Neuromuscular Physical Therapy
Why Choose PT for Neuromuscular Diseases?
Be Proactive With PT for Neuromuscular Diseases!
Those diagnosed with Neuromuscular diseases may be experiencing a significant impact on their daily function or noticing that some tasks that used to be easy are becoming more difficult. While a diagnosis of a neuromuscular disease can be scary, physical therapy is an important tool to help you combat many of the consequences of these conditions. Let’s dive a little further into neuromuscular diseases and how physical therapy can help preserve function and address some of the common symptoms.
WHAT IS A NEUROMUSCULAR DISEASE?
Neuromuscular diseases are those which impair the function of the muscles due to their effects on the muscles themselves or the nerves that innervate the muscles. While relatively uncommon, these disorders are typically inherited, caused by a spontaneous gene mutation or at times by an immune system disorder. Some of them may show up early in life while others may remain unexpressed until later in life.
Some of the more well-known neuromuscular diseases include Muscular Dystrophy, Amyotrophic Lateral Sclerosis (ALS), Charcot-Marie-Tooth disease (CMT), Spinal Muscular Atrophy, Polymyositis and Myasthenia Gravis but there are many more. These diseases fall within several distinct categories based on how they affect the muscles and the motor nerves. These categories are:
Muscular dystrophies: a group of diseases that cause weakness and degeneration of the skeletal muscle due to their effect on the muscle cells
Motor Neuron Diseases: a group of diseases that cause progressive deterioration of the motor neurons–nerves that supply the muscles and signal them to contract
Ion Channel Diseases: these diseases are caused by defects in proteins called ion channels. Muscular weakness, periodic paralysis or absent muscle tone are hallmarks of these conditions
Mitochondrial Diseases: mitochondria produce energy within the muscle cells. This subcategory of diseases is caused by an impairment in mitochondrial function
Myopathies: a large umbrella category of diseases characterized by impaired functioning of the muscle cells
Neuromuscular Junction Diseases: where the motor nerve and the body of the muscle meet is called the neuromuscular junction. Several very important processes occur at this junction that facilitate the contraction and relaxation of muscles
Peripheral Nerve Diseases: while the central nerves are those that travel within the brain and spinal cord, the peripheral nerves travel in the periphery of the body to the skin, muscles and organs. Impairments in these nerves can cause both loss of muscle function and sensation.
WHAT ARE THE SYMPTOMS OF A NEUROMUSCULAR DISEASE?
Because neuromuscular diseases impair the muscles either directly or through the nerves that innervate them, a pattern of symptoms is often seen with these conditions though the area of the body most affected, the pattern or progression and severity can vary widely. Here is a list of some of the more common symptoms of a neuromuscular disease:
Muscle weakness, wasting/atrophy (most common)
Muscle twitching, cramps, aches and pain
Numbness, tingling and painful sensations
Difficulty with movement
Reduced balance
Difficulty walking
Trouble swallowing
Drooping eyelids
Difficulty breathing
Because muscle weakness is the primary symptom of a neuromuscular disease, performing everyday tasks may become more difficult. If the muscles that coordinate swallowing or breathing become affected, a tube to provide nutrition and machines to support breathing may be necessary.
WHAT CAN PT DO TO HELP WITH THESE SYMPTOMS?
There are many ways that a physical therapist can help a person diagnosed with a neuromuscular disease. Here are some of the elements of physical therapy treatment you may encounter:
Exercise: While it may seem counterintuitive, exercise to improve strength, endurance and aerobic capacity is safe and beneficial in most cases of neuromuscular diseases (Anziska, Y & Inan, S, 2014). That being said, it is a good idea to consult with a knowledgeable exercise professional like a physical therapist when starting an exercise program if you have been diagnosed with a neuromuscular disease. They will be able to individualize the program in a way that maximizes both safety and effectiveness given the severity of your condition.
Manual Therapy: Manual therapy includes hands-on techniques to improve joint and tissue extensibility, reduce pain, improve flexibility and range of motion.
Balance training: Impairments in the nerves that transmit motor and sensory information can lead to difficulty balancing and may lead to falls. Balance training can help your body compensate for these changes and reduce your risk for falls.
Gait and mobility training: Independent mobility is an important goal of physical therapy. Aside from working to improve strength, balance and endurance to improve walking (or rolling), prescribing and fitting assistive devices or assisting in getting a wheelchair can be an important aspect of physical therapy for neuromuscular diseases.
Pain Management: Pain may be a direct symptom of the disease itself or a result of altered movement patterns, joint position and stress that results from having weaker muscles. Your physical therapist can assess the underlying causes of your pain and work with you to find strategies for pain relief whenever possible.
Equipment prescription: When muscle weakness begins to impair the performance of daily tasks or activities we need and love to do, a physical therapist can help you with finding equipment to compensate for the loss of strength and mobility. This may include devices for mobility like canes, walkers and wheelchairs. They may also prescribe equipment to help you perform daily tasks in the kitchen, the bathroom, and the workplace. You may even find there is great equipment to help you continue to drive or participate in your favorite sport.
Bracing and orthotics: As muscles weaken, bracing and orthotics can help to support the joints externally. Bracing of the feet and ankles may help with standing and prevent tripping, for example. Bracing of the wrist and hand may provide the stability you need to grip and grasp onto something. Also, bracing and orthotics can help with pain relief when prescribed appropriately.
Education: Patient education is an important part of physical therapy for neuromuscular diseases. Not only can your PT help educate you on how your condition may affect your daily functioning and on strategies for compensation, but education on things like pacing and energy conservation are also a part of the treatment plan.
Living with a neuromuscular disease can feel scary but healthcare professionals like physical therapists are here to help you be proactive and take back some control over your health and function. Don’t wait to call us here at Evolve PT so that we can begin to work with you on a plan that will help meet your goals.
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