The awareness of Parkinson’s disease has increased greatly over the last 15 years, and is something that we treat on a regular basis with physical therapy. It is a progressive, degenerative clinical condition that worsens over time with symptoms which include tremors, loss of facial expression, stiffness, slowing down of movement and a multitude of other problems.
In the past few years, there have been significant developments in the understanding of Parkinson’s disease. Muhammad Ali, the legendary boxer, was diagnosed with Parkinson’s in 1984 at the age of 42 and is currently unable to speak in public as a direct result of this condition. The actor Michael J Fox is another well-known celebrity struggling with Parkinson’s. These high profile cases have helped raise awareness. Treatment includes a combination of medication, diet, exercise, lifestyle modifications, counseling and participation in support groups.
What a lot of people do not know is what our role of physical therapy is in treating this condition. However, before going any further let’s briefly describe the basis behind how exactly this disease process works. Parkinson’s disease is associated with the inability to produce the chemical dopamine in the brain. Dopamine is a chemical messenger that transmits information between brain cells. The reduction of dopamine causes symptoms such as tremors (typically described as ‘pill rolling’), tightening of the muscles (called rigidity) and slowing down of movements (called hypokinesia). These features can cause a great deal of disability, and can be effectively managed with physical therapy.
Since there is no known cure, the objective of physical therapy in Parkinson’s disease is to slow down the degenerative effects of this disease as much as possible. Parkinson’s disease affects each individual in a different way. A physical therapist will work closely with the patient and family members to monitor the condition and improve functional capacity as much as possible. This is a life-altering event and caregivers or family members may react with denial, confusion, fear, anger, or self-blame.
The physical therapist will conduct an evaluation of gait, balance, coordination, strength and posture of the patient. The caregiver is provided the tools and information to keep the patient mobile with movement patterns and home exercise programs. Depending upon the severity and nature of the patient’s condition, the treatment plan focuses on the following:
1. Developing an effective strategy to get in and out of bed and maintain balance in sitting and standing.
2. Improving endurance, strength, and flexibility.
3. Enhancing dexterity to perform hand movements.
4. Maintaining coordination while walking and changing directions.
5. Decreasing risk of falls.
6. Ascending and descending stairs.
7. Managing multiple tasks simultaneously.
8. Participating in day-to-day activities.
In the early phase, physical therapy helps maintain activity and reduce the risk of falling. Group activities in the community are encouraged, with dance classes or exercises classes at a local bym providing a refreshing way to explore movement and music.
Over a period of time, the goal is to stimulate muscle activities and preserve existing function. As the disease progresses, patients may be confined to a bed or a wheel chair. Treatment is now focused towards maintaining vital bodily function. Walking aids like a cane or walker may be prescribed.
Anxiety and despair is common when dealing with a progressive condition with no known cure. Despite the complexity of the condition, the benefits of physical therapy are significant. Helping a patient cope with disability and dysfunction from a physical and emotional perspective is the foundation of physical therapy treatment for every condition, including one as progressive as Parkinson’s. You can contact us at Advanced Physical Therapy of Clinton today to schedule an evaluation and we’ll show you several ways in which we can help you live a healthy, productive life.
Dr. Daniel Skulavik, PT, DPT, OCS, is with Advanced Physical Therapy located in the Food Lion Shopping Center, Clinton.