Which of these is a later treatment option for ALS?

In the context of Amyotrophic Lateral Sclerosis (ALS), treatment typically shifts as the disease progresses. Secretion clearance techniques become particularly important in the later stages of ALS. Patients with advanced ALS often experience respiratory muscle weakness, which can lead to difficulty in clearing secretions from the airways, increasing the risk of aspiration and respiratory infections. Therefore, focusing on secretion clearance becomes crucial to manage these complications and improve the quality of life for patients.

The other options, while relevant at various points in the disease's course, may not be specifically prioritized in the later stages. Gait aids and energy conservation techniques are often implemented earlier to assist with mobility and fatigue management. Core activation exercises might be beneficial for maintaining strength and function during the earlier stages but are less applicable as the disease progresses and patients experience significant motor decline. Thus, secretion clearance is the most pertinent treatment option in the later stages of ALS, as it directly addresses the challenges faced by patients at that point in their disease trajectory.