• Amyotrophic lateral sclerosis (ALS) is the most common type of MND and causes muscle weakness and stiffness.
• Progressive bulbar palsy (PBP) accounts for 20% of MND cases and causes difficulty with speaking and swallowing.
• Progressive muscular atrophy (PMA) accounts for 10% of cases and causes muscle weakness, wasting and twitching

MND affects people in different ways and there is a difference in how quickly each type of MND progresses.

The symptoms of MND depend on the type of MND you have. The main symptom of MND is muscle weakness that becomes progressively worse over time. The first symptoms commonly develop in the hands and arms, or feet and legs. Although physical functions decline, cognitive function remains intact and your memory, sight and smell remain unchanged. 

Other initial difficulties may include some of the following:

• Stumbling,
• Dragging of a foot
• Difficulty gripping objects.
• Stiff joints
• Fatigue especially with daily activities
• Pain and discomfort
• Muscle wasting
• Spasticity or stiffness in the arms and legs.
• Difficulties with speech, chewing and swallowing.
• Breathing problems

• Increase muscle strength through strengthening and mobilisation exercises
• Improve postural alignment through mobilisation and strengthening
• Improve balance and mobility through assessment of different seating and mobility aids plus postural  re-education
• Reduce muscle stiffness, spasms and pain through stretching programmes
• Reduce the risk of falls through balance work, gait re-education and training
• Increase independence and quality of life through management of positioning in bed and seating.