Decreased mobility is one of the challenges faced by every ALS patient. However, there are steps that patients and caregivers can take to improve mobility at each stage of ALS.
Physical and Occupational Therapy
One of the most important steps you can take to maintain or improve your mobility is to undergo physical or occupational therapy. A physical therapist can recommend exercises and treatments to help maintain strength and flexibility while preventing discomfort or pain. Occupational therapists can help ALS patients learn new ways to do common everyday tasks, and recommend equipment to improve mobility. All of the other recommendations listed below are best done under the guidance of a physical or occupational therapist.
Exercise
Range of motion and stretching exercises can help people with ALS maintain flexibility, making movement easier.
However, not all exercises are helpful. If a muscle has weakened to the point where it takes all of its strength just to move a limb, trying to lift additional weight may be harmful. And if the exercise makes you feel weaker afterwards, you’ve probably pushed your muscles too much.
Stretching improves flexibility and can help correct imbalances in the muscles and tendons on each side of a joint. For example, foot drop occurs when the calf muscle and Achilles tendon at the back of your ankle tighten, pulling your heel up and causing the front part of your foot to drop. Stretching the tightened calf and Achilles can balance the forces on your ankle and correct foot drop.
Stretches can be either active, meaning the patients do the stretching exercises themselves, or passive, meaning the caregiver moves the patient’s limbs to perform the stretches.
Some ALS patients find pool therapy, or exercising in the water of a swimming pool, to be helpful. The buoyancy created by the water means less strength is needed to move the limbs, and there is less danger of falling.
As mentioned before, it is important that you consult with a physical therapist before starting any exercise programs.
Equipment
At various stages along the ALS journey, different pieces of equipment can be invaluable for improving mobility.
For people with weakness in specific joints, braces can be used to add support or hold limbs in the correct position. For instance, foot drop can be treated by an ankle-foot orthosis (AFO), a simple brace that runs behind the ankle and under the foot. Resting hand splints, low-back braces, and cervical (neck) collars are other examples of ALS braces.
For patients who have difficulty walking due to balance issues, a variety of canes and walkers exist to help you stay mobile.
Eventually, almost all ALS patients will require wheelchairs to get around. Even if you are still able to walk without one, a wheelchair can be useful for longer trips or whenever you become fatigued.
When choosing a wheelchair, make sure it fits your needs as an ALS patient. This may include features like a high reclining back, headrest, elevating legrests, and (for power wheelchairs) special electronic controls.
A physical or occupational therapist can help you determine what equipment and features will work best for your mobility needs.
Home Adaptations
Sometimes people with ALS can improve their ability to get around and accomplish everyday tasks by making modifications to their home. These changes can include building ramps or widening doors to accommodate wheelchairs, installing grab bars or guardrails in the bathroom, and placing kitchen items in lower cabinets for easier reach.
Other specialty in-home equipment includes patient lifts, transfer boards, and adjustable beds. Again, a therapist can help recommend what adaptations or equipment would make sense for your situation.
Together, all of these activities and equipment aids can help ALS patients stay mobile and active, while making the caregiver’s job easier in the process.