Exercise can be used to help ease the symptoms associated with ALS related to loss of muscle strength and its deteriorating effect on joint movement.
It is important, however, that those diagnosed with ALS seek medical advice before they embark on any exercise routine. One reason for this is that the wrong kind of exercise can actually have a detrimental effect on the individual.
Range of motion exercises can help individuals with ALS to maintain flexibility and mobility for as long as possible following their diagnosis .
Range of motion (ROM), in a biological sense, refers to the amount of movement that is present in the joints of an individual. The elbow, for example, will have a different range of motion from a shoulder joint. If joints become stiff this can reduce the individual’s mobility and cause pain when movement is attempted.
It’s advised to work out any potential range of motion exercise regime with a healthcare professional who has experience in dealing with ALS patients.
The exercises should be performed everyday and care should be taken to begin each one slowly.
Individuals should ideally repeat each one 10 times and move to the point of resistance for the joint, holding for about half a minute.
It’s important not to force any stretch, even if range of movement has decreased.
Caregivers applying ROM exercises should carefully watch the patient’s face for a response if they are unable to communicate clearly.
Examples of Range of Motion Exercises
Whilst active range of motion exercises can be performed by the individual themselves, passive ROMs are more complicated because they need to be performed with the help of a caregiver.
Some examples of range of motion exercises include:
All these exercises should be performed
Hip and Knee Flexion: Bend the
knee, holding the base of the heel and underneath the knee joint or upper calf.
Gently bend the knee towards the chest in a straight line. Be careful not to
twist the hip joint. Move back and forwards slowly.
Hip Rotation: Again, lift the
knee, holding the leg just below the joint around the calf. Hold the top the
thigh and move it up to a 90° angle.
Slowly bring the foot towards you to the point of resistance but no further.
Hamstring Stretch: Support the
knee and the heel with your hands but keep the leg straight. Lift slowly to
stretch the hamstring at the back of the thigh. Lower again and repeat.
These can be carried out either whilst sitting in a chair or when lying down.
Shoulder Flexion and Extension:
Hold the wrist and the elbow. Gently turn the wrist towards the head and move
the arm slowly up above the head. Bring the arm back to the original position
Shoulder Rotation: Place one
hand under the elbow and hold the wrist with the other. Pull the arm gently out
to the side at shoulder level. Move the hand back and forwards to move the
joint in the shoulder.
Neck Rotation: Turn the head
slowly to the right and then return to the center. Next, turn the neck to the
right. Tilt the head slowly to one side and then the other.
With all ALS range of motion exercises, it is really important to ensure that the individual does not go beyond the point of resistance.
For the caregiver, this can be challenging, but it’s all about moving things slowly and stopping when you have reached that point. It’s better to under rotate a joint than to move it too far.