is coordination affected? or is it an issue of stiffness

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Kristina1

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PALS
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03/2017
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Grafton
Is ALS affecting my coordination or is it just seeming that way due to stiff muscles?

On affected left hand the fingers are pretty stiff. I have incidents where I meant to scratch my eyebrow but poke myself in the eye by accident instead. Or today I meant to use my thumb to keep food from leaking out my lips and instead I somehow bit my thumb.

Is this just due to stiff fingers not being as agile?
 
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I am not sure Kristina, but I have done the same. Not sure of the cause.
Al
 
It sounds like muscle spasticity.

The signals are not getting through correctly so the muscles are kind of 'hearing' all this static with the signal you want, and it's like the timing goes off.

Let's think about a simple action - if you want to bend your elbow then your bicep has to contract and your triceps has to lengthen. Lots of other muscles at play but to keep it simple these are two opposites that have to work together. So at the same time your bicep needs to be told one thing while the triceps has to be told the opposite. Instead the timing is off and both get told: contract ... oh no, lengthen ... oh no static, not sure ... oh yeah contract. Suddenly as you go to scratch your eyebrow, bam you poke yourself instead. :neutral:
 
I am a person who has poked herself in the eye with a fork, chopsticks, business end of a toothbrush, and the handle of a butter knife due to spasticity. Tillie describes it very well. It takes a while to remember you have to be very deliberate with every action and not just depend on body memory to get things where they need to be.

Upper Motor issues also include the feedback your brain gets from muscles as you use them. So, not only is your brain struggling to get messages through to your muscles, but it's only getting half the story back about where your limbs and digits are at any given time. It's like a terrible game of "telephone"- with the final message ending up way different than the initial command.
 
I've never heard of ALS affecting the coordination, per se....However, if a muscle in your hand is paralyzed, limp and useless, then another muscle might try to make up for it.
 
Definitely shiftkicker! Chris and I discussed this a bit in the early days and we would watch him doing things and see it happen.

He may want to reach out and pick up a coffee cup, he would reach a bit, kind of stop but you could see he was intending to still be reaching, then his hand would shoot forward a few inches suddenly and if too close could knock the cup over.

It's really obvious when you observe attempts to walk and that game of telephone is wreaking havoc with so many muscles at once.

When Chris could still walk in a way that looked perfectly normal, we discovered that he could not do the same thing when trying to walk fast or even run. (this is what was so appalling about that pt making a PALS move fast). As soon as it had to be done in a hurry all the coordination would be just gone.

This was all spasticity, rather than individual muscles being paralysed. Chris had a lot of UMN involvement which is why he was so rigid (spasticity really mean increased muscle tension), uncoordinated and experienced so much pain.
 
That makes sense. I had come across the term "spasticity" regarding ALS but did not know what it meant. Thanks for explaining!
 
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