ALS and Related Disorders Overview
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What is a characteristic of Stage III ALS?

  • Severe weakness in ankle, feet, and hands (correct)
  • Improved respiratory function
  • Significant muscle strength in the legs
  • Enhanced capability in activities of daily living

    • In ALS Phase I, what type of medical referral might be necessary for foot weakness?

  • PT or Ortho referral (correct)
  • Psychological referral
  • Dietary referral
  • Cardiology referral

    • Which intervention is not recommended for a patient in Stage III ALS?

  • Manual or power wheelchair
  • High-intensity strength training (correct)
  • Education on bathroom equipment
  • Home modification

    • Which of the following is aimed at keeping ALS patients as independent as possible?

    <p>Encouraging deep breathing exercises</p> Signup and view all the answers

    What symptom is commonly associated with Stage III ALS?

    <p>Increased fatigue with long ambulation</p> Signup and view all the answers

    What are common sites for pressure ulcers during the acute phase?

    <p>Sacrum and heels</p> Signup and view all the answers

    Which of the following is an effective prevention strategy for pressure ulcers?

    <p>Cushion use</p> Signup and view all the answers

    During which stage of Parkinson’s Disease do the signs become bilaterally impaired, but balance is not affected?

    <p>Stage II</p> Signup and view all the answers

    What is the recommended frequency for repositioning a patient to prevent pressure ulcers?

    <p>Every 30 minutes to 1 hour</p> Signup and view all the answers

    At what age is early onset Parkinson’s Disease defined?

    <p>50 years or less</p> Signup and view all the answers

    Which seating or mobility aid is recommended for pressure relief?

    <p>Sliding board</p> Signup and view all the answers

    In which stage of Parkinson's Disease is the condition considered functionally disabling?

    <p>Stage IV</p> Signup and view all the answers

    Which is a less common site for pressure ulcers?

    <p>Scapula</p> Signup and view all the answers

    What is a symptom associated with Progressive Bulbar Palsy?

    <p>Dysarthria</p> Signup and view all the answers

    Which of the following symptoms is indicative of Primary Lateral Sclerosis?

    <p>Progressive Spastic paresis</p> Signup and view all the answers

    What is the primary biological basis for Progressive spinal muscular atrophy?

    <p>Lower motor neurons damage</p> Signup and view all the answers

    Fasciculations are generally associated with which type of condition?

    <p>Lower motor neuron damage</p> Signup and view all the answers

    What is a common symptom of ALS that affects swallowing?

    <p>Dysphagia</p> Signup and view all the answers

    Individuals with symptoms of muscle wasting are likely experiencing issues with which part of the nervous system?

    <p>Lower motor neurons</p> Signup and view all the answers

    Which of the following is NOT a symptom of Progressive Bulbar Palsy?

    <p>Spasticity</p> Signup and view all the answers

    What aspect of ALS is highlighted by muscle wasting of limbs and trunk?

    <p>Lower motor neuron lesions</p> Signup and view all the answers

    What is the highest stage in the Modified Hoehn and Yahr Scale?

    <p>Stage 5</p> Signup and view all the answers

    Which part of the UPDRS focuses on self-evaluation of activities of daily living (ADLs)?

    <p>Part II</p> Signup and view all the answers

    At which stage in the Modified Hoehn and Yahr Scale does bilateral involvement occur without impairment of balance?

    <p>Stage 2</p> Signup and view all the answers

    Which section of the UPDRS is focused on clinician-scored motor evaluation?

    <p>Part III</p> Signup and view all the answers

    What kind of involvement is observed in Stage 1.5 of the Modified Hoehn and Yahr Scale?

    <p>Unilateral and axial involvement</p> Signup and view all the answers

    In the context of OT's role, what aspect is NOT a focus depending on the stage of Parkinson's disease?

    <p>Pharmaceutical interventions</p> Signup and view all the answers

    What defines Stage 3 in the Modified Hoehn and Yahr Scale?

    <p>Moderate bilateral disease with postural instability</p> Signup and view all the answers

    Which scale measures the severity of Parkinson’s Disease through various stages?

    <p>Unified Parkinson’s Disease Rating Scale</p> Signup and view all the answers

    What is a characteristic of Stage I in ALS Phase I?

    <p>Clumsiness</p> Signup and view all the answers

    Which occupational therapy intervention might be needed to support a patient in Stage II of ALS?

    <p>Adaptation of tasks</p> Signup and view all the answers

    What does the acronym AFO stand for in the context of orthotic devices?

    <p>Ankle Foot Orthosis</p> Signup and view all the answers

    In the context of ALS Phase I, what is a recommended intervention for a patient experiencing mild weakness?

