Occupational therapy for motor neuron disease

There are many types of neuron that controls our whole body function.  And one of the most important neuron is motor neuron that sends electrical signals to muscles so that muscles can contract or relax. It helps vertebrate animals including humans to move their internal skeletal structure.  The motor system controls all of the movements we make with any part of our bodies, from a simple nod of the head or wave of the hand to more complex movements like walking or running.

 

Slowly your motor neuron stops working! What happens next?

The signals coming from brain to muscles and spinal cord gradually stop  and causes symptoms like weakness and wasting, leading to a group of related diseases affecting the motor neuron, this complete action is formally known as motor neuron disease.

The French Neurologist Jean-Martin Charcot first described Motor Neuron Disease (MND) in 1874. The term motor neuron disease also explain a group of related disease that affected motor neuron cells in the brain and spinal cord and stops sending messages to the muscles. People with MND become increasingly disabled, and may lose speech, have difficulty swallowing and eventually die from respiratory failure.

MND can cause muscle weakness, clumsiness, changes in hand, leg and voice, chewing difficulties, weight loss, emotional liability and also cause respiratory changes. The actual cause of this disease is still unknown but research includes that virus, toxic chemicals, may affect the motor neurons. But genetic factors that people inherited from their family is an increased risk of developing MND.

Motor neuron are divided into two group’s upper motor neuron and lower motor neuron. Both upper and lower motor neuron can be affected by MND. There are various kind of MND disease but four types of MND is main, these are:

Amyotrophic lateral sclerosis (ALS)

Progressive bulbar palsy (PBP)

Progressive muscular atrophy (PMA)

Pseudobulbar palsy

ALS is the most common form that degenerate both the upper and lower motor neuron.  It is detected by weakness in the limbs and tripping while walking or dropping things.

Sinaki and Mulder (cited in Dal Bellow-Haas et al., 1998) describe the natural course of ALS as six stages:

Stage I: Early stage of the disease. Independent in mobility and ADL. A specific group of muscles are mildly weak; may be limitations in performance, endurance, or both.

 Stage II: Moderate weakness in groups of muscles.

 Stage III: Still ambulatory but has severe weakness in certain muscle groups. May exhibit mild to moderate limitation of function. May have difficulty holding head erect.

  Stage IV: Severe weakness of the legs and mild involvement of the arms. May use a wheelchair and may be unable to perform ADL.

 Stage V: Progressive weakness and deterioration of mobility and endurance. Uses a wheelchair. Arm muscles may exhibit moderate or severe weakness. May exhibit pain in immobilized joints.

Stage VI: Bedridden and requires maximal assistance with ADL. Progressive respiratory distress develops.

How can occupational therapy help with the difficulties of Motor Neurone Disease?

Occupational therapists work with people with Motor Neurone Disease and their families to provide advice, support and guidance during their journey.

For some they may require recommendations for a specific item of equipment whilst for other clients we are involved in more substantial home modifications and support as their needs change with the progressing condition. Below are some ways that an occupational therapist can help:

Providing advice on new techniques to continue to complete everyday activities such as dressing and meal preparation for as long as possible as the condition advances

 

Support with sourcing the right equipment to help with difficulties as they arise, such as beds or chairs

Making longer term recommendations to ensure the home environment will meet both current and future needs. This includes considering adaptations such as wet rooms or through floor lifts.

Working with a client and / or their employer to advise on ways to remain at work for as long as possible. This may involve pacing strategies to maximize energy or work place changes to ensure you are positioned correctly

Helping manage fatigue by identifying priorities for the day’s energy, whether that be getting the children to bed or maintaining a work role, and then planning how to conserve energy levels for this.

Ensuring the correct seating and wheelchair are provided to maximize function and independence

 

Recommending environmental controls which allow the control of functions in the home such as opening curtains, turning on lights or adjusting music or TV settings to be controlled by the client from their wheelchair, armchair or bed. An occupational therapist will work with a client to identify the most suitable environmental controls for them that will preserve their independence for as long as possible.

