What is the physical limit for people with ALS?

To avoid overexertion, a “submaximal” workload is recommended: this refers to a workload that is below one’s maximum individual capacity.

It is recommended to regularly use up to 80% of one’s individual capacity during physical therapy (or other physical activities). Most people have a level of body awareness that allows them to estimate their own capacity at 80%.

A specific type of overexertion must be taken into account in cases of spasticity. Physical activity can lead to additional muscle tension and an increase in existing spasticity (“sudden onset spasticity”).

Therefore, in cases of ALS with predominant involvement of the upper motor neuron (and associated spasticity), physical therapy must be carefully “modulated” so as not to exceed the threshold for provoked spasticity.

It should be emphasized that “sudden-onset spasticity” is temporary and usually subsides within a few minutes. Nevertheless, the increase in spasticity may be associated with reduced function (e.g., an increase in gait disturbance) or with pain.

Physical therapists who are familiar with the treatment of neurological disorders play an important role in assessing an individual’s tolerance level.