    <p>Energy conservation</p> Signup and view all the answers

    What indicates a likely complication in Stage II ALS when a patient finds it difficult to raise arms?

    <p>Progressive weakness</p> Signup and view all the answers

    Which of the following diagnoses can ankle foot orthoses (AFO) be used for?

    <p>Stroke (CVA)</p> Signup and view all the answers

    What is a common challenge faced by individuals in Stage II of ALS when performing daily tasks?

    <p>Difficulty with fine motor tasks like buttoning clothing</p> Signup and view all the answers

    What intervention may be necessary for a patient in Stage II of ALS who shows signs of dysphagia?

    <p>Baseline dysphagia management</p> Signup and view all the answers

    Study Notes

    Progressive Bulbar Palsy

    • Bulbar tracts and brainstem are affected
    • Symptoms include dysarthria, dysphagia, facial and tongue weakness, and wasting

    Progressive Spinal Muscular Atrophy

    • Lower motor neurons in the spinal cord and brainstem are affected
    • Symptoms include muscle wasting in limbs, trunk, and sometimes the bulbar muscles

    Primary Lateral Sclerosis

    • Corticospinal and corticobulbar regions are affected
    • Symptoms include progressive spastic paresis (progressive weakness and stiffness in the legs)

    ALS Phase I

    • Characteristics: mild weakness, clumsiness, ambulation, independent with ADLs
    • OT interventions: normal activities, energy conservation, providing opportunity for voice concerns, range of motion exercises, gentle resistance exercises

    ALS Phase II

    • Characteristics: moderate selective weakness, slight decrease in ADLs, difficulty climbing stairs, difficulty raising arms for buttoning clothing or tying shoes, baseline dysphagia
    • OT interventions: assess self-care, work, and leisure, adapt tasks, provide DME, orthotics as needed, stretching, cautious strength/resistance exercises (nothing over 3+/5), orthotics

    ALS Phase III

    • Characteristics: severe weakness in ankle, feet, hands, moderately decreased ADLs, easily fatigued especially during long ambulation, slightly increased respiratory effort
    • OT interventions: manual or power wheelchair, leg rests, trunk supports, adapt or provide DME, home modifications, education on bathroom equipment, keep the patient as independent as possible, encourage deep breathing exercises

    Complications: Pressure Ulcers

    • Common sites: sacrum, heels (acute phase), ischial tuberosities, trochanters (subacute/chronic phase), occiput, scapula, malleoli, metatarsals (less common)

    Prevention: Pressure Ulcers

    • Implement pressure relief maneuvers, heel reliefs, ankle foot orthotics, specialty beds, wheelchair cushions, bowel/bladder management strategies, and patient/family education.

    Prevention: Pressure Ulcers - Repositioning

    • Reposition every 30 minutes to 1 hour or more frequently
    • Use pressure relief techniques
    • Weight shifts

    Prevention: Pressure Ulcers – Friction and Shearing

    • Avoid friction and shearing
    • Ensure proper cushion use
    • Use a sliding board
    • Encourage use of commodes and modified wheelchairs

    Parkinson's Disease

    • Early onset affects 3% of individuals 50 years of age or less
    • Stages:
      • Stage I: Symptoms are one-sided
      • Stage II: Symptoms are bilateral but balance is not impaired
      • Stage III: Symptoms are bilateral and balance is impaired
      • Stage IV: PD is functionally disabling
      • Stage V: The person is confined to bed or a wheelchair.

    Severity of Parkinson’s Disease Rating Scales

    • Unified Parkinson’s Disease Rating Scale (UPDRS)
      • Part I: Evaluation of mentation, behavior, and mood
      • Part II: Self-evaluation of ADLs including speech, swallowing, handwriting, dressing, hygiene, falling, salivating, etc.
      • Part III: Clinician-scored motor evaluation
      • Part IV: Complications
    • Hoehn and Yahr (stages 0-5, describing severity)
    • Schwab and England ADL (ADL scale)

    OT’s Role in Parkinson’s Disease

    • Depends on the client’s stage of PD, focus on:
      • Compensatory strategies
      • Client and family education
      • Environment and task modifications
      • Community involvement

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    OSC 605: OT Process: Older Adult PDF

    Description

    This quiz provides an overview of Amyotrophic Lateral Sclerosis (ALS) and related neurological conditions such as Progressive Bulbar Palsy, Progressive Spinal Muscular Atrophy, and Primary Lateral Sclerosis. It highlights symptoms, affected areas, and occupational therapy interventions across different phases of ALS care.

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