WHAT IS PARKINSON DISEASE?
Parkinson disease is related to a loss of nerve cells in your brain that produce a chemical called dopamine. Dopamine is an important factor in controlling movement.
The exact cause of PD is not yet known. Family history, aging, or exposure to certain environmental toxins may contribute to the onset of PD. It is a chronic degenerative disease, which means that it gets worse over time; however, people usually do not die from PD.
The severity and type of symptoms of PD can vary widely. Some people have the disease for 20 to 30 years and have a slower progression and decline in mobility over a long period of time. For others, the disease progresses more quickly, and they may experience difficulty with mobility within 5 to 10 years.
How Can Physical Therapy Help?
Because PD affects each person differently, your physical therapist will partner with you to manage your specific situation — now and as your condition changes. You are not alone!
Your treatment plan will be developed after an extensive evaluation by your physical therapist. The examination will include many questions about how your PD affects your life. Tests will be conducted to examine your posture, strength, flexibility, walking, balance, and coordination.
Your physical therapist will help you stay as active and as independent as possible. You will be taught special exercises and techniques to combat the symptoms of PD. Depending on the nature and severity of your condition, your treatment program may focus on treatment to help you:
- Improve your fitness level, strength, and flexibility
- Develop more effective strategies to get in and out of bed, chairs, and cars
- Turn over in bed more easily
- Stand and turn to change directions more efficiently
- Improve the smoothness and coordination of your walking
- Improve your ability to perform hand movements
- Decrease your risk of falling
- Climb and descend stairs and curbs
- Do more than 1 task at a time more efficiently
- Participate in activities that are important to you
Some of the medications that are used to manage PD symptoms may have an immediate effect. For example, movement is typically much easier shortly after you begin taking certain PD medications. Your physical therapist will know how to time treatments, exercise, and activity based on both the schedule and the effects of your medications to get the best results.
Parkinson disease can make daily activities seem frustrating and time-consuming. Your physical therapist will become a partner with you and your family to help you combat and manage the symptoms of PD. As your condition changes, your treatment program will be adjusted to help you be as independent and as active as possible.
Some people with PD benefit from using a cane, a walker with wheels, or a walker with a laser beam. Your physical therapist can work with you to determine if any of these devices may be helpful to you. If you need physical assistance to help you with moving in bed or getting out of a chair, your physical therapist can team with you and your family to teach strategies to make moving easier and help prevent injury. In addition, your physical therapist can make suggestions on changes to your home environment to optimize safe and efficient daily function at home.
SIGNS AND SYMPTOMS
The symptoms of PD can be very mild at first. A common early symptom is a tremor in one hand, most often when you are at rest. It might look like you are rolling a pill between your thumb and forefinger. Tremors also can occur in your legs or jaw when you are at rest. Since the tremors are most apparent during rest, they usually go away when moving and typically don’t interfere substantially with daily function.
As the condition progresses, you may notice other symptoms:
- Your movements may become smaller, possibly resulting in:
- shuffling when you walk, end of a sentence.
- arms swinging less when you walk, and
- your handwriting trailing off at the end of a sentence.
- You may develop a feeling of stiffness or rigidity in your muscles, causing discomfort in your neck, trunk, or shoulders.
- You may have postural instability, resulting in poor balance and a greater risk of falling.
- Your movements may become slower when doing daily activities such as dressing, showering, or moving in bed.
- You might feel as though your feet “freeze” to the floor, making it hard to take a first step.
- You may develop a stooped posture.
- You may find it physically difficult to speak loudly.
- Family and friends might notice that you show less expression in your face.
You might find it difficult to do things that you were once able to do easily, such as gardening or playing tennis or golf.
Other symptoms might include:
- Difficulty paying attention to a task for a long period of time or dividing attention between more than one task
- Lack of motivation
HOW IS IT DIAGNOSED?
There is no specific “test” like an x-ray or head scan that can be used to identify PD, so it can be difficult to diagnose. A diagnosis is usually made based on your medical history and a neurological examination. If your physical therapist suspects that you have symptoms of PD, you may be referred to a neurologist for further examination.
A diagnosis of PD may be made if you have the following: [custom_blockquote style=”blue”]
- At least 2 of the key signs of PD — tremor when resting, slowing of motion, or muscle rigidity
- A significant improvement in your symptoms when taking levodopa, a medication to treat PD
- Initial symptoms on 1 side of the body only
Parkinson disease (PD) is the second most common degenerative brain disorder, after Alzheimer disease. PD is more common in men than in women. People of all ethnic groups can develop PD, but it is less common among African-American and Asian populations. Most often, symptoms begin when people are around 60 years of age. Symptoms typically include stiffness (rigidity), shaking (tremor), slowness with movement, and balance problems. Because of these symptoms, people with PD are at risk of falling and breaking their bones. Treatment includes a combination of medication and physical therapy – and, in some cases, surgery.
CAN THIS INJURY OR CONDITION BE PREVENTED?
To date, there is no known way to prevent PD. Studies have shown improved walking, balance, strength, flexibility, and fitness in people with PD who participated in an exercise program. However, these studies also indicated that people with PD gradually lost the gains they had made when their supervised exercise program ended. It’s important to work with your physical therapist to help develop good long-term exercise habits.