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Physical Therapy for a Patient Through Six Stages of Amyotrophic Lateral Sclerosis

V Dal Bello-Haas, PT, is Assistant Professor, Department of Health Sciences, Cleveland State University, Health Science Bldg, Room 122, 2501 Euclid Ave, Cleveland, OH 44115 (USA) (v.dalbello-haas@popmail.csuohio.edu).
AD Kloos, PT, is Research Physical Therapist, Department of Neurology, The Cleveland Clinic Foundation, Cleveland, Ohio.
H Mitsumoto, MD, DSc, is Director of the Amyotrophic Lateral Sclerosis Association Center, Department of Neurology, The Cleveland Clinic Foundation.

Background and Purpose. This case report describes the use of Sinaki and Mulder's approach to staging amyotrophic lateral sclerosis (ALS) and functional outcome measures in designing a treatment program for a 59-year-old woman with ALS. Case Description and Outcomes. As the patient progressed from stage I through stage VI, over 12 months, the physical therapy goals changed from optimizing remaining function, to maintaining functional mobility, and finally to maximizing quality of life. Discussion. Disease staging and the use of functional outcome measures provide a framework for physical therapy evaluation and treatment of patients with ALS throughout the disease process. Physical therapists can assist patients with ALS through the provision of education, psychological support, rehabilitation programs, and recommendations for appropriate equipment and community resources.

Key Words: Amyotrophic lateral sclerosis • Physical therapy • Staging of disease

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