Amyotrophic Lateral Sclerosis: Pathophysiology and Implications for Physical Therapy

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Amyotrophic Lateral Sclerosis: Pathophysiology and Implications for Physical Therapy This work will provide a basic overview of the pathophysiology for amyotrophic lateral sclerosis (ALS) as well as the medical interventions used in treatment of the disease. Physical therapy interventions for ALS and therapeutic exercise recommendations are the major focus of this study, and will be discussed in greater detail in the later portion. Description Amyotrophic lateral sclerosis, or Lou Gehrig's disease as it is commonly called, is described by the ALS association (ALSA, 2010) as “a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord.” Amyotrophic is described by Porth and Matfin (2009) as muscle wasting or atrophy as a result of the death of lower motor neurons which is the most easily observed result of the disease process. Lateral sclerosis refers to the degradation of nervous tissue in the lateral columns of the spinal cord due to scarring. ALS presents with the following signs and symptoms (S&S). Early stages involve muscle weakness, involuntary movements, spasticity, twitching and cramping; these usually begin in the distal extremities (Lescher, 2011). Progressive S&S include atrophy and paralysis of muscles of the limbs, trunk, and face as well as fatigue, dysarthria, dysphagia, and hyperreflexia (i.e. highly sensitive gag reflex and positive Babinski reflex). As a result of weakness and paralysis in the muscles of the face and throat, feeding and respiration are affected. Most people with ALS are eventually dependent on mechanical ventilation. Demographics ALS most commonly affects people between the ages of 40 and 70; the average age is 55, most are Caucasian (93%) and it is 2... ... middle of paper ... ...451-461. Available from http://iospress.metapress.com/content/j8p10mxtu180u036/ Lui, A. J., & Byl, N. N. (2009). A systematic review of the effect of moderate intensity exercise on function and disease progression in amyotrophic lateral sclerosis. Journal of Neurologic Physical Therapy, 33(2), 68-87. doi: 10.1097/NPT.0b013e31819912d0 Pflumm, M. (2012). Exercise: Stretching the limits of ALS care. Retrieved from ALS Therapy Development Institute website: http://blogs.als.net/post/Exercise-does-a-body-good-But-what-about-pALS.aspx Porth, C. M., & Matfin, G. (2009). Pathophysiology: Concepts of altered health states (8th ed.). Philadelphia, PA: Wolters Kluwer Health-Lippincott Williams & Wilkins. University of Pittsburgh, Center for ALS Research. (2013). Occupational and physical therapy. Retrieved from http://www.alsresearchcenter.pitt.edu/patients/pt_ot_therapy.php

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