Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder in which nerve cells that control muscles gradually degrade. With disease progression, more and more muscles are affected, and it becomes challenging for patients to accomplish everyday tasks.

The goal of occupational therapy is to help patients maintain their independence for as long as possible as well as to improve their quality of life. Occupational therapists practice in schools, health agencies, hospitals, and social services. Health professionals, such as nurses or doctors, can help patients and their families find an occupational therapist.

The occupational therapist needs a clear picture of the situation in the patient’s home and work environment so he or she can first assess the patient’s needs, abilities, and problems. He or she can then suggest ways to meet these needs and overcome problems. For example, the occupational therapist can suggest aids and equipment that can help the patient. He or she can also provide guidance to the patient’s caregivers so that they can better support the patient. Finally, an occupational therapist can advise the patient on a tailored exercise program that can help them stay healthy for longer and increase their quality of life.

Aids and adaptations

Many aids and adaptations can be useful for ALS patients. There are devices available to make eating, dressing, grooming, walking, and bathing easier. The occupational therapist can make equipment suggestions and help patients and their families decide which type of equipment is most appropriate.

The occupational therapist can also help make adjustments at home considering the patient’s future needs. For example, even if the patient does not need a wheelchair yet, they may consider wheelchair access because the disease can progress rapidly.

The therapist will try to find aids that can be used long term, even as the patient’s abilities change in order to avoid having to regularly introduce new ones. The occupational therapist will reassess the skills of the patient periodically and adjust the aids and adaptations as necessary.

Caregiver education

As the disease progresses, patients gradually lose their independence and have to rely on the help of caregivers in everyday life. An occupational therapist can train the patient’s primary caregivers on dressing, transferring, and toileting techniques for the patient.

The occupational therapist can also teach energy conservation techniques, which become more critical as fatigue increases with disease progression. Energy conservation techniques can help optimize daily tasks in a way that they require less energy. The occupational therapist focuses on doing the routines that are necessary and saving energy for more meaningful activities. Energy conservation techniques also identify actions that are not as important or that can be done by a caregiver.

Exercise

The aim of exercise is to preserve muscle strength and flexibility for as long as possible. It is especially recommended during the early stages of ALS. It focuses on muscles that have not yet been affected by the disease as strengthening working muscles can help support weaker ones. Exercise programs are usually developed together with a physiotherapist.

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