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How Does Parkinson Disease Affect The Muscular System

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Disorders Of The Muscular System

Parkinson’s Disease and the Basal Ganglia

Figure 12.6.1 Devices can be a pain in the neck literally.

Pain in the Neck

Spending hours each day looking down at hand-held devices is a pain in the neck literally. The weight of the head bending forward can put a lot of strain on neck muscles, and muscle injuries can be very painful. Neck pain is one of the most common of all complaints that bring people to the doctors office. In any given year, about one in five adults will suffer from neck pain. Thats a lot of pains in the neck! Not all of them are due to muscular disorders, but many of them are. Muscular disorders, in turn, generally fall into two general categories: musculoskeletal disorders

are injuries that occur in muscles or associated tissues because of biomechanical stresses. They may be caused by sudden exertion, over-exertion, repetitive motions, or long periods of maintaining awkward positions. Musculoskeletal disorders are often work- or sports-related, and generally just one or a few muscles are affected. They can often be treated successfully, and full recovery can be very likely. The disorders include muscle strains, tendinitis, and carpal tunnel syndrome.

What Is The Quality Of The Reviewed Studies

Overall, quality scores were mediocre for both non-intervention and intervention studies. The main points that studies scored low on were sample size justification, electrode placement procedures and signal processing techniques. Individuals with PD exhibit great heterogeneity and generally high inter- and intra- subject gait EMG variability necessitating greater sample sizes than for HOA. However, the median sample size was only twenty-two and no study in this review performed power analysis to justify their selection of participant number. Most studies included a greater proportion of males, reflecting the gender bias in PD although some studies did not specify gender. Gender differences in muscle activity during walking have previously been reported, indicating it is an important factor. Only four studies determined electrode location using validated guidelines such as the SENIAM guidelines. Identification of the optimal electrode site helps ensure the signals with higher signal to noise ratio are recorded from the selected muscle with minimal cross-talk from adjacent muscles.

Over half of the studies did not report any signal normalisation methods,,,,,,,,. Such normalisation is essential to allow comparisons of EMG between muscles, sessions and participants as factors such as thickness of adipose tissue, presence of oedema and number and orientation of muscle fibres will modify amplitude,. Excluding normalisation can invalidate subsequent results.

Feature: Human Biology In The News

On June 3, 2016, media all over the world exploded with news of the death of Muhammad Ali at the age of 74. The world champion boxer and Olympic gold medalist died that day of complications of a respiratory infection, but the underlying cause was Parkinsons disease. Ali was diagnosed with Parkinsons in 1984 when he was only 42 years old. Doctors attributed his disease to repeated head trauma from boxing.

In the days following Alis death, the news was full of stories and images from milestones in the athletes life, both before and after his diagnosis with Parkinsons disease. Sadly, the news coverage also provided an overview of his gradual decline as the disease progressed. Ali was pictured in 1996 lighting the flame at the Summer Olympics in Atlanta however, in 2012, Ali had to be helped to his feet by his wife just to stand before the flag

Figure 12.6.6 Muhammad Ali and Michael J. Fox became unlikely allies in the fight against Parkinsons Disease, testifying together before a Senate Committee in 2002.

he was supposed to carry into the stadium. He was unable to carry it because of the ravages of Parkinsons disease.

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How Is Parkinsons Disease Treated

There is no cure for Parkinsons disease. However, medications and other treatments can help relieve some of your symptoms. Exercise can help your Parkinsons symptoms significantly. In addition, physical therapy, occupational therapy and speech-language therapy can help with walking and balance problems, eating and swallowing challenges and speech problems. Surgery is an option for some patients.

How Is Parkinsons Disease Diagnosed


Diagnosing Parkinsons disease is sometimes difficult, since early symptoms can mimic other disorders and there are no specific blood or other laboratory tests to diagnose the disease. Imaging tests, such as CT or MRI scans, may be used to rule out other disorders that cause similar symptoms.

