By now we are aware of amyotrophic lateral sclerosis (ALS or Lou Gehrig’s’ disease) and the impressively successful viral Ice Bucket Challenge fundraising campaign. While we may be seeing the volume of ice bucket videos beginning to decline, the fact remains that individuals and families impacted by ALS must continue day to day with this and other related disorders and the challenges they present. While funding motor neuron disease research is absolutely necessary, it’s important to also shed light on how positive change is made daily in the lives of those with ALS and related conditions with occupational therapy and its practitioners.
First, what are other motor neuron diseases?
ALS is the most common of the five motor neuron diseases. As many of us now know, ALS is a disorder that causes degeneration and weakening of muscles, and results in difficulty in speaking, swallowing and breathing. The other diseases in the motor neuron disorder family include
- primary lateral sclerosis (PLS)
- progressive muscular atrophy (PMA)
- progressive bulbar palsy (PBP)
- pseudobulbar palsy
To varying degrees, all motor neuron disorders are characterized by weakness, difficulty with balance and consequently clumsiness. Other symptoms are involuntary muscle contraction in the hands, feet, or legs; speech and swallowing problems; and breathing difficulty. In contrast to ALS, PMA affects only lower motor neurons and thus often results in a better prognosis than classic ALS. Because both progressive bulbar palsy and pseudobulbar palsy patients have such difficulty swallowing, food and saliva can be inhaled into the lungs, which can cause gagging and choking and increase the risk of pneumonia.
The loss of muscular control and strength present in these disorders not only creates physical challenges, but also impacts patients’ ability to perform activities and affects overall quality of life. As such, the care of people with these types of disorders typically involves an entire healthcare team including speech-language pathologists, dieticians, nutritionists, physical therapists, as well as occupational therapists.
How do occupational therapists and occupational therapy assistants work with those with motor neuron disorders.
Occupational therapists (OTs) or certified occupational therapy assistants (COTAs) are critical in the care of those with motor neuron disorders. These healthcare professionals provide exercises and education that enable people with muscular degeneration to be more independent. They assist with the activities of daily living such as eating, bathing, dressing, writing, cooking and shopping. In addition, OTs and OTAs help people with degenerative diseases by training them how to use various assistive devices, as well as teach them how to adapt to their progressing disorders and changing environments. Below are more details on the roles OTs and OTAs play in the lives of those with ALS, PLS, PMA, PBP and pseudobulbar palsy.
- As certain muscles deteriorate and become weaker, OTs and OTAs may use compensatory approaches and help people develop and use intact muscle groups to compensate for weaker muscles.
- OTs and OTAs train patients to use their body more efficiently through energy conservation techniques
- To make daily activities more manageable, OTs and OTAs also train patients to use adaptive devices such as button hooks, key holders, utensils with built-up handles, tub transfer seats, lifting cushions and raised toilet seats.
- OTs and OTAs make recommendations on home and work alterations such as ramps, widened doorways, raised seating, walk-in showers and rails.
- Ergonomic devices such as computer arm supports, armrests and footrests can enable those with arm weakness to continue working and be productive.
- OTs and OTAs may facilitate therapeutic exercises such as range-of-motion, fabrication of splints and other orthotic devices to maintain and improve hand function.
Occupational Therapist and Occupational Therapy Assistants are both care providers and educators.
ALS and other motor neuron disorders illustrate the dual nature of the role of OTAs and OTs. Educated and trained in therapeutic applications and having undergone hours of fieldwork, OTs and OTAs provide the care patients require. In addition, these healthcare experts are trained on client support, human occupations, and the changing nature of the body as it ages or as degenerative disorders progress. The must have instructional skills to prepare and empower patients and their families to manage the symptoms and new lifestyle associated with their disorders.
Are you interested in helping people every day? Consider St. Kate's online OTA program.