 

Occupational therapy for motor neuron disease

There are many types of neuron that controls our whole body function. And one of the most important neuron is motor neuron that sends electrical signals to muscles so that muscles can contract or relax. It helps vertebrate animals including humans to move their internal skeletal structure. The motor system controls all of the movements we make with any part of our bodies, from a simple nod of the head or wave of the hand to more complex movements like walking or running. Slowly your motor neuron stops working! What happens next? The signals coming from brain to muscles and spinal cord gradually stop and causes symptoms like weakness and wasting, leading to a group of related diseases affecting the motor neuron, this complete action is formally known as motor neuron disease. The French Neurologist Jean-Martin Charcot first described Motor Neuron Disease (MND) in 1874. The term motor neuron disease also explain a group of related disease that affected motor neuron cells in the brain and spinal cord and stops sending messages to the muscles. People with MND become increasingly disabled, and may lose speech, have difficulty swallowing and eventually die from respiratory failure. MND can cause muscle weakness, clumsiness, changes in hand, leg and voice, chewing difficulties, weight loss, emotional liability and also cause respiratory changes. The actual cause of this disease is still unknown but research includes that virus, toxic chemicals, may affect the motor neurons. But genetic factors that people inherited from their family is an increased risk of developing MND. Motor neuron are divided into two groups upper motor neuron and lower motor neuron. Both upper and lower motor neuron can be affected by MND. There are various kind of MND disease but four types of MND is main, these are: Amyotrophic lateral sclerosis (ALS) Progressive bulbar palsy (PBP) Progressive muscular atrophy (PMA) Pseudobulbar palsy ALS is the most common form that degenerate both the upper and lower motor neuron. It is detected by weakness in the limbs and tripping while walking or dropping things. Sinaki and Mulder (cited in Dal Bellow-Haas et al., 1998) describe the natural course of ALS as six stages: Stage I: Early stage of the disease. Independent in mobility and ADL. A specific group of muscles are mildly weak; may be limitations in performance, endurance, or both. Stage II: Moderate weakness in groups of muscles. Stage III: Still ambulatory but has severe weakness in certain muscle groups. May exhibit mild to moderate limitation of function. May have difficulty holding head erect. Stage IV: Severe weakness of the legs and mild involvement of the arms. May use a wheelchair and may be unable to perform ADL. Stage V: Progressive weakness and deterioration of mobility and endurance. Uses a wheelchair. Arm muscles may exhibit moderate or severe weakness. May exhibit pain in immobilized joints. Stage VI: Bedridden and requires maximal assistance with ADL. Progressive respiratory distress develops. How can occupational therapy help with the difficulties of Motor Neurone Disease? Occupational therapists work with people with Motor Neurone Disease and their families to provide advice, support and guidance during their journey. For some they may require recommendations for a specific item of equipment whilst for other clients we are involved in more substantial home modifications and support as their needs change with the progressing condition. Below are some ways that an occupational therapist can help: Providing advice on new techniques to continue to complete everyday activities such as dressing and meal preparation for as long as possible as the condition advances Support with sourcing the right equipment to help with difficulties as they arise, such as beds or chairs Making longer term recommendations to ensure the home environment will meet both current and future needs. This includes considering adaptations such as wet rooms or through floor lifts. Working with a client and / or their employer to advise on ways to remain at work for as long as possible. This may involve pacing strategies to maximize energy or work place changes to ensure you are positioned correctly Helping manage fatigue by identifying priorities for the days energy, whether that be getting the children to bed or maintaining a work role, and then planning how to conserve energy levels for this. Ensuring the correct seating and wheelchair are provided to maximize function and independence Recommending environmental controls which allow the control of functions in the home such as opening curtains, turning on lights or adjusting music or TV settings to be controlled by the client from their wheelchair, armchair or bed. An occupational therapist will work with a client to identify the most suitable environmental controls for them that will preserve their independence for as long as possible.