Physical therapy can help people with amyotrophic lateral sclerosis (ALS) learn to adjust to their physical disabilities. Physical therapy can maximize existing capabilities and prevent further loss of motion or prevent pain that may develop from stiff joints.

Physical Therapist

By evaluating each patient’s joint range of motion, strength and general mobility skills, physical therapists can provide guidance for such tasks as walking or getting out of a chair. They specialize in:

  • Improving function and providing instruction on managing physical disabilities.
  • Recommending appropriate exercises to maintain flexibility, while preventing and reducing physical pain.
  • Providing instruction regarding the use of assistive devices, braces or other mobility aids to maximize independence.

Exercise Guidelines

Aerobic exercise can increase muscle efficiency and endurance by increasing heart rate, respiratory rate and overall cardiovascular fitness. Remember to exercise in moderation - exercising to the point of fatigue may actually result in increased muscle weakness.

Stretching exercises

May help decrease the frequency or intensity of muscle cramping. These should be done daily to prevent pain and stiffness.

Range of motion exercises (ROM)

Help move the joints through their full range of motion. These should be performed actively, if possible, or passively if muscle weakness limits movement. These should be done daily to prevent pain and stiffness.

Strengthening exercises

Are not recommended. Working out with weights will not strengthen those muscles already weakened by ALS and could result in increased muscle weakness.

Equipment Recommendation

Assistive Devices

There are various types of assistive devices that can make walking safer. A cane may be the most useful tool when one leg is weaker than the other, or when there are mild balance deficits. Here are some guidelines for cane use:

  • The cane is held on the stronger side of the body while the weight is shifted away from the weaker side.
  • A quad cane (or four-legged cane) provides more stability than a standard cane.
  • Walkers may be more appropriate when there is significant leg weakness. They can also provide support for maintaining balance. Wheels or platforms may be added to the walker if necessary.

Bracing

Weakness of the leg muscles may make it more difficult to maneuver on stairs, rise from a chair or walk. Bracing or other aids may be recommended.

An ankle-foot brace can stabilize the ankle when there is weakness in the foot muscles. This brace fits into an ordinary shoe and prevents the toes from dragging during the swing phase of walking.

Weakness in the neck muscles may make it difficult to hold your head up. A neck brace may be recommended to make you more comfortable.

Wheelchairs

Wheelchairs may provide patients with more independence and less reliance on others. Wheelchairs are usually recommended when a patient experiences excessive fatigue, unsteadiness or occasional falls.

This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

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