Characterization and Physiotherapy Evaluation of Patients with Amyotrophic Lateral Sclerosis in Costa Rica

Aim: To characterize the profile of individuals with amyotrophic lateral sclerosis treated at the National Center for Pain Control and Palliative Care during the 2020-2022 period, through an analysis of clinical and sociodemographic assessments.

Methods: A descriptive, cross-sectional study was conducted with a retrospective review of the medical records of patients treated in the outpatient and home care programs of the physical therapy service. All variables analyzed were related to the physiotherapy evaluation and demographic characteristics. Various tests were used to assess the patient’s physical and functional status (body composition assessment using electrical bioimpedance, muscle strength measurement, and the revised Amyotrophic Lateral Sclerosis Functional Rating Scale). The presence of pain and risk of falls were also assessed. Data were obtained from the start of follow-up at the health center.

Results: The analyzed population consisted of 200 patients, 61.5% of whom were male. Patient ages at the time of assessment ranged from 30 to 89 years, although the majority were between 55 and 59 years old. Distributed by province, 44.5% of users were from San José, followed by 15.8% from Alajuela, 11.4% from Puntarenas, 7.9% from Cartago, 7.4% from Heredia, 6.4% from Guanacaste, and 6.4% from Limón. Regarding the clinical characteristics of the study population, the spinal phenotype represented the majority of cases (72%). The average time elapsed from symptom onset to diagnosis was 21 months. 62.8% of patients reported no falls. Regarding painful symptoms, 61.4% indicated that they experienced pain in some anatomical area. Using the revised amyotrophic lateral sclerosis functional rating scale, 37% of patients had involvement in all four domains (stage 5), followed by 17.4% with involvement in three domains (stage 4), 16.4% were determined to be stage 3, 16.9% were stage 2, and only 10.9% were stage 1.

Conclusion: Establishing patient profiles is important, and this study found that patients treated in the physical therapy department of this specialized national center present with advanced stages of the disease, with significant impairment in function. Furthermore, pain is a common symptom, and its location depends on the type and underlying mechanisms.