Podcast
Questions and Answers
Which of the following is NOT a characteristic of ALS?
Which of the following is NOT a characteristic of ALS?
- Progressive loss of motor function
- Muscle weakness
- Degeneration of motor neurons in the CNS and PNS
- Sensory problems (correct)
Which of the following factors is NOT considered a potential etiological factor for ALS?
Which of the following factors is NOT considered a potential etiological factor for ALS?
- Excessive glutamate
- Oxidative stress
- Hereditary factors
- Bacterial infection (correct)
Bulbar pathology in ALS is characterized by impairments primarily affecting which of the following functions?
Bulbar pathology in ALS is characterized by impairments primarily affecting which of the following functions?
- Bowel and bladder control
- Speaking and swallowing (correct)
- Vision and hearing
- Balance and coordination
Which of the following is NOT typically associated with UMN impairments in ALS?
Which of the following is NOT typically associated with UMN impairments in ALS?
Which of the following is a characteristic LMN impairment seen in ALS?
Which of the following is a characteristic LMN impairment seen in ALS?
A patient with ALS reports experiencing shortness of breath when lying down. Which respiratory symptom is this most indicative of?
A patient with ALS reports experiencing shortness of breath when lying down. Which respiratory symptom is this most indicative of?
In ALS, the disease typically spreads initially within:
In ALS, the disease typically spreads initially within:
A patient with ALS is experiencing increasing impairments, moderate activity limitations, and participation restrictions. According to the staging of ALS, which stage is this patient likely in?
A patient with ALS is experiencing increasing impairments, moderate activity limitations, and participation restrictions. According to the staging of ALS, which stage is this patient likely in?
Which of the following factors generally suggests a faster progression of ALS?
Which of the following factors generally suggests a faster progression of ALS?
Which of the following is LEAST likely to be associated with a faster progression of ALS?
Which of the following is LEAST likely to be associated with a faster progression of ALS?
Which of the following outcome measures is specifically designed to assess functional limitations in individuals with ALS?
Which of the following outcome measures is specifically designed to assess functional limitations in individuals with ALS?
Which intervention approach is MOST appropriate for a patient in the early stages of ALS?
Which intervention approach is MOST appropriate for a patient in the early stages of ALS?
In the middle to late stages of ALS, the primary goal of intervention shifts towards:
In the middle to late stages of ALS, the primary goal of intervention shifts towards:
Which type of intervention is appropriate throughout all stages of ALS?
Which type of intervention is appropriate throughout all stages of ALS?
Which intensity level is most appropriate for exercise prescription in patients with ALS?
Which intensity level is most appropriate for exercise prescription in patients with ALS?
Resistance exercises are appropriate for patients with ALS, provided that the muscle strength is at least:
Resistance exercises are appropriate for patients with ALS, provided that the muscle strength is at least:
Which is a symptom LEAST likely to be related to overuse in ALS patients?
Which is a symptom LEAST likely to be related to overuse in ALS patients?
A patient with ALS reports increased muscle cramping and fasciculations after a recent increase in their exercise intensity. What is the most likely explanation for these symptoms?
A patient with ALS reports increased muscle cramping and fasciculations after a recent increase in their exercise intensity. What is the most likely explanation for these symptoms?
Disuse atrophy is a consequence of which?
Disuse atrophy is a consequence of which?
Moderate and low intensity exercises are prescribed for ALS to prevent:
Moderate and low intensity exercises are prescribed for ALS to prevent:
What is the primary focus of interventions in the late stages of ALS?
What is the primary focus of interventions in the late stages of ALS?
Which of the following interventions would be MOST appropriate for a patient with bulbar pathology in ALS?
Which of the following interventions would be MOST appropriate for a patient with bulbar pathology in ALS?
A patient with ALS is experiencing difficulty with fine motor tasks such as buttoning a shirt. This impairment is MOST likely related to:
A patient with ALS is experiencing difficulty with fine motor tasks such as buttoning a shirt. This impairment is MOST likely related to:
Which of the following symptoms would LEAST likely indicate respiratory involvement in a patient with ALS?
Which of the following symptoms would LEAST likely indicate respiratory involvement in a patient with ALS?
What is the purpose of performing AROM and stretching exercises for a patient with ALS?
What is the purpose of performing AROM and stretching exercises for a patient with ALS?
Which of the following is the LEAST important component of an exercise prescription for patients with ALS?
Which of the following is the LEAST important component of an exercise prescription for patients with ALS?
After a diagnosis of ALS, the average survival rate is approximately:
After a diagnosis of ALS, the average survival rate is approximately:
Which of the following is typically preserved in individuals with ALS?
Which of the following is typically preserved in individuals with ALS?
Upon examination, a patient with ALS demonstrates decreased reflexes, weakness, and atrophy in the intrinsic hand muscles. These findings are MOST consistent with:
Upon examination, a patient with ALS demonstrates decreased reflexes, weakness, and atrophy in the intrinsic hand muscles. These findings are MOST consistent with:
Which of the following BEST describes the primary goal of preventative interventions in patients with ALS?
Which of the following BEST describes the primary goal of preventative interventions in patients with ALS?
A patient in the late stage of ALS is primarily bedridden and requires assistance with most activities. Which of the following outcome measures would be MOST appropriate for assessing their functional status?
