{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T23:41:28Z","timestamp":1792280488211,"version":"4.4.0"},"reference-count":49,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100010390","name":"saint louis university","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010390","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Neurorehabil Neural Repair"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>Progressive disability occurs in persons with amyotrophic lateral sclerosis (pALS), but change over time across phenotypes remains understudied, limiting clinical decision-making. This descriptive study describes functional motor change with detailed measures across ALS phenotypes to enhance clinical decision making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>Electronic health record data from an interdisciplinary ALS clinic (n\u2009=\u2009109 pALS, 2018-2022) including demographics, disability (ALS Functional Rating Scale-[ALSFRS-R]), and functional motor scores (10\u2009m Walk, Handheld dynamometry [grip and ankle]) was utilized. Phenotype groups were defined by site of onset (bulbar, limb onset; upper limb or lower limb). Analysis was conducted using R and included changes scores and measures of central tendency in 3-month intervals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>PALS included n\u2009=\u200943 bulbar, n\u2009=\u200932 upper limb, n\u2009=\u200934 lower limb onset, age 65, 60 to 71 (median, interquartile range). ALFSRS-R decline was greatest in bulbar, and similar in upper and lower limb. Patterns of change within motor scores suggest greatest loss of grip strength in bulbar and upper limb, ankle strength in upper limb, walking speed in lower limb, and preservation of community ambulation in upper limb.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>While ALSFRS-R scores were similar in upper and lower limb, detailed functional motor measures indicated differences in groups. These patterns provide insight to guide clinical decision making and future research to enhance care in pALS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15459683261445435","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T10:31:30Z","timestamp":1781087490000},"page":"903-916","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Functional Motor Change Across Time and Phenotypes in Patients With Amyotrophic Lateral Sclerosis: A Descriptive Study"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6806-978X","authenticated-orcid":false,"given":"Elissa C.","family":"Held-Bradford","sequence":"first","affiliation":[{"name":"Department of Physical Therapy and Athletic Training, Saint Louis University, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4488-9772","authenticated-orcid":false,"given":"Elisabeth","family":"DeMarco","sequence":"additional","affiliation":[{"name":"Department of Health and Clinical Outcomes Research, Saint Louis University, School of Medicine, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1766-2018","authenticated-orcid":false,"given":"Samantha","family":"Zocher","sequence":"additional","affiliation":[{"name":"Department of Health and Clinical Outcomes Research, Saint Louis University, School of Medicine, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4368-3360","authenticated-orcid":false,"given":"Kate","family":"Weaver","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy and Athletic Training, Saint Louis University, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Forsman","sequence":"additional","affiliation":[{"name":"Department of Neurology, SSM Health Saint Louis University Hospital, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghazala","family":"Hayat","sequence":"additional","affiliation":[{"name":"Department of Neurology, SSM Health Saint Louis University Hospital, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4897-2409","authenticated-orcid":false,"given":"Divya S.","family":"Subramaniam","sequence":"additional","affiliation":[{"name":"Department of Health and Clinical Outcomes Research, Saint Louis University, School of Medicine, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6891-6734","authenticated-orcid":false,"given":"Meghan","family":"Doherty","sequence":"additional","affiliation":[{"name":"Department of Occupational Science and Occupational Therapy, Saint Louis University, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"Stroke NIoNDa. 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