Riluzole acts by decreasing glutamate release from nerve terminals. Experimental trials of nerve growth factor have not demonstrated any benefit. A physical therapist works with the patient and family to implement exercise and stretching programs to maintain strength and range of motion, and to promote general health. Swimming may be a good choice for people with ALS, as it provides a low-impact workout to most muscle groups. One result of chronic inactivity is contracture, or muscle shortening.
Contractures limit a person's range of motion, and are often painful.
Regular stretching can prevent contracture. An occupational therapist can help design solutions to movement and coordination problems, and provide advice on adaptive devices and home modifications. Speech and swallowing difficulties can be minimized or delayed through training provided by a speech-language pathologist. This specialist can also provide advice on communication aids, including computer-assisted devices and simpler word boards. Nutritional advice can be provided by a nutritionist.