Sekundarni povzetek: |
Amyotrophic lateral sclerosis is a neurodegenerative, progressive, incurable and fatal disease. The focus of patient care is to address problems of breathing, movement, feeding, speech and swallowing. In a multidisciplinary healthcare team, physiotherapy plays a key role in the holistic treatment of ALS patients. Physiotherapy treatment has an impact on the patient's functional status, pain and mobility in ALS and, through this, on the patient's quality of life. The range of exercises includes: stretching exercises, exercises to improve joint mobility and mobilization, balance exercises, exercises for the strength of unaffected muscles, exercises for the strength of affected muscles, and aerobic activity. A combined program of aerobic exercise, strength exercises, and standard rehabilitation has the greatest impact on improving the quality of life and reducing fatigue in ALS patients. All forms of exercise are safe for patients if performed in a condition-specific manner, with all precautions and fall prevention. Therapeutic exercise helps to slow down muscle deterioration and functional decline in ALS patients, making it easier for them to perform activities of daily living, even if it does not prolong survival. Exercising inspiratory and expiratory muscles leads to improved respiratory muscle function, yet it does not prolong survival but improves the quality of life until the end of the disease. The current recommendations for exercise in ALS patients are 20 to 60 minutes of aerobic activity, 3 to 5 days per week, at an intensity of 40 to 85 percent of maximal heart rate. Patients should perform strength training twice a week, at moderate intensity. High-intensity training is discouraged.
ALS patients receive a variety of supportive therapies. NIV is most helpful in prolonging survival and improving quality of life. Treatment of sialorrhoea with botulinum toxin improves the quality of life of ALS patients. Gastrostomy feeding improves both survival and quality of life. The introduction of alternative communication is of paramount importance. Treatment of psychological problems, anxiety, and depression through BCT, psychotherapy, and medication greatly improves the quality of life of ALS patients.
But the quality of life of an ALS patient is linked to the individual's self-perception, which is poor, despite various forms of support, due to the nature and progression of the disease. |