**3. Conclusion**

ALS is a complex and challenging condition with no cure. Current "gold-standard" management is ''multidisciplinary care''which includes neurological, rehabilitative and palliative care. As consistent with the guidelines from the American Academy of Neurology (Miller et al., 2009b) and the World Federation of Neurology (Andersen et al., 2007), multidisciplinary care should be available to all persons with ALS. Where multidisciplinary care is currently available, it should be delivered with a high level of coordination and integration, with evidence-based intervention to ensure holistic and seamless care for persons with ALS and their caregivers. Many areas in ALS are poorly understood, with research often further hindered by the logistical and ethical difficulties. Much more work is needed in the area of evidence-based interventions. At present, much of the evidence has been concentrated in areas such as respiratory and nutritional management. There is paucity of information on effective rehabilitation interventions and very little is understood with regards to the "black box of rehabilitation". For example, evidence to guide exercise prescription (such as strengthening, stretching, aerobic/endurance exercises) is much needed. The use and development of assistive technology is another area that warrants much more attention, as is a better understanding of bowel, bladder and sexuality issues. Further research is also needed into appropriate study designs; outcome measurement; the evaluation of optimal settings, type, intensity or frequency and cost-effectiveness of multidisciplinary care; and the different phases of ALS, covering the spectrum of care required for this patient population. The interface between neurological, rehabilitative and palliative components of care, and caregiver needs should be explored and developed to provide long-term support for this population. Last but not least, national and international guidelines incorporating evidence-based practice in rehabilitation should be further developed to enable optimisation of clinical care and practice.