To diagnose Parkinsons disease, you will be asked about your medical history and family history of neurologic disorders as well as your current symptoms, medications and possible exposure to toxins. Your doctor will look for signs of tremor and muscle rigidity, watch you walk, check your posture and coordination and look for slowness of movement.

If you think you may have Parkinsons disease, you should probably see a neurologist, preferably a movement disorders-trained neurologist. The treatment decisions made early in the illness can affect the long-term success of the treatment.

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What Medications Are Used To Treat Parkinsons Disease

Medications are the main treatment method for patients with Parkinsons disease. Your doctor will work closely with you to develop a treatment plan best suited for you based on the severity of your disease at the time of diagnosis, side effects of the drug class and success or failure of symptom control of the medications you try.

Medications combat Parkinsons disease by:

  • Helping nerve cells in the brain make dopamine.
  • Mimicking the effects of dopamine in the brain.
  • Blocking an enzyme that breaks down dopamine in the brain.
  • Reducing some specific symptoms of Parkinsons disease.

Levodopa: Levodopa is a main treatment for the slowness of movement, tremor, and stiffness symptoms of Parkinsons disease. Nerve cells use levodopa to make dopamine, which replenishes the low amount found in the brain of persons with Parkinsons disease. Levodopa is usually taken with carbidopa to allow more levodopa to reach the brain and to prevent or reduce the nausea and vomiting, low blood pressure and other side effects of levodopa. Sinemet® is available in an immediate release formula and a long-acting, controlled release formula. Rytary® is a newer version of levodopa/carbidopa that is a longer-acting capsule. The newest addition is Inbrija®, which is inhaled levodopa. It is used by people already taking regular carbidopa/levodopa for when they have off episodes .

Treating Fatigue In Parkinsons Disease

There are currently few treatments available that directly alleviate fatigue, which can make it difficult to treat. However, people with PD who experience fatigue should talk to their doctor as changes in their current medications may help relieve fatigue. Complementary therapies, such as acupuncture or massage, may help improve symptoms of fatigue. In addition, there are several lifestyle approaches that can help manage fatigue, including:

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Alternative And Home Treatments

Getting regular exercise can help you reduce the pain and discomfort that can happen with akinesia and other motor function conditions that may result from PD or PSP. Talk to your doctor or a physical therapist about developing an exercise plan thats comfortable and safe for you depending on your symptoms and the progression of akinesia. Making sure that you dont overexert yourself or fall during exercise is important. Doing yoga or tai chi, which help stretch your muscles, can help slow the progression of akinesia. Exercise has been shown to delay functional decline in PD.

Taking coenzyme Q10 for several months can help you if youre in the early stages of PD or PSP. Eating foods with a lot of fiber and drinking plenty of water can help keep your symptoms to a minimum.

Treatments that help relax your muscles, such as massages and acupuncture, can also relieve the symptoms of PD and PSP. Meditating or doing activities that relax you, such as listening to music or painting, can help slow the effects of akinesia and help you retain control over your muscles.

Causes And Symptoms Of Muscle Disorders

What is Parkinson’s Disease?

The causes of muscle disorders can be quite expansive, as their function relies on other processes in the body to be working optimally as well. Muscular disorders that result in the loss of function of a certain muscle group can lead to a condition called muscular atrophy, which is caused by wasting away of muscle tissue due to underutilization. Muscle atrophy is characterized by weakness and the shrinking of muscle mass. Pain may also be present in muscle disease and is primarily caused by defects in blood circulation, injury, or inflammation. Muscular pain may also result in additional symptoms of weakness and fatigue.

The following is a muscular system disease and disorders list outlining the intricacies of each condition.

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Diseases That May Occur In Muscular System

The muscles in our body perform various functions like maintaining posture by steady contraction, making movements of the skeleton and generating body heat by cell metabolism. Muscular system disease includes muscle pain, weakness in the muscles and paralysis. It could be caused by various conditions like hormonal disorder, auto-immune problem, genetic factor, infections, cancer or misuse of the muscle.

