• Problem list
  • Drop foot
  • Shortness of breath on exertion
  • Right leg weakness
  • Deconditioning
  • Respiratory complications
  • ALS Progression

Treatment Plan:

• Drop foot 

• AFO
• Education patient on falls prevention programs
  • Make sure lighting in the house is bright 
  • Any change in flooring has to be clearly shown by an indicator
  • A clean house with less clutter decreases the chance of falling
• General ankle strengthening 

• Shortness of breath on exertion
  • Pacing education
  • Segmental breathing
  • Positions of ease
  • Cardiovascular exercise
  • General strengthening
• Right leg weakness
  • General strengthening secondary to ALS. 
  • Be cautious of working them to fatigue.
    • Want to work the muscles but not totally fatigue them (pacing education)
    • Mobilize with gait aid if shortness of breath is significant without a gait aid
• Deconditioning
  • General strengthening (with an understanding of the progressive nature of ALS)
  • Mobilize with gait aid if shortness of breath is significant without a gait aid
  • Bed mobility, transfer practice 
  • Pacing educations
• Respiratory complications
  • Secretion clearance if necessary 
  • Educating the patient and family on risk of dysarthria and dysphagia.
  • Segmental breathing
  • Pacing education
  • Monitoring shortness of breath  
• ALS progression
  • Weakness progression moves distally, often asymmetrical 
  • Risk of dysarthria and dysphagia
  • Respiratory muscles affected
  • Cognitive and behaviour changes. 
  • As disease progresses, more preventative care and compensatory care (wheelchair, powered wheelchair, home supports).