In Amyotrophic Lateral Sclerosis or S.L., physiotherapy is based on maintenance and comfort and not on gaining muscle strength. Electrical stimulation is formally discouraged.

The frequency of sessions will rarely be less than 3 times a week.

The duration of each session will be at least half an hour (OJ of 04/10/2000). It will adapt to the fatigability of the patient.

Musculo-articular management

Progressive paralysis of the limbs will cause joint stiffness, a source of pain, trophic disorders, sometimes vicious positions. This will have an impact on the quality of life.

The objectives are:

  • 1.fighting against ankylosis
    • passive mobilization of the joints in all their amplitude (emphasis to put on the shoulders, the fingers and the wrists)
    • stretching
    • rest orthoses in the absence of spasticity

  • 2.fighting pain
    • Progressive exercises of short duration, effortlessly
    • massages to lift contractures

  • 3.fighting against trophic disorders
    • circulatory massage
    • massage points of support
    • maintenance of walking
    • drainage posture

Respiratory management:

Progressive paralysis of the respiratory muscles will cause a decrease in breathing capacity, difficulty in coughing and expectoration. This will have an impact on the patient's vital prognosis.

The objectives are:

  • 1.Correction of the posture
    • Verticalization sessions

  • 2.Muscular maintenance
    • Preservation of abdomino-diaphragmatic breathing

  • 3.Désencombrement
    • Postures of drainages
    • Sputum facilitation
    • Training and use of Cough Assist