About MND
Motor neurone disease is a group of conditions where the nerve cells controlling muscles progressively stop working. MND Australia reports about 2,750 Australians are living with MND, with around two people diagnosed every day. Average life expectancy after diagnosis is two to three years, although this varies widely. About half of people diagnosed are under 60.
Early signs often include weakness in a hand, foot or shoulder, tripping or slurred speech. Over time, MND can affect walking, arm function, speech, swallowing and breathing. Thinking and behaviour are affected in some people.
Is exercise safe with MND?
This is one of the most common questions we hear. A Cochrane review of therapeutic exercise for MND found no evidence of harm, such as increased cramping, soreness or fatigue and people who exercised showed better scores on a functional rating scale after three months. The review was small, so the evidence is limited, but it supports carefully prescribed, moderate exercise.
The goals of exercise with MND are different from most programs. We are not chasing big strength gains. We are aiming to:
- Maintain range of motion and reduce stiffness, cramps and joint pain
- Keep unaffected muscles as strong as possible for longer
- Support heart and lung health and breathing capacity
- Maintain balance and reduce falls risk while walking is still possible
- Support mood, sleep and a sense of control
Key principle: exercise with MND should be moderate and should never leave you exhausted. If fatigue, cramping or weakness lasts more than an hour or so after a session, the dose was too high. Your EP adjusts the program each visit as things change.
What occupational therapy does
OT is one of the most important supports for people with MND because needs change quickly and planning ahead prevents crises.
- Energy conservation: prioritising the activities that matter most and simplifying the rest
- Assistive technology: from built-up cutlery and button hooks through to power wheelchairs, hoists, pressure care and environmental controls
- Home modifications: bathroom access, ramps, rails and bed setup, planned early given how long approvals and works can take
- Upper limb supports: splints and arm supports to keep hands and arms functional
- Work and driving: adjusting work tasks and assessing driving safety
- Carer training: safe transfers, positioning and equipment use
How EP and OT work together
Exercise physiologist
- EP keeps muscles and joints moving and maintains fitness
- EP monitors changes in strength and balance each session
- EP flags when walking safety is changing
- EP adapts exercise as function changes: standing, seated, then bed-based
Occupational therapist
- OT uses EP's observations to time equipment and mobility changes
- OT sets up the home and routine so energy goes to what matters
- OT fast-tracks equipment reports before a crisis
- OT trains carers in safe transfers and positioning
Because Exercare's EP and OT communicate directly, changes spotted in an exercise session, such as a new stumble or weaker grip, reach the OT quickly. That means equipment and home changes can be put in place before a fall, not after one.
Responsive support at home
Exercare visits at home across Melbourne: exercise physiology in the south-east and east and occupational therapy in the north-east, east and inner suburbs. One NDIS intake form covers both.
Funding
People diagnosed with MND before 65 can apply for the NDIS. Both are usually funded from your Capacity Building budget, most often under Improved Daily Living Skills (Category 15). Exercise physiology can also be funded under Improved Health and Wellbeing (Category 12). Equipment and home modification recommendations from your OT are funded from your Capital budget. Because MND progresses, it is important to request a plan reassessment whenever your needs change rather than waiting for the scheduled review.
If you are over 65 at diagnosis, supports are usually accessed through My Aged Care. Exercare offers exercise physiology through Support at Home and Medicare. Our OT services are available through the NDIS and Support at Home. MND Victoria also provides advisors, an equipment service and information for people living with MND and their families.
Evidence referenced in this article
- What is motor neurone disease? MND Australia.
- Dal Bello-Haas V, Florence JM. Therapeutic exercise for people with ALS or motor neuron disease. Cochrane Database of Systematic Reviews.
- Morris ME, et al. Outcomes of physical therapy, speech pathology and occupational therapy for people with motor neuron disease: a systematic review. Neurorehabilitation and Neural Repair, 2006.
Written by the Exercare allied health team. This article is general information only and is not a substitute for individual medical advice. Exercare provides mobile exercise physiology and NDIS occupational therapy across south-east and eastern Melbourne.
OT services mentioned in this article:
Adult OT → · Assistive technology → · Home modifications →
Frequently asked questions
Should people with MND exercise?
Moderate, carefully prescribed exercise appears safe and may help maintain function. It should never cause exhaustion or lasting cramps. An exercise physiologist can adjust the program as your condition changes.
What equipment can an OT help with for MND?
OTs assess for and recommend equipment such as mobility aids, wheelchairs, hoists, shower and toilet equipment, pressure care, arm supports and daily living aids and write the reports the NDIS needs.
How quickly can OT and EP start?
Contact us as soon as you have NDIS funding. We prioritise progressive conditions like MND because early planning prevents equipment and safety gaps.
What if I am over 65 when diagnosed?
Supports are usually accessed through My Aged Care. Exercare provides exercise physiology through Support at Home and Medicare. Our OT services are available through the NDIS and Support at Home.