Mobility and ALS
Decreased mobility is a challenge faced by every person living with ALS. However, you can take certain steps throughout each stage of ALS to improve your mobility. Your caregivers can help with some of them.
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 you learn new ways to do common everyday tasks and recommend equipment to improve mobility. All other recommendations listed below are best done under the guidance of a physical or occupational therapist.
Range of motion and stretching exercises can help people living 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 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 you do the stretching exercises yourself, or passive, meaning a caregiver moves your limbs to perform the stretches.
Some people living with ALS 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’s less danger of falling.
As mentioned before, it’s important that you consult with a physical therapist before starting any exercise programs.
At various stages along your ALS journey, different pieces of equipment may be important 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.
If you have difficulty walking due to balance issues, a cane or walker can help you stay mobile.
Eventually, almost all people living with ALS will require wheelchairs to get around. Even if you’re 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 a person living with ALS. Consider features like a high-reclining back, headrest, elevating leg rests 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.
Sometimes people living 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.
All these activities and equipment aids can help you stay mobile, active and independent longer while making your caregiver’s job easier.