Neuro Navigators Episode 26: Success in ALS/HD: How Do We Measure Progress When Decline Is Expected?

Join host ⁠J.J. Mowder-Tinney, PT, PhD⁠, as she sits down with ⁠Matthew Caraher, PT, DPT, NCS⁠, a board-certified specialist with extensive experience in multidisciplinary ALS and Huntington’s disease care. Together, they explore how to move past a “fear-based” clinical mindset and toward intentional, staged rehabilitation when working with neurodegenerative conditions. You’ll discover practical, evidence-based strategies for dosing moderate-intensity exercise, using objective assessment tools and subjective reports to guide treatment, and recognizing when “skilled maintenance” is the ultimate clinical win. Learn how to shift your focus from impairment correction to maximizing participation and quality of life for patients and their caregivers.

Learning Outcomes

• Analyze the evidence regarding exercise and rehabilitation dosing across disease stages in amyotrophic lateral sclerosis (ALS) and Huntington’s disease (HD), including strength, aerobic, and respiratory training
• Apply evidence-based, practical strategies to select outcomes and dose interventions across the disease continuum while balancing fatigue, fall risk, and respiratory decline
• Solve patient case scenarios involving clinical decision-making for ALS and HD related to staging, dosing, equipment, and interdisciplinary coordination

Timestamps

• (00:00:00) Welcome
• (00:00:05) Introduction to neurodegenerative conditions
• (00:01:14) Matt's journey into neurodegenerative medicine
• (00:05:25) Addressing clinician fears in treatment
• (00:07:29) Redefining success in patient care
• (00:10:22) The importance of multidisciplinary care
• (00:13:45) Assessment tools for ALS patients
• (00:22:43) Challenges in assessing Huntington's disease
• (00:26:00) Principles for effective patient management
• (00:29:30) Understanding patient emotional states
• (00:31:00) The importance of therapeutic presence
• (00:36:20) Exercise guidelines for neurologic patients
• (00:49:40) Effective communication with patients and caregivers
• (00:56:17) Key takeaways for clinicians

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