- Parkinson’s disease is a chronic, progressive disorder of the nervous system characterized by the cardinal features of rigidity, akinesia, bradykinesia, tremor, and postural instability.
- In this article, we’ll be discussing how to identify the signs of Parkinson’s disease, the diagnostic process, and the possible treatments or solutions.
- The term parkinsonism is used to refer to a group of disorders that produce abnormalities of basal ganglia function.
- Parkinson’s disease or primary parkinsonism is the most common cause affecting about 78% of the patients. Secondary parkinsonism results from any different cause. Parkinsonism plus syndromes imply the symptoms of multiple system degeneration.
- According to recent statistics, over 10 million people in the world have Parkinson’s disease. Parkinson’s disease is a neurodegenerative disorder that occurs when neurons in the brain break down. When these nerve cells die, it reduces dopamine levels in the brain. Dopamine is a neurotransmitter that sends messages from one nerve cell to another.
- Low dopamine levels are correlated with abnormal brain activity. Parkinson’s is usually the first symptom of this, which can lead to tremors.
Parkinson's Disease, Symptoms & its Diagnosis
- The basal ganglia play an important role in the production of voluntary movement and control of postural adjustments associated with voluntary movements.
- Damage to the basal ganglia in PD results in motor disturbances which can be hyper or hypokinetic.
- (Hyperkinetic– chorea, dyskinesia, dystonia, Hypokinetic– akinesia, bradykinesia)
- PD is associated with the degeneration of dopaminergic neurons that produce dopamine. Loss of these neurons influence leads to a reduction in spontaneous movements, thus the patient wants to move but cannot.
- Postural instability
Indirect impairments and complications include poverty of movements, fatigue, masked face, musculoskeletal changes, gait disturbances, swallowing and communication dysfunctions, cognitive and behavioral dysfunctions, autonomic dysfunctions, and cardio-pulmonary issues.
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An assessment of the functional status of the patient plays an important role.
Measures of functional ability by using FIM(functional independence measure), Katz index of independence in activity of daily living.
Disease-specific measures by using the unified Parkinson’s disease rating scale (UPDRS-assess the direct and indirect effects of PD and the effect of drug-related fluctuations).
It is divided into three parts
- Mental status
- Motor scale
Parkinson’s disease questionnaire (PDQ-39) – this contains a 39-item questionnaire that addresses the impact of PD on daily life and also the health-related quality of life dimensions like mobility, ADLs, emotional well-being, stigma, social support, cognition, etc
Symptoms of Parkinson’s disease
- Parkinson’s disease is a progressive neurological disorder. The symptoms are often subtle and develop slowly, but they can include shaking, stiffness and difficulty with walking.
- Parkinson’s disease is a progressive neurological disorder that can be difficult to identify. The symptoms are often subtle and develop slowly, but they can include shaking, stiffness and difficulty with walking. Parkinson’s Disease is caused by the loss of dopaminergic neurons that produce dopamine in the brain.
- As of this date, there is still no cure for Parkinson’s Disease. However, there are treatments that have been shown to be helpful for managing the symptoms. These include medications and surgery to relieve symptoms and improve quality of life.
How do physiotherapist diagnose Parkinson’s disease?
Parkinson’s disease is typically diagnosed by taking a detailed medical history, running a neurological examination, and by performing brain imaging tests. It features tremor, rigidity, slowness of movement and postural instability
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- Relaxation exercises- gentle rocking and rotation exercises, PNF techniques like rhythmic initiation
- Flexibility exercises- ROM exercises, stretchings, positioning, hold relax, and contract-relax techniques.
- Mobility exercises- based on functional movement patterns, bed mobility exercises, pelvic mobility exercises, weight bearings.
- Balance training in sitting and standing
- Gait training for improving stepping, lengthening stride, improving heel-toe gait pattern, increasing contra-lateral trunk movement and arm swing, PNF activity of braiding, sidestepping and cross-stepping
- Motor learning strategies
- Patients are advised to take a high-calorie low protein diet(not more than 15% of calories from protein)
- Education about the symptoms and disease entails
- Possible strategies to solve movement patterns- the teaching of optimal self-care, completion of daily tasks, etc.
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