapist is trained to help people perform activities that require major
muscle groups. For people with ALS, a physical therapist may focus on mobility issues
such as walking, getting in and out of bed, or standing from a chair. The goal is
to keep ALS patients as active as possible for as long as possible.
Physical therapy can improve mobility, relieve pain, and can delay or limit permanent
physical disabilities. A physical therapist can suggest exercise regimens (see Exercise
for ALS Patients) that can help maintain and promote overall good health.
Testing and evaluation will help a physical therapist see a patient's overall level
of functioning during various stages of ALS. From these tests, a therapist can advise
a patient about what equipment or adaptive devices might help accomplish everyday
tasks.
Occupational therapy
An occupational therapist helps those with ALS manage the changes that the disease
brings. The goal is to help those in the early stages of ALS to continue to function
and remain as independent as possible. This is done through:
- Home and work modifications
- Adaptive devices
- Exercise
- Therapeutic intervention
A large part of occupational therapy for ALS includes retraining the body. Using
compensatory strategies, a therapist can help someone with ALS learn to use stronger,
intact muscle groups to compensate for weaker ones. It is also important to understand
the fundamental principle of rest and energy conservation.
Speech therapy
Speech therapy is a vital component of ALS treatment during all stages of the disease.
Being able to communicate with family, health care providers, and friends can help
increase independence and positive feelings.
In the beginning stages of ALS, speech therapy may focus on learning compensatory
strategies to combat slurred speech. The goal of such strategies is to make everyday
communication less frustrating for both the person with ALS and his or her friends
and family. As the disease progresses, therapy may focus on alternative forms of
communication – such as aids or nonverbal techniques – to help express ideas and
needs.
Even though speech problems are caused by muscle weakness, speech therapy never
focuses on strengthening muscles. Exercising to the point of fatigue can actually
speed up muscle degeneration. Additionally, speech drills can be so tiring that
the person is too fatigued to speak.
Respiratory therapy
For people with ALS, it is important to carefully monitor respiratory function.
Likewise, therapy instruction is essential to overall care.
Therapy for ALS respiratory dysfunction is aimed at supportive measures. Considerations
may include:
- Using ventilatory maneuvers to prevent lung collapse
- Beginning a smoking cessation program (if the person is a smoker)
- Maintaining nutrition and preventing aspiration (taking food or fluid into the lungs)
- Getting flu vaccinations
- Prescribing medications to decrease the work of breathing