Amyotrophic Lateral Sclerosis (ALS)

Amyotrophic Lateral Sclerosis (ALS) is a disease of unknown origin that affects motor neurons. Regardless of the type of stroke, EARLY INITIATION OF REHABILITATION IS KEY TO REDUCING LONG-TERM SEQUELAE.

Symptoms typically begin insidiously, and diagnosis is often delayed by several months, as the initial signs may mimic other neurological disorders.

Progressive muscle weakness impairs motor function and ultimately leads to complete dependency.
Swallowing disorders and advancing muscular weakness often result in prolonged mechanical ventilation.

Since ALS only affects motor functions, patients remain mentally alert until the final stages.
As there is no definitive treatment, comprehensive professional support is essential, especially to facilitate communication through various assistive technologies.

Our Approach to ALS Care

Our multidisciplinary team—including a pulmonologist, physiatrist, speech-language therapist, occupational therapist, respiratory and motor physical therapists, and specially trained nurses—provides care and communication support through various strategies.

Key aspects of motor care include:

• Active/assisted/passive mobilization to preserve joint range
• Motor therapy tailored to functional capacity (e.g., pulley-based therapy)
• Postural care (orthotic devices as prescribed)
• Standing exercises using chairs or electric standing beds

Speech-language and swallowing therapy focuses on:

•  Language rehabilitation: use of alternative communication methods, visual command-based mouse training, and active family involvement.
• Voice rehabilitation: relaxation techniques, vocal cord adduction, phonation-respiration coordination, vocal projection.
• Swallowing rehabilitation: Oro-motor praxis exercises
• Thermal-gustatory stimulation of the swallowing reflex
• Deep pharyngeal stimulation
• Tolerance testing for oral intake
• Bedside assessments and objective studies (e.g., Videofluoroscopic Swallowing Study, FEES)
• Use of compensatory maneuvers and postures for safe swallowing
• Family participation in the rehabilitation process
• Phonation with leak ventilation and subglottic air