Physiotherapy for people with motor neurone disease (MND)

What happens after assessment?
In the early stages of the disease, you might start with simple maintenance
exercises, which you can do yourself. However, as the disease progresses,
you will probably need to move on to a different regime of less active
exercises. This can still be very helpful to prevent joint stiffness and muscle
shortening.
Each physiotherapist will have a different approach, but within common
themes. This means that individual programmes are likely to include:
ROM exercises: to maintain range of movement in the joints, which helps to
prevent joint deformity and soft tissue shortening. These are usually done
systematically, with the joints of one limb exercised in a particular order
before the next limb is exercised and so on. The object is to move each
affected joint through its full range of motion every day to prevent joint
stiffening.
Massage and soft tissue mobilisation: to increase circulation, mobilise
connective tissue, reduce pain, aid relaxation, assist muscle tone and reduce
spasticity (stiffening and tightening).
Breathing techniques: to facilitate respiratory effort and to aid clearance of
secretions.
Exercises: to achieve the best possible functionality dependent on your
current circumstances. These can be split into three categories:
• Active exercises: when you do not require any assistance to make
your muscles perform their full movement
• Active-assisted exercises: when you can no longer fully move
through a ROM exercise on your own, but a helper can assist the
movement
• Passive exercises and stretches: when the muscles can no longer
perform any of the movement and a helper guides joints through their
range of movement by supporting and moving your limb. Please note
that passive exercises work the joints, but not the muscles. Carers
should be trained by a physiotherapist to do these exercises correctly.
Although MND will continue to progress and cannot be reversed, access to
ROM exercises in the early stages of MND can help to maintain and possibly
improve functional range of movement, for a period of time:
“With gentle persuasion and exercise, my husband regained enough range of
movement for me to wash under his arms again and dress him pain free.”
Wife and carer of someone living with MND
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