What Is Parkinsons Disease

Parkinsons disease is a nervous system disease that affects your ability to control movement. The disease usually starts out slowly and worsens over time. If you have Parkinsons disease, you may shake, have muscle stiffness, and have trouble walking and maintaining your balance and coordination. As the disease worsens, you may have trouble talking, sleeping, have mental and memory problems, experience behavioral changes and have other symptoms.

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What Are The Symptoms

Each person is affected differently by Parkinsons disease and no two people will experience exactly the same symptoms. The impact of Parkinsons disease can be unpredictable and it is common for people to have good days and bad days.

The main symptoms of Parkinsons disease are:

  • tremor
  • rigidity
  • balance problems
  • problems with posture

Other possible symptoms include difficulty initiating movement , a shuffling gait when walking, and freezing when trying to move . People might experience a loss of facial expression, speech problems , swallowing problems, bowel and bladder problems, difficulties at night and tiredness during the day. Skin can become greasy and people might experience excessive sweating. Sexual problems are common. People often experience depression and anxiety. Another common symptom is small handwriting .

Other less common symptoms can include pain and memory problems.

About The Muscular System

Parkinsons Disease

Every single movement you maketalking, walking, sitting, standing, and even blinking is controlled by your muscles. You even have muscles that you are not aware offor example, those that control posture and contract blood vessels.

There are over 600 muscles in the human body and three recognized muscle types. Each of the three types has its own specific functions.

  • Skeletal muscle: These muscles are connected to the bones and supported by tendonsflexible, but tough cords of tissue. As muscle contracts, it will pull on the tendons, moving bone. Bones are also connected to other bones by ligaments, which are similar to tendons and help to hold the skeleton together.
  • Smooth muscle: This is a type of muscle that is smooth and responsible for muscle actions that are involuntary and out of your control. Smooth muscle exists in places such as your stomach, intestines, and blood vessels. These muscles perform all the tasks your body needs to function.
  • Cardiac muscle: Cardiac muscle is a type of muscle marked with slanted dark and light branches made up of stretched-out fibers. Cardiac muscle is found in the heart and responsible for coordinated and involuntary contractions that allow the heart to pump blood efficiently. The heart is the only muscle in the body that continuously contracts.

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Can Parkinsons Disease Be Prevented

Unfortunately, no. Parkinsons disease is long-term disease that worsens over time. Although there is no way to prevent or cure the disease , medications may significantly relieve your symptoms. In some patients especially those with later-stage disease, surgery to improve symptoms may be an option.

Causes Of Fatigue In Parkinsons Disease

Many of the symptoms of PD, including slow movement, muscle stiffness, depression, and changes to sleep quality can cause or worsen the symptom of fatigue.

  • Akinesia Fatigue may be caused by akinesia . People experiencing akinesia find it challenging to accomplish simple tasks, requiring significantly more energy to get through the daily activities.
  • Muscle fatigue Many of the symptoms of PD that affect the muscles, like stiffness, cramping, tremor, and difficulty starting movement, put extra stress on the muscles, causing fatigue. In addition, some people with PD experience muscle atrophy, in which the muscles shrink and weaken due to lack of use. Muscle atrophy decreases a persons stamina and endurance, contributing to the sense of fatigue.
  • Depression Depression is another common non-motor symptom of PD, occurring in approximately 40% of people with PD. Depression can cause fatigue, adding to a sense of low energy or lack of motivation.
  • Sleep disturbance PD often causes changes in sleep cycles, which can add to a sense of fatigue during the day.
  • Medications Some of the medications used to treat PD, including dopamine agonists, can cause fatigue as a side effect. Others may cause insomnia as a side effect, leading to daytime fatigue.1,2

