Amy J. Litterini
© 2018 Gianna G. Pezzano
Background and Purpose: This case report provides a detailed description of how balance training was incorporated into physical therapy (PT) treatment to reduce fall risk and maintain functional mobility in an elderly patient diagnosed with ALS. Due to lack of research on ALS, and the terminal nature of the disease, clinicians and researchers may benefit from a palliative care PT plan to maintain functional mobility for patients with neurodegenerative diseases. Case Description: An 82-year old female presented to outpatient PT with the diagnosis of ALS, with decreased functional mobility, high fall risk, and left hip/knee pain due to arthritis. She received 13 sessions over 12 weeks. The outcome measures used include the Berg Balance Score (BBS), Timed Up and Go (TUG) in seconds (s), 6 Minute Walk Test (6MWT) in meters (m), and manual muscle testing (MMT). Outcomes: Balance training was used throughout the sessions to decrease fall risk, as well as therapeutic exercise to maintain strength for activities of daily living (ADL). Throughout treatment, she demonstrated slight decline in function, but was able to maintain function within the minimal clinically important difference (MCID). Maintenance of function was shown by the 6MWT (120 m to 126m) where distance was still within the MCID, and the TUG (23.75 s to 29 s) showed continued independence in transfers. Only slight decline in strength was shown in left dorsiflexion (4 to 3+/5) and in balance on the BBS (37 to 29/56). Discussion: PT serves an important role in palliative care for the maintenance of function in neurodegenerative diseases and further research is needed to determine beneficial interventions.
Pezzano, Gianna G., "Functional Mobility For An Elderly Patient With Amyotrophic Lateral Sclerosis: A Case Report" (2018). Case Report Papers. 100.