Today’s technology allows for mobility for almost everyone, no matter how few muscles remain functional. In the early stages, a cane or a supportive brace (“orthosis”) may be all that’s needed. An ankle-foot orthosis, or AFO, can keep the foot from dropping with each step and causing tripping while walking. Later, additional devices may be useful, such as walkers, manual wheelchairs and power wheelchairs.
For many with ALS, speaking ability may be lost as weakness increases in the muscles in the mouth and throat that control speech and in the muscles that help generate the pressure that moves air over the vocal cords. This happens earlier in the bulbar-onset form of the disease (when the disease begins with weakness of the speaking and swallowing muscles) than it does in the limb-onset form (when weakness begins in a limb). Early in the disease process, while speech is still normal or nearly so, speech therapists may suggest that a person with ALS record his or her speech.