Medical Matters for Drivers, Caregivers & Family Members

Mobility Challenges

Below are links to more information based on your mobility challenge.

ALS

MobilityWorks and You

At MobilityWorks, we understand the desire of individuals with ALS to maintain their independence to get around. We also understand that each individual with ALS has unique mobility needs and that those mobility needs may change through the years.

Our Certified Mobility Consultants can work with you to assess your current physical condition and mobility needs and discuss what your needs may be in the future.

By asking a series of questions such as; are you currently using a cane or a scooter, are you able to get into and out of a vehicle seat easily and safely and/or are you able to drive, we can determine whether adaptive seating or adaptive driving aids might be the best option for you. Adaptive seating is designed to help you move into the front seat of a vehicle. Adaptive seating works through controls that allow the seat to move backward, forward, up, down and side-ways. You may find that adaptive seating may be the perfect solution to make entering and exiting your vehicle easier. In addition, you may find that adaptive driving aids such as hand controls, pedal extensions and steering knobs would make operating your vehicle easier as well.

If you are using a wheelchair full-time, then a wheelchair accessible vehicle may be the best option for you. If that is the case, we can evaluate the size/weight of your chair, as well as factors such as your ability to drive, the number of people that will be transported in the vehicle, where it would be parked/garaged and your budget—in order to offer you options for mobility solutions.

At MobilityWorks, we pride ourselves on developing lasting relationships with our customers. We want to ensure that you have the most appropriate mobility equipment for your needs—today and in the future.

What is Amyotrophic Lateral Sclerosis (ALS)?

Amyotrophic Lateral Sclerosis (ALS) is a progressive, neurodegenerative disease that affects nerve cells in the brain and spinal cord. Motor neurons reach from the brain to the spinal cord and from the spinal cord to the muscles throughout the body. ALS causes those motor neurons to degenerate and eventually die. When motor neurons die, the ability of the brain to initiate and control muscle movement is lost. Without voluntary muscle movement; people may lose the ability to speak, eat, move and/or breathe.

ALS is classified into two different types:

  • Sporadic—The most common form of ALS in the U.S., sporadic ALS accounts for 90-95% of all cases. Sporadic ALS may affect anyone, anywhere.
  • Familial--- Familial ALS is a form of the disease which is inherited. In families with a history of ALS, there is a 50% chance that each offspring will inherit the gene mutation and may develop the disease.

The initial symptoms of ALS include:

  • Increasing weakness in one limb; especially in a hand
  • Difficulty walking
  • Clumsiness of the hands
  • Fasciculations  (subtle, light twitches under the skin)
  • Impaired speech
  • Difficulty swallowing

As ALS progresses, symptoms may include:

  • Weakening of other limbs, perhaps accompanied by twitching, muscle cramping and exaggerated reflexes
  • Problems with chewing, swallowing and breathing,
  • Paralysis

Risk Factors / Prevention for ALS

Established risk factors for ALS include:

  • Heredity >> Five to ten percent of people with ALS inherited it (familial ALS). In most people with familial ALS, their children also have a 50-50 chance of developing the disease.
  • Age >> ALS most commonly occurs in persons between the ages of 40 and 60.
  • Sex >> Before the age of 65, slightly more men than women develop ALS. This sex difference disappears after age 70.

Researchers also believe that certain environmental risk factors may trigger ALS. In addition, some studies examining the entire human genome (genome-wide association studies) have found numerous genetic variations that people with familial ALS and some people with non-inherited ALS had in common. These genetic variations might make people more susceptible to ALS.

In addition, certain environmental factors may modify a person's individual risk of ALS. Those factors include:

  • Smoking >> Smoking cigarettes appears to increase a person's risk of ALS to almost twice that of a nonsmoker. The more years spent smoking, the greater the risk. However, quitting smoking can eventually lower the increased risk.
  • Lead exposure >> Some evidence suggests that exposure to lead in the workplace may be associated with the development of ALS.
  • Military service >> Recent studies indicate that people who have served in the military are at higher risk for ALS. Exactly what about military service may trigger the development of ALS is uncertain, but it may include exposure to certain metals or chemicals, traumatic injuries, viral infections and intense exertion.
Treatments & Rehabilitation for ALS

Although no treatment slows or halts the progression of ALS; various drugs and therapies are available to help control symptoms and make living with the disease easier.

Rilutek (riluzole) is a drug approved for use in the treatment of ALS. How Rilutek works is not exactly known; but it appears that it prevents damage that can result from nerve cells being overexcited by glutamate. Studies have also shown that Rilutek may improve overall functioning. Persons with ALS are advised that, due to potential side effects involving the liver, close monitoring by their doctor is required when utilizing this drug.

Physical therapy is a way to improve circulation and help prolong muscle use in the early stages of ALS. Also, additional medications may be prescribed as the disease progresses to help with symptoms. Baclofen relieves stiffness in the limbs and throat. Muscle decline and weight loss can be slowed with nutritional supplements called branched-chain amino acids (BCAAs). Antidepressants may also be prescribed to help with depression, which often accompanies a severe illness.

ALS Research

A recent study conducted by the Columbia University Medical Center has resulted in the finding of a new gene that is believed to be a cause of familial ALS. The newly associated gene, called TBK1, plays a key role at the intersection of two essential cellular pathways: inflammation (a reaction to injury or infection) and autophagy (a cellular process involved in the removal of damaged cellular components). Researchers indicate that the discovery of this gene and its relationship to ALS moves them one step closer to developing drugs that could potentially treat the disease.

ALS Resources

Mobility Challenges

Below are links to more information based on your mobility challenge.

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