Parkinson’s is a neurodegenerative disorder of the brain causing tremors, and difficulty walking, movement, and coordination. This disease is characterized by a decrease in production of dopamine, a neurotransmitter that helps control muscle movement, in the basal ganglia of the brain.
Etiology – unknown, contributing factors that can produce symptoms include genetic defect, toxicity from carbon monoxide, encephalitis, and other neurodegenerative diseases such as Huntington’s disease and Alzheimer’s disease. The majority of patients are between 50-79 years old and approximately 10% are diagnosed before 40 years.
Signs and symptoms – resting tremor in hands or feet that increases with stress and disappears with movement or sleep, problems with balance and walking, movement problems such as difficulty starting movement or continuing to move, slowed movements, loss of fine hand movements, slow blinking, difficulty swallowing, rigid or stiff muscles, stooped position, slowed speech, drooling, no expression in the face (mask-like), and shuffling gait pattern. Other symptoms may include anxiety, stress, tension, confusion, dementia, depression, fainting, hallucinations, memory loss, muscle atrophy, and changes in heart rate.
Treatment – relies mostly on medications to increase the levels of dopamine. Medications such as Levodopa for movement-related symptoms, Memantine for cognitive difficulties, antidepressants for mood disorders, Gabapentin for pain, Fludrocortisone for autonomic dysfunction, and Armodafinil for sleep disorders. Dopamine replacement therapy is most effective in reducing movement disorders, rigidity, and tremor. Physical therapy as well as occupational and speech therapy may also be ordered throughout the course of the disease.
Physical therapy interventions should focus on maximizing endurance, strength, functional mobility, posture, and safety with balance, coordination, and gait exercises. The following are examples of exercises that might be included in a physical therapy program:
Endurance – walking with or without using a treadmill
Strength – sit to stand exercises
Mobility – stretching upper and lower extremities and trunk
Balance – standing still either on one leg at a time or closing eyes, standing with perturbations
Gait – walking with cones at a distance to increase step length
Posture – education on the importance of maintaining an upright posture
Coordination – hand-eye coordination activities such as standing still and trying to hit a balloon back and forth
Complications – difficulty performing daily activities, swallowing or eating, disability, injuries from falls, pneumonia from breathing in saliva, and side effects of medications.
Prognosis – most individuals respond well to the medications, however if untreated, the disorder will get worse until a person is totally disabled.
We treat Parkinson’s patients in the 34711 area! Call us today!