Summary of Exercising with ALS #
- Exercise can be beneficial in managing symptoms of ALS, maintaining functional abilities, and improving quality of life.
- The exercise program should be individualized and regularly monitored to meet the client’s goals, abilities, and pre-existing levels of physical fitness. Refer to physiotherapy services for more individualized exercise programs as needed (see below)
- Exercise should include strengthening and aerobic training, and stretching/range of motion exercises.
- Exercise should not be prioritized over meaningful daily activities.
These are general exercise handouts that can be given to clients to maintain strength and range of motion. Review these exercises carefully with the clients, and remove/add exercise as appropriate. Refer to physiotherapy for more individualized exercise programs.
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Although the “Everybody Stretch” handout was designed for people with Multiple Sclerosis, some of the exercises could be adapted for individuals with ALS. The physiotherapist should review these exercises with the clients to determine which are most appropriate for the client.
Caution when exercising with ALS #
- Fall prevention is essential.
- Use any assistive devices required for safety while exercising.
- Avoid highly repetitive or heavy resistance exercise. It can damage weakened muscles.
- Discontinue any exercise causing pain, weakness, or cramping.
- Extreme fatigue or fatigue lasting more than 1 hour means an activity is too intense.
- Avoid laboured breathing or increased shortness of breath.
Options for Physiotherapy and ALS (Ontario) #
Some clients may wish to pursue physiotherapy services to address their individual needs. Clients have the option of homecare physiotherapy, private neurological physiotherapy, and OHIP-funded clinics. Please read for more information and considerations about these options below.
Homecare Physiotherapy #
- Referral required to Home and Community Care Support Services (http://healthcareathome.ca )
- Consultative model – approximately 3-4 sessions per referral
- Provides home exercise program and training for care partners to assist client with ongoing exercises
- Only eligible for clients who have difficulty traveling to outpatient clinics due to limited mobility.
Private neurological physiotherapy #
- Available by self-referral to private clinics.
- Often have extensive knowledge and experience with neurodegenerative diseases and related symptoms (such as spasticity management)
- May be covered by private insurance.
- View list of neurological physiotherapy clinics
OHIP-Funded Clinics #
- Link to Publicly-Funded Physiotherapy: Clinic Locations – https://www.health.gov.on.ca/en/public/programs/physio/pub_clinics.aspx
- Only available to select populations (over the age of 65 or recently hospitalized)
- Typically have long waitlists, but this varies by region
Resources & Further Reading #
- Comprehensive Rehabilitative Care Across the Spectrum of Amyotrophic Lateral Sclerosis (Early ALS: exercise and adaptive equipment)
- Canadian best practice recommendations for the management of amyotrophic lateral sclerosis (Exercise)
- “A Guide to Amyotrophic Lateral Sclerosis (ALS) (page 45 – The Role of Exercise)
- Physical therapy for individuals with amyotrophic lateral sclerosis