Facing ALS: Exoskeletons as Hope in Neurological Rehabilitation

By Maite Molinuevo, Head of Neurology Specialized Physiotherapy and Clinic Coordinator at Movex Living Lab

In the broad field of neurological diseases, Amyotrophic Lateral Sclerosis (ALS) emerges as a formidable figure, challenging both those who suffer from it and healthcare professionals striving to understand and address it in the best possible way. Currently, it is the third most common neurodegenerative disease in Spain. From my experience in specialized neurology physiotherapy, I have been able to accompany patients along their journey and at different stages of this disease, and today I wish to share with you an insight into its nature, symptoms, treatments, and a look at the forefront of neurorehabilitation, where exoskeletons stand out as a promising tool.

What is ALS?

ALS, Amyotrophic Lateral Sclerosis, is a progressive neurodegenerative disease caused by the loss of spinal, bulbar, and cortical motor neurons, resulting in the paralysis of voluntary and respiratory muscles. It predominantly affects people between 40 and 70 years of age, and it is worth noting that the clinical course and pathophysiology of this disease are as heterogeneous and individual as the patients we may encounter.

Symptoms of ALS

Symptoms of ALS can vary significantly between individuals and over time. However, some common signs include muscle weakness, muscle spasms, difficulty speaking, swallowing, or breathing, changes in coordination, and difficulty in controlling voluntary muscle. It is important to note that ALS does not affect cognitive function, meaning that the person remains mentally alert, aware, and oriented as the disease progresses with all its symptoms.

ALS Treatment

To date, there is no cure or definitive therapy for ALS. However, there are various treatment strategies aimed at relieving symptoms, delaying disease progression, and improving the quality of life of patients. These may include physical rehabilitation therapies, medications to control symptoms, respiratory and feeding assistance equipment, as well as emotional and psychological support for both the patient and their family and caregivers.

Personal Experience: Human Connection in the Fight against ALS

Throughout my career, I have been able to work with various people facing ALS. Each patient has their own story, and each encounter has taught me the importance of empathy, understanding, and commitment in the rehabilitation process, always with the aim of providing, as much as possible, a better quality of life to each individual.

As a therapist accompanying the daily journey of each patient, each person leaves their personal mark on you. I especially remember J., a middle-aged man who, despite the constant progression of his disease and his difficulty in walking, never stopped trying every single day. For J., walking was a daily struggle, as he experienced an average of 5 falls per month. It was in this context that rehabilitation with exoskeletons restored his autonomy and quality of life, and with it, a new hope, both for him and for the entire team, as after several months of rehabilitation, he went on to have a maximum of 2 falls per year.

Exoskeletons: Innovation in Neurological Rehabilitation

In the field of neurorehabilitation, exoskeletons are emerging as a revolutionary tool for improving gait quality and mobility in patients with various neurological pathologies, including ALS. These biomechanical devices provide support and assistance to different joints and body structures through the principle of neuroplasticity, thus allowing improvement in strength, muscle activation, endurance, stability, and body schema deficient after a neurological injury or pathology.

In J.'s case, the use of an exoskeleton not only provided him with greater stability and balance while walking but also gave him a renewed sense of freedom. Through carefully tailored training sessions and continuous support from an interdisciplinary team, J. was able to maintain his mobility and independence for longer than he ever thought possible.

Conclusion: A Future of Hope and Empowerment

ALS can be a devastating disease, both for those who suffer from it and for their loved ones. However, in the midst of adversity, human resilience and technological innovation emerge. As we continue our search for more effective treatments and more accessible solutions for ALS, we must always remember the importance of addressing this disease comprehensively, providing not only medical care and physical therapies but also emotional and psychosocial support.

Ultimately, the fight against ALS is a fight for human dignity, quality of life, and hope. Let us continue moving forward together, united in our commitment to improve the lives of those facing this relentless disease.

Keywords: ALS, ALS disease, Amyotrophic Lateral Sclerosis, what is ALS.

ALS Exoskeletons Neurological Rehabilitation