ALS Exercise Routine

Important Considerations Before Starting:

  • Hydration: Sip on electrolyte water before, during, and after the routine. This helps maintain electrolyte balance, especially when increasing your heart rate and potentially sweating.
  • Listen to Your Body: Stop if you feel any pain, dizziness, or shortness of breath. Adjust the intensity and duration as needed.
  • Warm-up: Always begin with a gentle warm-up to prepare your muscles for exercise.
  • Cool-down: End with a cool-down to gradually lower your heart rate.
  • Consistency: Aim to repeat this routine several times a week for best results.

The Routine:

Phase 1: Warm-Up (5 minutes)

  • General Warm-up:

    • Standing: March in place, gently swinging arms (1 minute).
    • Sitting: Tap feet on the floor, gently swinging arms (1 minute).
    • Lying in bed: Gently kick legs like you are riding a recumbent bike. Swing arms gently (1 minute).
  • Shoulder Rolls: Gently rotate shoulders forward and backward (30 seconds each direction).

  • Arm Circles: Small arm circles forward and backward (30 seconds each direction).

  • Leg Swings: (Hold onto a chair or wall for balance if needed). Gently swing one leg forward and backward, then side to side. Repeat on the other leg. (30 seconds per leg, front-back and side-side).

  • Ankle Rotations: Rotate each ankle in a circular motion (30 seconds per ankle).

Phase 2: Arm and Leg Exercises (15 minutes)

  • (Standing Option):

    • Marching with Arm Raises: March in place, raising arms overhead with each step. (1 minute)
    • Squats With Arm Extension: Perform a squat while extending arms straight out in front of you. (10-12 repetitions)
    • Standing Leg Raises: Stand tall and raise one leg out to the side, keeping it straight. Alternate legs. (10-12 repetitions per leg)
    • Bicep Curls: Use light weights or resistance bands if available. Perform bicep curls, keeping elbows close to your body. (10-12 repetitions)
    • Overhead Press: Use light weights or resistance bands if available. Press arms overhead. (10-12 repetitions)
  • (Sitting Option - Chair):

    • Seated March: Sit upright and march in place, lifting knees as high as comfortable. (1 minute)
    • Chair Squats: Stand up slightly from the chair and return to a seated position, but don't sit all the way down. (10-12 repetitions)
    • Leg Extensions: Sit upright and extend one leg straight out, then slowly lower it back down. Alternate legs. (10-12 repetitions per leg)
    • Bicep Curls (Seated): Use light weights or resistance bands if available. Perform bicep curls, keeping elbows close to your body. (10-12 repetitions)
    • Overhead Press (Seated): Use light weights or resistance bands if available. Press arms overhead. (10-12 repetitions)
  • (Lying in Bed Option):

    • Leg Raises: Lie on your back and raise one leg toward the ceiling, keeping it as straight as possible. Alternate legs. (10-12 repetitions per leg)
    • Heel Slides: Bend your knees and keep your feet flat on the bed. Slide one heel up toward your buttocks, then slowly slide it back down. Alternate legs. (10-12 repetitions per leg)
    • Arm Circles: Lie on your back and perform small arm circles in the air, forward and backward. (30 seconds each direction)
    • Arm Raises: Lie on your back. Extend your arms straight up, then gently lower to your sides. (10-12 repetitions)
  • Torso Twists: Lie on your back or sit and gently twist your torso from side to side.

Phase 3: Neck, Mouth, and Swallowing Exercises (5 minutes)

  • Neck Stretches:

    • Chin Tuck: Gently tuck your chin towards your chest, holding for a few seconds. (5-10 repetitions)
    • Head Tilt: Gently tilt your head to the right, bringing your ear towards your shoulder. Repeat on the left side. (5-10 repetitions per side)
    • Head Rotation: Gently rotate your head from side to side, looking over your shoulder. (5-10 repetitions per side)
    • Neck Extension: Tilt your head back gently, looking up. (hold for 5 seconds)
  • Mouth Exercises:

    • Jaw Opening/Closing: Open your mouth wide and then close it slowly. (10 repetitions)
    • Lateral Jaw Movement: Move your jaw from side to side. (10 repetitions)
    • Lip Pucker/Smile: Alternate between puckering your lips as if to kiss and smiling widely. (10 repetitions)
    • Tongue Protrusion/Retraction: Stick your tongue out as far as you can and then pull it back in. (10 repetitions)
    • Tongue Sweep: Sweep your tongue inside your mouth around your teeth. (10 rotations in each direction)
  • Swallowing Exercises:

    • Dry Swallows: Swallow forcefully without food or liquid. Focus on squeezing your throat muscles. (5-10 repetitions)
    • Effortful Swallow: Swallow as hard as you can, squeezing all your throat muscles. (5-10 repetitions)
    • Mendelsohn Maneuver: While swallowing, try to hold your Adam's apple at its highest point for a few seconds. (5-10 repetitions)

Phase 4: Voice and Voice Projection (5 minutes)

  • Diaphragmatic Breathing: Place one hand on your chest and the other on your stomach. Inhale deeply through your nose, feeling your stomach rise while your chest stays relatively still. Exhale slowly through your mouth. (5-10 repetitions)
  • Humming: Hum a sustained "mmm" sound at different pitches. (1-2 minutes)
  • Vocal Warm-ups:
    • Lip Trills: Make a "brrr" sound with your lips. (30 seconds)
    • Tongue Twisters: Practice tongue twisters to improve articulation. (e.g., "She sells seashells by the seashore") (1-2 minutes)
  • Voice Projection:
    • Reading Aloud: Read a passage aloud, focusing on projecting your voice without shouting. Imagine you are speaking to someone at the back of a room. (2-3 minutes)
    • Counting Aloud: Count aloud from 1 to 20, gradually increasing your volume with each number, then decreasing again.
  • Yawning and Sighing: Yawn deeply and sigh audibly to relax your vocal cords.

Phase 5: Cool-Down (5 minutes)

  • Gentle Stretching: Repeat some of the warm-up stretches, holding each stretch for 20-30 seconds. Focus on relaxing your muscles.
  • Deep Breathing: Continue with diaphragmatic breathing to lower your heart rate.
  • Relaxation: Lie down or sit comfortably and focus on relaxing your body and mind. (2 minutes)

Important Considerations for Each Position:

  • Standing: Allows the greatest range of motion and uses more muscles, leading to a higher heart rate.
  • Sitting: A good option if you have balance issues or limited mobility. Ensure you have good posture.
  • Lying in Bed: Ideal if you have limited mobility or are recovering from an illness. Focus on controlled movements.

Increasing Heart Rate:

  • Intensity: Increase the speed or resistance of your arm and leg movements.
  • Intervals: Alternate between periods of higher intensity (e.g., faster marching) and lower intensity (e.g., slow walking).
  • Duration: Gradually increase the length of your workouts.

Electrolyte Water:

  • Sip before, during, and after.
  • Consider a homemade recipe: Water with a pinch of sea salt, a squeeze of lemon or lime, and a small amount of honey or maple syrup.

Modifications:

  • Difficulty: Adjust the intensity, duration, and repetitions of each exercise to suit your fitness level.
  • Limitations: If you have any limitations, modify the exercises as needed. For example, skip squats if you have knee pain.
  • Enjoyment: Choose exercises that you enjoy to make the routine more sustainable.

Remember to be patient and consistent with your routine. It may take time to see results. The most important thing is to listen to your body and make sure you are exercising safely. Good luck!