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Rigidity And Motor Control

When a joint is moved passively , there is a normal amount of tone . Rigidity refers to increased tone, or increased resistance to passive movement. To understand rigidity as a motor control abnormality, we must ask what is the role of muscle tone in motor control. The full answer to this question is not yet clear, but normal tone is likely part of a general mechanism for maintaining stability, that is, resistance to perturbations. When a limb is at rest and relaxed, the muscles are not active. If an external force, such as a physicians hand, moves the limb, some muscles are stretched. Some resistance to such a movement is produced by the physical properties of the limbs tissues . Additional resistance is caused by stretch reflexes. Sensory fibers detect lengthening of the muscles and cause motor neurons in the spinal cord to contract the same muscles. If the limb is truly relaxed, these responses are limited to short-latency reflexes , only involving circuits within the spinal cord. If the stretch is applied when the muscle is contracting, additional reflexes contribute to resistance . These are long-latency reflexes. They appear 50100 msec after onset of the stretch and are seen as muscle activation that occurs after activity caused by spinal reflexes, but before any voluntary reaction to the passive movement .

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What is Parkinson’s disease? | Nervous system diseases | NCLEX-RN | Khan Academy

APDAUncategorizedUnderstanding Weakness in Parkinsons disease

It is common for Parkinsons Disease patients to feel weak. They frequently describe their legs as feeling, like theyre made out of lead,like theyre in concrete. But they will also feel weak all over, or describe weakness in their hands or arms. In fact, when Parkinsons Disease patients are tested for strength they are normal but they do fatigue easier. That is, with repeated muscle contractions they do lose force, so it is more difficult for a Parkinsons Disease patient to do repetitive tasks.

When patients think about weakness in Parkinsons Disease they should recall that the original name for this disease was, The Shaking Palsy.Shaking refers to the tremor, of course, but palsy means weakness. James Parkinson called his monograph on the disease, The Shaking Palsy. Thus Parkinson, himself, called this disorder weakness and tremor, but substituted the technical terminology of his day. The coding book used for billing insurance companies calls Parkinsons Disease Paralysis agitans, meaning paralysis with tremor .

Although patients feel the weakness in their limbs, the problem is in the brain. Studies have shown that the actual, objectively measurable muscle weakness that occurs with repeated tasks improves with treatment of the dopamine deficit in the brain with Parkinsons Disease medications.

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Akinesia And Dyskinesia: Whats The Difference

Akinesia is different from dyskinesia. Dyskinesia can happen with conditions in which your muscles twitch or move involuntarily. In akinesia, you are unable to direct your muscles to move . But the muscles do not lose their abilities. Its the extrapyramidal system or movement centers that are faulty.

In dyskinesia, your muscles may move unexpectedly or constantly without the ability to stop. Like akinesia, dyskinesia can also happen in conditions like PD.

Treatment And Management Options

There are several treatment options available to alleviate the motor symptoms associated with Parkinsons disease. Most of them also help Parkinsons patients overcome issues related to rigidity. These include:

  • Medications such as levodopa , dopamine agonists, anticholinergics, catechol-O-methyl transferase inhibitors, and monoamine oxidase-B inhibitors. One treatment or a combination of treatments is commonly prescribed to Parkinsons disease patients to improve motor problems, including rigidity, that occur due to dysfunction in dopaminergic neurons.
  • Physiotherapy to improve mobility and the range of movement in muscles and joints, and to alleviate the muscle cramps common in Parkinsons disease patients. An occupational therapist or physiotherapist can advise on daily routines, exercises, and the use of assistive devices, such as walkers or canes, to help the patient stay as mobile and independent as possible. Occupational therapy is generally needed for patients to perform daily activities more effectively, such as rolling in bed or getting up from a chair, for example. Regular exercise and stretching can strengthen muscles and maintain flexibility.
  • Speech therapy that teaches facial exercises to help with speech and communication.
  • Deep brain stimulation for Parkinsons disease patients whose symptoms are not adequately controlled with medications and/or exercise.

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