What is Parkinson’s disease?
Parkinson’s disease is a chronic and progressive nervous system disease that affects the movement of the person. Symptoms can develop gradually and may start with slight tremors in one hand. Patients with Parkinson’s disease also can experience spasticity symptoms and slow movements – this is called bradykinesia.
What are the causes of Parkinson’s disease?
It’s not known. Currently, new researches have been revealed that Parkinson is a result of a combination of genetic changes and environmental factors may be responsible for the condition.
- Environmental factors.
- Other causes of parkinsonism “Parkinsonism” Can be caused by medication (drug-induced parkinsonism) –
- Cerebrovascular disease
How can physiotherapy help with treating Parkinson’s disease?
The physiotherapy in this group of patients can help maintain and improve levels of function and independence, consequentially, helping to improve a person’s quality of life. Utilisation of exercise and movement strategies enables the physiotherapist to assist in improving mobility, correcting and improve abnormal movement patterns/ posture, maximise muscle strength and joint flexibility. It also enables correction of posture and balance thus minimizing risks of falls. It is important also to maintain a good breathing pattern and effective cough. The education of the person with Parkinson’s is paramount with a focus also on enhancing the effects of drug therapy.
Exercise programme to consider
According to the European Physiotherapy Guideline, the interventions for Parkinson’s can be divided or subclassified into exercise and movement strategy training.
- Exercise. Increasingly being proven to maintain health. The exercise can address secondary prevention (focusing on strength, endurance, flexibility, functional practice and balance); Is necessary to evaluate exercise for neuroprotection focuses on endurance; and exercise using motor learning principles uses approaches, such as mental imagery and dual task training.
- Physical activity, in particular, aerobic exercise might slow down the motor skill degeneration and depression. It promotes and helps to improve the quality of life of patients. Also, quality of life may be increased when performing strength training against an external resistance (cycle ergometer, weight machines, therapeutic putty, elastic and, weight cuffs …). This also improves physical parameters, such as balance, gait parameters, physical performance … but the muscle strength does not improve necessarily. Executing a dual task, e.g. talking while walking, is commonly difficult in patients with Parkinson’s disease. Training this with Motor-Cognitive Dual-Task training improves dual-task ability and might improve gait, balance, and cognition.
The individual should be encouraged to continue being active and participate in physical exercise for as long as possible. Significant respiratory complications develop in many people as their Parkinson’s progresses, so attention should be paid to monitor and manage the encroaching weakness of respiratory muscles and rigidity of the thoracic cage.
Movement Training strategies (physical or attentional cues and combined strategies) can help overcome some of the resultant problems with mobility. Music based movement therapy is a promising intervention that needs some further research. It is interesting since it combines cognitive movement strategies, cueing techniques, balance exercises, and physical activity.
Examples of exercises include:
- Visual cueing – a focus point to step over and initiate gait; strips of tape on the floor to initiate or continue walking through areas that cause slowing or freezing
- Auditory cueing – counting 1-2-3 to initiate walking; stepping to the beat of a metronome or specific music at a specified cadence to continue the rhythm of a walk
- Attention – Thinking about taking a big step; making a wider arc turn
- Proprioceptive cueing – rocking from side to side ready to initiate a step; taking one step backward as a cue ready to then walk forwards