REHABILITATIDN MEDICINE IN ALS 
A. Pražnikar
Oepartment of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia
Amyotrophic latcral sclcrm,is (ALS) is a progrcssivc ncu­
rodcgencrative clisorder that poses a myriad or clinical. 
personal and social proble1m. ALS is clinically manifcsted 
predominantly by upper motor neuron signs and symptoms 
in limb and trunk musculature like spasticity. central paresis. 
loss or clexterity. desinhibition of pathological reflexes: lower 
motor ncuron signs ancl symptoms like atrophy. wcakncss. 
loss of tendon reflexes. Iowe red musclc tone. rascicu lation: 
ancl bulbar signs and symptoms like dysarthria. dysphagia. 
siallorhoe. emotional lability .... Fatigue. demcntia. pain. 
slecp disorclers. depression or cachexia could contribute to 
severity of clinical picture in some patients with ALS. At the 
moment therc is no causal treatment tliat would significantly 
change the prognosis or the paticnts with ALS. The disease 
course relentlessly progresses to respiratory compromisc. 
Rehabilitation medicine (also in neurology) bascs its inter­
vcntions on clisordcrcd function ( .. lack or activity .. ) in order 
to lessen the clisability of thc individual paticnt c·lack or 
participation 
.. 
). According to lntcrnational Classification or 
Functioning. Disability ancl Hcalth (ICF. WHO) functioning 
Ed 
and disability are vicwed as a complex intcraction bctwe
en 
thc health condition of the individual and thc context uat 
factors of the environmcnt as wel I as pcrsonal factors - "th e 
pcrson in his or her world". Rchabilita tion principlc trc ats 
thcse dimensions of hcalth as interactive and dynamic in 
each patient with ALS. By doing so. rchabilitation tcam that 
consists or rehabilitation specialist or ncurologist. physic
al 
and occupational therapists. specch language pathologist s, 
dietitians. psychologists. social workers. rehabilitation 
nurses and casc managers eval uates ancl treats loss of func­
tion due to motor. psychological and/or social consequences 
of ALS. The need for anticipation and for a quick response 
of thc health system makes rehabilitation of patients with 
ALS specific. The main goals are to prolong indcpendence, 
prevcnt complications ancl improvc quality or lile. Thcreli.)re, 
rehabilitation medicine olkrs activc approach in adclressing 
the discase. improves the quality of lile and prolongs the 
survival in paticnts with ALS as pari or complex multidis­
ciplinary team management as a gold standard of today's 
managemcnt of patients with ALS.