The ALS Association

ALS Ice Bucket Challenge Progress

Staying Active with ALS

As an assistant professor of physical therapy at Georgia Regents University and a physical therapist at an ALS Association Certified Treatment Center of Excellence in Georgia, Charlotte Chatto, PT, Ph.D., has extensive experience working with people living with ALS and their caregivers. Passionate about helping people living with ALS experience the best quality of life, Dr. Chatto recently shared the following tips:

1. Moderation is key

Further Reading

 
Therapeutic exercise for people with amyotrophic lateral sclerosis or motor neuron disease (Review)
 
A Systematic Review of the Effect of Moderate Intensity Exercise on Function and Disease Progression in Amyotrophic Lateral Sclerosis

People living with ALS and their caregivers must be aware that ALS works against the body’s ability to build strength. But, says Dr. Chatto, “being able to stay active and do the things that you want to do is really important.” She encourages people to be in tune with their bodies, examine what’s most important to their quality of life, and decide how best to spend their energy.

For some, that will involve moderate exercise, which can be beneficial for people with ALS, Dr. Chatto says. But what exactly does “moderate” mean? Picture exercise as a continuum: at one end, you have passive range of motion, in which someone is moving your limbs for you. On the other end, you have weight lifting to your maximum capacity. “Moderate” exercise, then, falls between these extremes. It involves moving your body yourself, but not taxing your body by trying to build strength. How much or what kind of exercise is appropriate will depend on the individual.

Dr. Chatto has provided two studies (see sidebar) regarding exercise and ALS that you may want to discuss with your physical therapist.

2. Work to preserve range of motion

With ALS, loss of range of motion and flexibility in the joints is common. This can cause muscles and joints to become stiff and even cause discomfort.
If you or the person you’re caring for is having difficulty freely moving their joints including their arms and legs, it’s important to enlist someone’s help. Dr. Chatto recommends that you get a referral to a Physical therapist (PT) and occupational therapist (OT) who can offer professional instruction and assistance to help preserve range of motion and comfort in the muscles and joints.

3. Explore whether an assistive device may help

PTs and OTs can also prescribe splints that will help prevent the loss of range of motion. If you or the person you’re caring for loses some range of motion in a joint, a splint can help hold the joints in a beneficial position during the time when you are not stretching or doing prescribed range of motion exercises.

PTs and OTs can also help make decisions about the need for assistive devices that can work wonders for energy conservation. For example, if a person living with ALS is able to walk, but has problems balancing, the constant fight to balance can be unnecessarily taxing on the muscles and can drain the body’s overall energy level. A PT or OT can help with the decision whether using a cane or walker may help conserve that energy.

4. Learn important breathing and coughing techniques

People with ALS have an elevated risk for pneumonia or other respiratory complications. Dr. Chatto says that people with ALS and their caregivers should learn diaphragmatic (or “deep belly”) breathing to help maintain breathing function. She also teaches her clients and their caregivers an assisted cough technique that can help people living with ALS clear their lungs of excessive mucus. You can view a video of Dr. Chatto demonstrating this technique by visiting http://www.toxtalk.com/ and clicking on the “Breathing Techniques for ALS Patients” link.

5. Ask the right questions

When choosing a physical therapist, knowing the answers to a few simple questions can make a big difference. It’s important to select a therapist who has the knowledge and experience to treat you or the person you’re caring for appropriately and safely.
Dr. Chatto recommends that you always ask a potential new therapist these three questions:

  1. Are you familiar with ALS?
  2. Have you ever treated anyone with ALS?
  3. Are you familiar with how the disease progresses?

If the therapist answers no to any of the questions above, you may want to keep looking. If you’re not sure where to start, Dr. Chatto suggests consulting The ALS Association’s website to find ALS Association Certified Centers or Clinics in your region.

You or your physical therapist may also contact Dr. Chatto at for ALS-specific physical therapy recommendations. Above all, the role of a physical therapist specializing in ALS is to help the person with ALS maintain their best quality of life.

Powered by Blackbaud
nonprofit software