Motor Neuron Disease & Physiotherapy

23 Oct

What are motor neurons?

Nerve cells that form the pathway along which impulses travel from the brain or spinal cord to the muscles or glands are motor neurons.Motor neurons control muscle activities, such as:

gripping
walking
speaking
swallowing
breathing

Those affected with Motor Neuron Disease gradually lose the ability to perform all these activities.

What is Motor Neuron Disease?

Motor Neuron Disease (MND) is an uncommon neurological condition that gradually affects the nervous system increasingly with time, lessening muscle strength and often impairing vision. Also known as Amyotrophic Lateral Sclerosis (ALS), this condition is caused when certain nerve cells in brain and spinal cord stop working in their usual manner.

Symptoms of MND:

The symptoms of MND usually follow a definite sequence. The appearance of symptoms in initial stages and its detection can improve the quality of life and survival chances of those affected with the condition.

1. The Initial Stage Symptoms:Two-thirds of the affected population experience
  - Weakness and loss of firmness in their limbs. These are painless symptoms sometimes escorted by fasciculation or cramps in the muscles and significant loss of weight.
  - Trouble in gripping objects and picking them up due to weakness in hands
  - Trouble in lifting the arm above the head
  - Losing one’s footing because of fragility at the ankle or hip
  - Slurring of speech often diagnosed as stroke
  - Difficulty in swallowing diagnosed as blockage of throat
  - Shortness of breath
  - Disturbed sleep because of temporary less supply of oxygen to the brain while lying down
  - Joint pain due to muscle stiffness and wasting
  - Drooling because of reduced swallowing and thickening of saliva
  - Certain cognitive changes causing marked problems in concentrating and planning.

1. The Advance Stage Symptoms:With advancement in MND, the symptoms affect more parts of the body and increase in severity. For example, shortness of breath may become more severe that may need non-invasive breathing assistance. The rate of multiplication of the condition neither speeds up not slows down for an individual. 15 of every 100 people affected with Motor Neuron Disease develop fronto-temporal dementia a little before or after their onset of muscle weakness symptoms. The patient may not even realize they have behavioral issues or change in their personality. Some symptoms are very close to those of aging process.

The End Stage Symptoms:In its final stage the disease causes physical paralysis and increased difficulty in breathing. The person may need help with performing activities of daily living. So non-invasive breathing assistance may not be sufficient to manage the lung damage and help in the normal functioning anymore. Most of the affected people become drowsy and fall asleep very often.

Survival Rates

3 years from the onset of symptoms is generally the life expectancy for all those affected with MND. Although some may live longer; Stephen Hawking for example is 75 years and doing well. Motor Neuron Disease is a condition that shortens life span. Surviving with the disease is exceptionally demanding and needs huge mental strength to accept and deal with the condition. However, with strong support and specialist supervision it is possible to improve the quality of life and extend life span.

How can physiotherapy and exercise help with MND?

Proper guidance and exercises to control muscle that have become weak can be done with physiotherapy. Maintaining muscle strength and elasticity can be done by physical therapy and exercises under the guidance of a skilled physiotherapist. It helps increase range of motion for joints and averts shortening of muscles. Physiotherapy for MND can help to maintain mobility for as long as possible. It lessens muscle stiffness and increases muscle strength with the help of strengthening exercises.

10 Ways Physiotherapy Can Help Motor Neuron Disease

Properly assess mobility, range of motion and muscle strength
Discuss physical difficulties related to movement and control
Advise walking and mobility aids to keep normal movement for as much and as long as possible
Help with managing pain because of muscle cramps with the help of gentle stretches and massage
Plan customised exercise and rehabilitation programme to increase muscle strength and stability in areas not affected with the disease
Help increase blood circulation and reduce discomfort in the joints
Suggest exercises and habits that will help maintain posture and ensure maximum breathing by teaching simple techniques to the care giver
Make the patient do exercises that helps in chest clearing and breathing control

Where can I receive physiotherapy?

TriBeCa Care’s excellent team of trained and experienced physiotherapists gives you the best of treatment at your home. To book an appointment: E-mail us at:enquiry@newwpsite.tribecacare.com or call us on +91 33 402 777 77
For further details, visit us at TriBeCa Care

References:
http://www.physiocomestoyou.co.uk/blog/10-ways-physio-can-help-motor-neurone-disease/

https://www.nhs.uk/Conditions/Motor-neurone-disease/Pages/Symptoms.aspx

https://www.mndassociation.org/wp-content/uploads/2015/06/06a-physiotherapy.pdf

Swarnali Roy