Motor neurone disease (MND) is the name which is given to a group of diseases which cause degeneration and death of the neurone. Motor neurone disease is a neurodegenerative disorder. Motor neurone disease cause the nerves in the brain and the spinal cord to lose their function over time. Some forms of Motor Neurone Disease are hereditary, most causes are unknown. In sporadic or non-inherited MNDs, genetic, viral, environment or toxic factors may be implicated.
MNDs are classified whether they are inherited or sporadic, and whether the degeneration is affecting the upper or low motor neurones or both.
- In adults the most common form is Amyotrophic lateral sclerosis (ALS), it has inherited and sporadic forms and effects both upper and lower motor neurones. It can affect arms, legs and facial muscles.
- Primary lateral sclerosis (PLS) this disease affects the upper motor neuron.
- Progressive muscular atrophy (PMA) affects only the lower motor neurons of the spinal cord.
- Progressive Bulbar Palsy (PBP) affects only lower motor neurons of the brain stem cause slurred speech, difficulty chewing and swallowing. There are always mild abnormalities of the arms and legs.
- Kennedy’s disease is also a progressive spinobulbar muscular atrophy.
- Post-polio Syndrome (PPS)
- Spinal muscular atrophy (SMA)
Diagnosis will depend on the type of MND and the age of the patient. With PLS and Kennedy’s disease the progression is slower and is not fatal. People with SMA appear to be stable for a longer period, but improvements are not expected in these cases.
This article discusses the causes and symptoms of MND and how physiotherapy can be helpful with this condition.
Types of Motor Neurone Disease
Amyotrophic Lateral Sclerosis (ALS)
ALS is a rare neurological condition that involves affecting the movement of your voluntary muscles. Voluntary muscles are those muscles that you choose to move. The most common symptoms of this disease include muscle cramps and twitches, having difficulty chewing or swallowing food, having difficulty with speech and more.
The causes of this disease may involve the person’s age, genetics, or the environmental factors.
Progressive muscular atrophy (PMA)
PMA is also a rare type of MND that impacts on lower and upper motor neurons. This type of MND is quite like ALS. There are also cases where the PMA has later turned out to be ALS but with a slower progression.
The symptoms of PMA include having difficulty with reflexes and spasticity and having weaknesses in your muscles.
Primary lateral sclerosis (PLS)
Primary lateral sclerosis or PLS is another rare type of MND that involves the central motor neurons and is a progressive condition and causes weakness/stiffness in arms and leg muscles. In 80% of the cases PLS can progress into ALS.
Some common issues for the patients with PLS include:
- PLS starts with weakness in leg muscles and as the disease progresses walking becomes more and more difficult for the patient
- Patients with PLS may not experience changes to their speech at first, however speech can also be affected as the disease progresses.
- Having difficulty keeping their head up and have a right posture
Progressive bulbar palsy (PBP)
Progressive bulbar palsy or PBS involves affecting your brain stem which allows you to chew, swallow and speak. Having difficulty in any of these functions can be initial symptoms of PBS. PBS is also known as a type of ALS and in some cases, there is a chance that it would develop into ALS.
Risk Factors for MNDs
The risk factors involving MND may include:
- MND is more likely to occur in men
- this condition can affect all ages depending on the type
- If MND is inherited is more likely to present at birth
- The disease is more likely to appear after the ages of 55-75 years
- The different types may have different risk factors
- 10% of ALS cases in the united states are hereditary
- Veterans appear to have 1.5-2 high chance of developing ALs than non-Veterans
Symptoms Motor Neurone Disease
The symptoms of Motor Neurone Disease vary as the disease progresses. The most common symptoms and signs at early stages of the disease may include:
- Weakness and pain in muscles
- Losing weight and muscle mass
- Having difficulty with speech
- Joint pain
- Fatigue
- Clumsiness and stumbling while walking
- Having difficulty breathing/reduced lung capacity
Physiotherapy for MND
The physical therapy rehabilitation may help to improve posture, joint immobility, and slow muscle weakness and atrophy. A physiotherapy professional can provide the patient with a treatment plan that may consist the combination of exercises and other types of treatment to improve patient’s overall quality of life and allow the patient to manage the symptoms of his/her condition.
A physiotherapy professional considers all the patient’s needs, weaknesses, and strengths and the type of MND the patient is dealing with to provide a comprehensive treatment plan.
Techniques used by the physiotherapy may include:
- To reduce spasticity, stretching exercise may be used to increase range of motion and maintain circulation.
- Braces, orthotics, speech synthesizers, and wheelchairs may help some people retain independence.
- Application of heat may relieve muscle pain
- Non-invasive ventilation at night may be required to prevent apnea in sleep, some people may require assisted ventilation due to muscle weakness in the neck, throat, and chest during the daytime.
Hydrotherapy for patients with MND
The exercises that involve the patient’s knee, back, hips and foot can be done easier in water due to the reduction in gravity. This allows the patient to do balance exercises and warm water can relax the muscles and relieve pain.
For more information in relation to hydrotherapy, you can click on services and choose hydrotherapy to find out more.
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