ALS/MND affects the nerve cells that control the muscles. As these nerve cells stop working, muscles become weaker. Over time, this changes how a person walks, stands, sits, and moves.
This page explains what these changes can look like, how exercise and physiotherapy can help, and where to find practical resources from Alliance members.
On this page
Muscles and movement │ Exercise │ Moving safely │ Physiotherapy │ Resources
How ALS/MND affects muscles and movement
Changes are different for each person. They depend on which muscles are affected first and how quickly the disease progresses. Common changes include:
- Muscle weakness, which can make walking, climbing stairs, or standing up from a chair more difficult
- Muscle cramps, which can be painful
- Stiffness or tightness in the muscles (spasticity)
- Loss of flexibility and range of movement, especially in the shoulders, hands, and ankles
- Stiff or painful joints when a limb is not moved regularly
- Paralysis in some muscles, while other muscles stay strong
Weakness in the neck and trunk muscles can also change posture and increase the risk of falls. Knowing what to expect helps people plan ahead, before a change affects their safety or independence.
Staying active and exercise
Exercise cannot repair a muscle once the nerve cells that control it have been damaged. It can still help in several ways:
- Keeping weakened muscles as strong as possible
- Strengthening muscles that are not yet affected, which helps compensate for weaker ones
- Maintaining flexibility and range of movement in the joints
- Reducing stiffness, discomfort, and pain
The right type and amount of exercise is different for each person and changes over time. Gentle, regular activity is usually more helpful than strenuous exercise. People with ALS/MND can tire quickly, so activity should be balanced with rest and should stop before it causes exhaustion.
Stretching and range-of-movement exercises remain useful as the disease progresses. When a person can no longer do these exercises alone, a family member or caregiver can learn to help safely.
Before starting or changing an exercise routine: Talk to a physiotherapist or another member of the ALS/MND care team. They can recommend activities based on the person’s current strength, mobility, and needs.
Moving safely as needs change
As strength and balance change, equipment can help people stay safe and independent. Options include walking sticks, orthotic devices such as ankle-foot braces, walkers and rollators, and wheelchairs. Transfer equipment and adjustable beds can help with moving between bed, chair, and toilet.
Needs change over time. Equipment works best when it is assessed and ordered before it is urgently needed.
For support with everyday tasks at home, see Daily Living.
How a physiotherapist can help
A physiotherapist helps people living with ALS/MND stay mobile, comfortable, and safe for as long as possible. A physiotherapist can:
- Assess strength, balance, posture, and movement, and review them as needs change
- Design an exercise and stretching program suited to the person’s current abilities
- Teach family members and caregivers how to help with stretches and movement safely
- Advise on posture and positioning to reduce pain and stiffness
- Recommend mobility equipment and show how to use it
- Help with breathing exercises and chest clearance (see Respiratory Care)
Physiotherapists often work with occupational therapists and orthotists, who make braces and supports. Together, they help people choose equipment that fits their needs.
Videos about muscles, mobility, and exercise
Watch videos about exercise, physiotherapy, mobility, and movement for people living with ALS/MND.
Resources from our members
Explore additional resources about muscles, exercise, physiotherapy, mobility, and equipment developed by Alliance member associations.
Muscles, exercise, and physiotherapy
What Does the Physiotherapist Do?
ALS Centrum Nederland · Dutch and English
An overview of how a physiotherapist can support people living with ALS/MND, with links to further information about equipment a physiotherapist may recommend.
Physiotherapy and Exercise with MND
MND Association · English
Information about how physiotherapy and exercise can help, how to access physiotherapy services, and other therapies people may consider.
Managing Pain
MND Association · English
Information about finding support for pain, particularly pain linked to problems with movement and mobility.
Muscle Weakness in MND
MND Association · English · For health professionals
Information for health professionals about how muscle weakness progresses in MND and the strategies and equipment used to manage it.
Mobility equipment and home access
Mobility and Movement
MND Association · English
An overview of how MND can affect mobility, the professionals who can help, and options for equipment, home adaptations, and driving.
Equipment and Wheelchairs
MND Association · English
Information about equipment, including wheelchairs, that can make daily life easier, and how to access it.