What frequency and duration of physiotherapy is recommended for ALS?

The intensity of the physiotherapy (frequency and duration of application as well as form of therapy) depends on the symptoms, the severity of the deficit and the course of the disease. In the case of a minor deficit (e.g. paralysis in one limb or a few regions), therapy lasting 45 minutes and two applications per week is sufficient. In addition to physiotherapy, many patients require accompanying heat therapy or massage. The combined application of physiotherapy, massage and heat therapy results in an application time of over an hour.

In the case of certain symptoms (e.g. contractures of the tendons due to spasticity or reduced use of the limb), more intensive physiotherapy may also be necessary in the early course of the disease, with applications up to five times a week. If the severity of ALS increases, high-frequency physiotherapy is required to avert the consequences of loss of mobility (prevention of contractures, pain, arthrosis, thrombosis, lymphoedema and inactive atrophy). In this constellation, physiotherapy up to five times a week makes sense and can be prescribed. In the case of severe paralysis of the entire body, daily physiotherapy is indicated.

Due to the limited availability of physiotherapy sessions at weekends, daily application is unrealistic, so therapy five days a week is recommended, supplemented by two days (weekends and public holidays) of self-treatment. Self-treatment” is also understood to mean physiotherapy carried out independently by nursing staff or family members on the basis of therapy instructions (without the presence of therapists). Daily mobilization and motor activity is crucial for strengthening and maintaining motor capacities and preventing complications. The use of therapeutic movement equipment is an important form of equipment-based self-therapy, which should be seen as complementary to physiotherapy and can help to increase the frequency of therapy.