Spinal muscular atrophy (SMA) is an inherited neurodegenerative disease. It is characterized by the loss of motor neurons, or nerve cells that control muscle movements. This loss leads to progressive muscle weakness and atrophy.
The muscle weakness is associated with impaired mobility and problems with breathing and swallowing, among other symptoms.
What is occupational therapy?
Occupational therapy focuses on adjustments that help patients manage their everyday lives. The goal of occupational therapy is also to improve quality of life.
An occupational therapist first assesses the abilities and needs of the patient, then advises which interventions might be helpful.
An occupational therapist works together with physiotherapists who focus on movement and exercises to improve body function.
Occupational therapists practice in schools, hospitals, health agencies, and social services. Health professional such as doctors and nurses can refer patients to an occupational therapist.
Aids and adaptations that occupational therapists might prescribe
Some children with SMA have problems walking independently. A walker may allow them to walk without a caregiver’s help by providing balance and arm support. For children with SMA, a walker with wheels (rolling walker) is recommended.
Orthotics: splints and braces
Orthotics support the foot and help maintain foot alignment while standing and walking. SMA patients frequently use supra malleolar orthosis (SMO), which support the hindfoot, and ankle-foot orthosis (AFO).
When SMA patients are not able to walk or if walking becomes too exhausting after a short time, the occupational therapist might recommend a wheelchair. The chair can be manual or electric.
The weakness of the muscles that support the spinal column can cause scoliosis or curvature of the spine. Scoliosis usually progresses slowly in SMA. Positioning devices on the wheelchair and bracing with a spinal orthosis can help maintain a straight sitting posture. These adaptations do not prevent the progression of scoliosis but may improve function and comfort.
Adaptive tricycles can provide young SMA patients mobility and independence. They are similar to tricycles that children usually use and may facilitate playing with peers.
SMA patients frequently have decreased respiratory function. This results in problems with coughing and clearing secretions, which can lead to infections. Non-invasive breathing supports, such as a BiPAP machine or a ventilator with a nasal mask, can assist breathing at night and may be prescribed by an occupational therapist.
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