Amyotrophic Lateral Sclerosis: Pathophysiology and Implications for Physiotherapy This work will provide a basic overview of the pathophysiology of amyotrophic lateral sclerosis (ALS) as well as the medical interventions used in treatment of the disease. Physical therapy interventions for ALS and therapeutic exercise recommendations are the focus of this study and will be discussed in more detail in the later section. DescriptionAmyotrophic lateral sclerosis, or Lou Gehrig's disease as it is commonly known, is described by the ALS association (ALSA, 2010) as "a progressive neurodegenerative disease that affects nerve cells in the brain and spinal cord." Muscular atrophy is described by Porth and Matfin (2009) as muscle wasting or atrophy resulting from the death of lower motor neurons, which is the most easily observed outcome of the disease process. Lateral sclerosis refers to the breakdown of nerve tissue in the lateral columns of the spinal cord due to scarring. ALS has the following signs and symptoms (S&S). The early stages involve muscle weakness, involuntary movements, spasticity, muscle twitching and cramping; these usually begin in the distal extremities (Lescher, 2011). Progressive S&S includes atrophy and paralysis of the muscles of the limbs, trunk and face as well as fatigue, dysarthria, dysphagia and hyperreflexia (i.e. the very sensitive gag reflex and the reflex positive Babinski). Due to weakness and paralysis of the facial and throat muscles, eating and breathing are affected. Most people with ALS end up relying on mechanical ventilation. Demographics ALS most often affects people aged 40 to 70; the average age is 55, most are white (93%) and he is 2...... middle of paper ......451-461. Available at http://iospress.metapress.com/content/j8p10mxtu180u036/Lui, AJ and Byl, NN (2009). A systematic review of the effect of moderate-intensity exercise on function and disease progression in amyotrophic lateral sclerosis. Journal of Neurological Physiotherapy, 33(2), 68-87. doi:10.1097/NPT.0b013e31819912d0Pflumm, M. (2012). Exercise: Pushing the boundaries of ALS care. Retrieved from ALS Therapy Development Institute website: http://blogs.als.net/post/Exercise-does-a-body-good-But-what-about-pALS.aspxPorth, CM and Matfin, G. (2009). Pathophysiology: Concepts of Altered Health States (8th ed.). Philadelphia, PA: Wolters Kluwer Health-Lippincott Williams & Wilkins. University of Pittsburgh, ALS Research Center. (2013). Occupational therapy and physiotherapy. Retrieved from http://www.alsresearchcenter.pitt.edu/patients/pt_ot_therapy.php