ALS

What does ALS do to nerves

Demyelinates motor nerves

Most common progression of ALS

Distal > Proximal

Stage 1

IND ADLs and ambulation

Weakness, clumsy

Stage 2

Mod weakness, min A ADLs

Stage 3

Severe weakness, Mod A ADLs, fatigue from ambulating

Stage 4

Severe LE weakness, Max A ADLs, Dep on w/c

Stage 5

Mod to severe UE weakness, mostly DEP ADLs, risk of skin breakdown

Stage 6

Severe weakness, extreme fatigue, Dep ADLs

Interventions in Stage 1

Energy conservation, gentle resistance, ROM

Interventions in Stage 2

Adapt ADLs, work/leisure, AE, gentle ex in 3+ muscles, ROM and orthotics

Interventions in Stage 3

manual/power w/c, home modification, reassess AE

Interventions for Stage 4

Arm support, ROM and isometric ex

Interventions in Stage 5

Family training for ADLs, Skin

Interventions in Stage 6

PROM, sensory stim, massage, skin, suction, dysphagia

Mnemonic

ALS I ever wanted was a WArm WHAFL

WArm WHAFL

Warm up > Adapt ADLs > W/c, Home mod > Arm support > Family training > Life