Optimizing Movement: The Role of Physiotherapy in Parkinson's

Parkinson's is a movement disorder that causes gradual deterioration of the brain and nerves controlling the body.

The risk of developing Parkinson's disease naturally increases with age, but it can also occur in young adults. While there is a genetic component, not all cases are hereditary.

CLINICAL FEATURES

Signs and symptoms might begin gradually and go unnoticed, but the cardinal symptoms one must look out for are resting tremors, rigidity, and slowness of movement.

TREMOR

When the patient is at rest, the hand or foot is usually trembling, especially in a pill-rolling pattern, and it disappears during activity.

BRADYKINESIA

Slowness of movement persists in patients while performing a task or walking. This is not because of a lack of muscle strength but because of decreased motor control.

RIGIDITY

Patients have two types of rigidity: -

• Lead pipe rigidity - constant stiffness while moving a body part

• Cog-wheel rigidity - leadpipe rigidity along with tremors
  

GAIT

Due to rigidity and slowed movements, the patient may exhibit a rigid posture and shuffling gait, it gives the impression of potential loss of balance and risk of falling.

HYPOMIMIA

As the disease progresses, the patient may exhibit mask-like facial expressions with little to no change in facial expressions. If any of these symptoms persist, they must visit a healthcare professional to get diagnosed and begin treatment.

TREATMENT

Parkinson's cannot be completely cured; the symptoms can only be managed, and this varies from person to person.

• Medications such as levodopa work by increasing the levels of dopamine in the brain, which helps reduce tremors and stiffness.

• Deep brain stimulation is an alternative approach used when medications prove ineffective. It aids in alleviating the Parkinson's features.
  

PHYSIOTHERAPY MANAGEMENT

1. To reduce tremors

• Administration of levodopa

• Holding on to weighted cutlery

• Hand exercises such as ball squeezing

2. To reduce rigidity

• Relaxation techniques such as yoga, biofeedback, and audiotape.

• Exercises that include large rhythmic movements like trunk rotation, slow rocking, vestibular stimulation, and swinging movements.

• Stretching and joint mobilization to reduce tightness of joint capsule.

3. To reduce bradykinesia

• Games with the help of virtual reality

• Music therapy

• Zumba
  

4. To train balance

• Maintaining position

• Include reach-outs and perturbations

• Partial wall squats

• Heel raises

• Vestibular ball exercises

5. To train gait

• Walking with the support of parallel bars

• Visual and verbal feedback

• Spot marching

• Treadmill training
  

6. To correct posture

• Stretching flexor muscles

• Strengthening extensor muscles

• Positioning of the patient by placing a pillow under the upper thorax

• Visual and verbal feedback

7. Patient and caregiver education

• Encourage patients to perform exercises following the administration of levodopa for optimal benefits during that period.

• Improve confidence by reducing risks of falling.

• Increase independence in activities of daily living by modifying activities.

• Correct lifting techniques.

• Decrease depression.
  

Due to advancements in medicine, individuals with Parkinson's disease can enjoy a near-normal life expectancy and lead lives that are almost similar to those without the condition. So, don't hesitate to contact your nearest physiotherapist today!

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