I have shared reports of the patient & handwritten history of the patient & neuro physiotherapy assessment format. Chief complaint: difficultly in walking maintaing balance & difficulty in speech . Positive findings : tightness in hamstrings, adductors, calf then clonus present bilateral lower limb , reflex 3+ in achalis then 4 + in knee jerk , spacticity is also there then thick toung & provisional diagnosis is : charcot type ALS now give me Proper physiotherapy assessment & PG 2nd year level evidence based management for this case