ALS Disease Treatment and Rehabilitation

ALS Disease Treatment and Rehabilitation: Slowing Progression and Supporting Daily Function

Treatment & Rehab for ALS focuses on multidisciplinary care, medications that slow progression & support for breathing & nutrition, improving survival & life quality.

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Medical Treatment Options

The core of ALS treatment options focuses on managing symptoms and slowing the progression of the disease. While there is currently no cure, specific medications have been approved to protect motor neurons and extend survival time by several months. Treatment involves working with a large team of healthcare professionals to address all patient needs.

The neurologist often prescribes two types of medication: those that modify the disease itself and those that manage difficult symptoms.

Riluzole (Rilutek®, Exservan®): This medication is often recommended immediately and works by preventing the buildup of glutamate, a compound thought to damage nerve cells. Riluzole is shown to slightly delay the need for breathing support and extend median survival.
Edaravone (Radicava®): An antioxidant that helps protect nerves from degeneration, this medication can slow the decline in muscle function.
Targeted Therapies: Tofersen (Qalsody®) is used for patients with the SOD1 genetic mutation and can decrease nerve damage.

Symptom Management and Care

Managing symptoms is a fundamental part of ALS treatment options to improve the patient’s quality of life. As the disease progresses, medication and therapy are adjusted to address new complications, such as muscle stiffness, pain, and difficulty controlling saliva.

Spasticity: Muscle relaxants, such as baclofen or tizanidine, are prescribed to manage painful muscle stiffness and cramps.
Pain Relief: Nonsteroidal anti-inflammatory medications (NSAIDs) or other pain medications may be used to manage chronic pain associated with stiffness and immobility.
Mental Health: Medications may be prescribed to address symptoms of depression and emotional changes that accompany the diagnosis.

Multidisciplinary ALS Care

Multidisciplinary care (MDC) is the standard and preferred approach for ALS, proven to extend survival and improve quality of life. This model brings together a dedicated team of specialists to address the patient’s broad range of complex needs during a single visit.

Effective MDC requires seamless collaboration and coordination among all health professionals.

Core Team: The MDC team typically includes a neurologist, respiratory therapist, physical therapist, dietitian, speech language pathologist, and palliative care specialists.
Survival Benefit: Studies have shown that patients receiving coordinated multidisciplinary care gain a survival benefit, often increasing life expectancy by several months.

Managing Respiratory Function

Respiratory failure is the most common cause of death in ALS, making breathing support a central and mandatory issue in ALS treatment options. Discussions about respiratory options begin early in the treatment plan.

Timely intervention with breathing support is a fundamental aspect of the survival benefit seen in MDC clinics.

Non-Invasive Ventilation (NIV): Initially, patients benefit from positive pressure ventilation delivered via a mask, which helps support breathing muscles. Timely use of NIV is strongly associated with longer survival.
Tracheostomy: In late-stage ALS, a tube may be surgically placed into the windpipe (trachea) to provide assisted breathing via a ventilator.

Nutritional Support and Intervention

Difficulties with chewing and swallowing (dysphagia) are commonly observed in ALS, leading to weight loss and malnutrition. Nutritional support is critical, as maintaining adequate weight helps preserve muscle function and overall health.

Dietitians work with the patient to ensure nutritional needs are met throughout the disease course.

Dietary Adjustments: Eating calorie-dense foods and nutritional beverages is recommended.
Gastrostomy (PEG Tube): If swallowing becomes too challenging, a tube may be surgically inserted into the stomach to provide direct nutritional support. The timely use of gastrostomy is a factor associated with increased survival.

Rehabilitation and Therapy

Rehabilitation focuses not on curing the disease, but on maximizing function and independence for as long as possible. A comprehensive program involves various allied health professionals.

Therapy helps patients adapt to their progressive muscle loss.

Physical Therapy (PT): Utilizes exercises to maintain strength, endurance, and flexibility. PT helps with gait training and mobility.
Occupational Therapy (OT): Helps patients adapt to daily tasks (e.g., eating, dressing) by recommending and providing essential aids and appliances.
Speech-Language Pathology: Works to maintain communication abilities for as long as possible and introduces alternative communication aids.

Why Choose LIV Hospital

LIV Hospital is dedicated to giving patients caring and specialized treatment for serious neurological conditions like ALS. We follow international standards for multidisciplinary ALS care so every patient receives organized, high-quality support.

Our system makes sure patients don’t have to manage their illness alone. Instead, all medical experts work together and coordinate care to reduce stress and improve outcomes.

How LIV Hospital supports patients:

Team-Based Care: We use a teamwork approach where all specialists talk and work together to make the best and quickest treatment decisions.
Skilled Doctors: Our doctors are highly experienced neurologists and surgeons who use advanced techniques and have strong success results.
Full Support Services: Patients get support from many experts like lung doctors, nutrition specialists, rehab therapists, and palliative care teams during their regular clinic visits.

Follow-up and Monitoring

Follow-up care for ALS is very active and personalized. Patients are usually seen every few months in a special multidisciplinary clinic, where many experts work together. The goal is to catch any changes early especially in breathing and nutrition because early support can help patients live longer and stay healthier.

What the follow-up includes:

Breathing Checks (Pulmonary Function Tests): Doctors regularly measure lung strength to know when to start non-invasive ventilation (a machine that supports breathing).
Nutrition Checks: Weight and swallowing are monitored closely. If eating becomes difficult, a feeding tube (gastrostomy) can be placed early to prevent weight loss.
Aids and Equipment: The team provides devices that help with communication, moving around, and swallowing. These tools make daily life much easier and improve overall quality of life.

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ALS Disease Treatment and Rehabilitation