A patient in the late stage of ALS is primarily bedridden and requires assistance with most activities. Which of the following outcome measures would be MOST appropriate for assessing their functional status?
Which objective finding is least associated with UMN pathology in ALS?
Which objective finding is least associated with UMN pathology in ALS?
Which treatment strategy is LEAST appropriate for managing disuse atrophy in a patient with late-stage ALS?
Which treatment strategy is LEAST appropriate for managing disuse atrophy in a patient with late-stage ALS?
A patient with ALS reports difficulty breathing while lying flat in bed. The PTA should suspect:
A patient with ALS reports difficulty breathing while lying flat in bed. The PTA should suspect:
Which of the following activities would be MOST appropriate for a patient with ALS in the EARLY stages of the disease?
Which of the following activities would be MOST appropriate for a patient with ALS in the EARLY stages of the disease?
Flashcards
What is ALS?
What is ALS?
A progressive neurodegenerative disease involving the degeneration and loss of motor neurons in the CNS and PNS, leading to muscle weakness without sensory problems. Survival rate is approximately 5 years.
Etiology of ALS?
Etiology of ALS?
The cause is often unknown, but can include genetic factors, oxidative stress, and excessive glutamate.
Who does ALS affect?
Who does ALS affect?
ALS typically affects males over the age of 50.
Bulbar Pathology
Bulbar Pathology
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UMN Impairments in ALS
UMN Impairments in ALS
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LMN Impairments in ALS
LMN Impairments in ALS
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Respiratory Pathology in ALS
Respiratory Pathology in ALS
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Progression of ALS?
Progression of ALS?
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Stages of ALS?
Stages of ALS?
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Factors Influencing ALS Progression
Factors Influencing ALS Progression
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Outcome Measures for ALS
Outcome Measures for ALS
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Types of Interventions for ALS
Types of Interventions for ALS
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Exercise Prescription for ALS
Exercise Prescription for ALS
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Symptoms of Overuse in ALS
Symptoms of Overuse in ALS
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Disuse atrophy
Disuse atrophy
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Study Notes
- Lou Gehrig’s disease, known as ALS, involves the degeneration and loss of motor neurons in both the central and peripheral nervous systems.
- ALS is characterized by muscle weakness without sensory impairment.
- The survival rate for individuals with ALS is approximately 5 years.
Etiology
- The causes of ALS are idiopathic and hereditary.
- Other potential factors include oxidative stress and excessive glutamate levels.
Affected Population
- ALS typically affects males over the age of 50.
Bulbar Pathology
- 20-30% of ALS cases manifest as bulbar pathology, impacting speech and chewing.
- Bulbar pathology affects cranial nerves, leading to dysarthria, dysphagia, sialorrhea (drooling), and pseudobulbar affect.
UMN Impairments
- Muscle weakness is a key symptom of UMN impairment.
- Spasticity and hyperreflexia are observed in UMN impairments.
- Clonus and abnormal timing are characteristic of UMN impairments.
- Fatigue, loss of dexterity, and dyssynergic movements are also associated with UMN impairments.
LMN Impairments
- LMN impairments include hyporeflexia, or decreased/absent reflexes.
- Atrophy and fasciculations are indicative of LMN impairments.
- Cramping and weakness are also symptoms of LMN impairments.
Respiratory System Pathology
- Ventilatory muscle weakness affects the respiratory system.
- Dyspnea (shortness of breath) is a common respiratory symptom.
- Orthopnea (shortness of breath when lying down) occurs.
- Hypoventilation and ineffective cough are respiratory complications.
ALS Progression
- ALS initially spreads within the same spinal cord segments.
Stages of ALS
- Early Stage: Characterized by few impairments with minimal to no activity limitations or participation restrictions.
- Middle Stage: Involves an increasing number of impairments and minimal to moderate activity limitations and participation restrictions.
- Late Stage: Marked by severe impairments, activity limitations, and participation restrictions.
Factors Influencing ALS Progression
- Older age of onset (over 40) is associated with faster progression.
- Bulbar onset leads to quicker progression compared to limb onset.
- Dyspnea diagnosis accelerates the disease.
- Psychological stress can speed up the progression.
- Severe involvement at diagnosis indicates faster progression.
Outcome Measures
- Gait speed is a key measure to assess ALS.
- The Functional Independence Measure (FIM) is used.
- BERG Balance Scale, POMA, and Timed Up and Go (TUG) tests are utilized.
- The Fatigue Severity Scale measures fatigue levels.
- The ALS Functional Rating Scale is a specific tool for ALS assessment.
Types of Interventions
- Restorative interventions, like strengthening unaffected muscles, are used in early stages.
- Compensatory interventions, such as modifying activities and tasks, are applied in middle and late stages.
- Preventative interventions, including ventilation techniques to avoid secondary complications, are implemented in all stages.
Exercise Prescription
- Moderate and low-intensity exercises are recommended.
- Active Range of Motion (AROM) exercises and stretching are beneficial.
- Resistance exercises are appropriate only if MMT (Manual Muscle Testing) is >3/5.
- Aerobic exercise should be performed at submaximal levels.
Symptoms of Overuse
- Symptoms of overuse include exhaustion, pain, increased muscle cramping, and increased muscle fasciculations (vibrations).
Disuse Atrophy
- Reduced physical activity leads to contractions in disuse atrophy.
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