最新の知見に基づくリハビリテーション

抄録

A “recovery from functional disabilities” is the major highlight of rehabilitation medicine. However, in diseases such as amyotrophic lateral sclerosis (ALS), which is characterized by a progressive muscular weakness including that of the respiratory muscles, and where a curative treatment is not available, the rehabilitation goal is to maintain the remaining abilities, or allow the maximum performance of activities using aids and other devices to achieve an optimal mental state during treatment, ultimately improving the quality of life of the patient and their family.

Thus, in the course of ALS, various disabilities such as physical, speech and swallowing, nutritional, communication, respiratory, and psychological impairments (anxiety and depression, among others) can become significant issues. In rehabilitation medicine, training and support such as physical, occupational, and speech therapies are provided to address these issues. Moreover, efforts are exerted to improve the treatment environment through financial, human, and material social resources as well as through environmental improvements such as housing renovations.

Currently, the guideline revision for the treatment of ALS is in the final stages, and the revised version includes a chapter on rehabilitation. However, the lack of large–scale randomized controlled trials on effective ALS rehabilitation indicates that there is a dearth of evidence or recommendations demonstrating the effectiveness of rehabilitation in disease treatment.

In this report, we summarize the current rehabilitation strategies for ALS based on papers and references used in guideline creation. Furthermore, effective rehabilitation techniques and future considerations for ALS treatment are also reported.