BackgroundAmyotrophic Lateral Sclerosis (ALS) is a degenerative, disabling and fatal motor neuron disease affecting 450,000 adults worldwide [1]. The prognosis of ALS is affected by age at disease onset, rate of progression, and presence of bulbar signs early in the disease [2,3]. Currently there is no cure for ALS and the cause of the disease remains unknown. Therefore, treatment is based on symptom management to optimize lifespan and maximize QoL [4,5].Individuals with ALS experience muscle weakness due to the progressive degeneration of motor neurons in the spinal cord, brainstem, and cerebral hemispheres [6]. This ultimately results in activity limitations and participation restrictions for these individuals. About 50% of people experience initial signs and symptoms in the upper extremities, whereas for 40% of individuals the onset occurs in the lower extremities [7]. In the remaining 10%, onset may be observed in areas of the bulbar region showing symptoms of changes in voice and speech, poor articulation, a decrease in range of pitch and loudness of voice, spasms in muscles of the jaw, face, voice box, throat and tongue [8].As the disease progression can occur rapidly, it is essential that people with ALS have quick access to services from a range of health professionals that are Abstract Background: Many factors can affect a person's outlook on his/her life; rehabilitation interventions vary greatly and little is known about the effect of rehabilitation to maintain and/ or enhance Quality of Life (QoL) in people with Amyotrophic Lateral Sclerosis (ALS).