What is Parkinson’s?
Parkinson’s disease is a chronic and progressive neurological condition that causes various uncontrollable movements such as shaking/tremors, rigidity, stiffness, slow and reduced movements, and eventually difficulty with balance and walking.
Parkinson’s is caused when nerve cells called neurons in the brain which begin to break down and stop producing a chemical called dopamine which is responsible for the control of muscles. When the levels of dopamine decrease in the body, it causes impaired movement and other symptoms of Parkinson’s disease.
How does it get diagnosed?
Currently, Parkinson’s cannot be diagnosed through having a blood test or a scan, but instead a diagnosis is usually made following an extensive medical history, clinical features and a neurological examination.
Symptoms of Parkinson’s can include:
- Uncontrollable tremor/shaking in hands and arms
- Stiffness/rigidity throughout the whole body
- Slow or jerky movements
- Impaired balance and coordination
- Increased falls risk due to balance and freezing of gait
- Problems with attention and memory
- Freezing of gait/walking – the sudden inability to walk
Physiotherapy management for Parkinson’s:
Physiotherapy treatment consists of testing patients to identify their specific concerns and treating them based off the symptoms they demonstrate. The aim of training is to promote attention to movement and allow patients to be more aware of how to manage their symptoms.
Treatment strategies we can use are:
- Verbal Cues: instructions to stop freezing
- Visual Cues: markers to step to/reach to, mirrors
- Auditory Cues e.g. metronome/music
- Tactile Cues: big or small objects, soft or firm objects
- Encourage “big movements” e.g. big arm swings, big steps
Although Parkinson’s is a neurodegenerative disease, people with Parkinson’s have the capacity for their bodies to learn, so when strategies are applied to functional activities, this may result in improvements.
As Physiotherapists we are proud to be able to provide Parkinson’s patients with support and rehabilitation to improve their ability to perform daily functional tasks to the best of their ability and improve their general quality of life.
References
DeMaagd, G., & Philip, A. (2015). Parkinson’s Disease and Its Management: Part 1: Disease Entity, Risk Factors, Pathophysiology, Clinical Presentation, and Diagnosis. P & T : a peer-reviewed journal for formulary management, 40(8), 504–532.
Mayo Foundation for Medical Education and Research. (2023, February 17). Parkinson’s disease. Mayo Clinic. Retrieved April 4, 2023, from https://www.mayoclinic.org/diseases-conditions/parkinsons-disease/diagnosis-treatment/drc-20376062
Sellbach, A., & Silburn, P. (2012). Management of parkinson’s disease. Australian Prescriber, 35(6), 183–188. https://doi.org/10.18773/austprescr.2012.084
Goldenberg M. M. (2008). Medical management of Parkinson’s disease. P & T : a peer-reviewed journal for formulary management, 33(10), 590–606.
Okun, M. S. (2012). Deep-brain stimulation for parkinson’s disease. New England Journal of Medicine, 367(16), 1529–1538. https://doi.org/10.1056/nejmct1208070
