La  es una enfermedad neurológica progresiva que ataca a las neuronas encargadas de controlar los músculos voluntarios. Estas neuronas sirven como unidades de control y enlaces entre el sistema nervioso y los músculos voluntarios del cuerpo.

Los músculos se debilitan gradualmente (atrofia) y se contraen (fasciculaciones). Los pacientes pierden la fuerza y la capacidad de mover brazos, piernas y cuerpo. Cuando los músculos del diafragma y de la pared torácica fallan, los  pacientes pierden la capacidad de respirar sin un ventilador artificial.

La ELA generalmente afecta a personas entre los 40 y 60 años de edad y más a los hombres. La mayoría de las personas con ELA mueren de fallo respiratorio entre 3 a 5 años a partir del comienzo de los síntomas. Sin embargo, alrededor del 10% de los pacientes con ELA sobreviven más de 10 años.

Síntomas

– Dificultad para respirar y/o deglutir
– Babeo
– Náuseas
– Caída de la cabeza debido a la debilidad en los músculos del cuello
– Calambres musculares
– Contracciones musculares (fasciculaciones)
– Debilidad muscular
– Parálisis
– Problemas en el lenguaje: patrón de habla lento, mala articulación de palabras
– Cambios en la voz: ronquera
– Pérdida de peso

Tratamiento de Fisioterapia en la Esclerosis Lateral Amiotrófica

Los objetivos de la fisioterapia se centran principalmente en mejorar la autonomía y calidad de vida de los pacientes. En las primeras fases de la enfermedad está indicado el ejercicio aeróbico moderado; ya que aumenta la capacidad del paciente al esfuerzo y mejora la resistencia a la fatiga muscular.

La reeducación postural como la RPG, puede ayudar a evitar contracturas y retracciones en las extremidades. Los estiramientos suaves y los masajes, también pueden ayudarnos al mantenimiento del tono muscular y de una correcta circulación venosa.

Los métodos Kabat o Bobath se utilizan en el paciente con afectación neurológica. El objetivo es buscar un estímulo propioceptivo en las extremidades que desencadene una respuesta motora.

En fases avanzadas de la enfermedad, cuando no existen respuestas motoras en las extremidades, se pueden realizar movilizaciones pasivas, estiramientos muy suaves y masajes para evitar retracciones y deformidades.

En la mayoría de los casos, el paciente con ELA tiene una respiración superficial debido a la pérdida de fuerza en la musculatura inspiratoria y espiratoria. Para tratar de evitar cualquier complicación (neumonía, bronquitis…); utilizaremos técnicas de fisioterapia respiratoria con el objetivo de mejorar la función pulmonar, aumentar el volumen de aire, mejorar el intercambio de gases, disminuir el trabajo respiratorio y facilitar la eliminación de las secreciones.

Las técnicas manuales más utilizadas son la respiración diafragmática, la ventilación dirigida, el drenaje autógeno, la espiración forzada (TEF), la ventilación Mecánica No-Invasiva (VMNI) y la ventilación Percusiva Intrapulmonar (IPV).

En el Centro de fisioterapia y osteopatía Eguzki integramos todas estas técnicas con el objetivo de mejorar la funcionalidad y autonomía de los pacientes y aumentar de este modo su calidad de vida en la lucha contra la enfermedad.

Markel Etxeberria Martin

Col. nº 2303

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