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Occupational Therapy Interventions For Parkinson’s Disease

Using Eating Utensils Designed To Help With Parkinsons Tremors

Occupational Therapy & Parkinsons Disease

The first thing to assess is the cause of your difficulty. Is your grip not strong enough? Is your tremor interfering with eating? There are many utensils that are on the market to help people with PD eat more independently. These include built-up utensils that have a wide circumference to hold onto, weighted utensils, and stabilizing utensils, which contain sensors that detect the force and direction of a tremor and move to counteract the tremor. My recommendation as to which is best really depends on the person. Weighted utensils can work well for some people with tremor. My favorite weighted utensils are manufactured in stainless steel by Vive Health. They have enough weight in them to really work. Stabilizing spoons can be expensive and they dont solve the problem for everyone.

Positioning is an important thing to consider. Are you trying to eat in your recliner chair or in bed? If so, you will probably find it difficult to get food to your mouth when lying back. The best position for eating is sitting in a supportive chair at a kitchen table. Occupational therapists can assess your positioning and find the best setup for you.

Whos A Candidate For Dbs

Although DBS is the most common surgery for Parkinsons disease, its not appropriate for everyone.

The procedure seems to help people for whom levodopa has become less effective over time, or for people who have developed disabling side effects from levodopa .

One area of research is exploring whether its helpful to employ DBS earlier in the course of the disease while levodopa is still working.

DBS isnt recommended for people with memory problems, hallucinations, severe depression, poor health, or a consistently poor response to levodopa.

DBS hasnt been shown to benefit people with other parkinsonisms .

As with any surgery, DBS surgery carries a risk of infection. Because DBS is a brain surgery, theres also a small risk of brain hemorrhage or stroke.

What Is Parkinson Disease

Parkinson disease is related to a loss of nerve cells in the brain that produce dopamine. Dopamine and other brain chemicals are normally in balance. They control body movements, thought processes, decision making, moods, and other behaviors.

The exact cause of PD is not yet known. Family history, aging, or exposure to certain toxins may contribute to the onset of the disease. PD is a chronic degenerative disease. This means that it gets worse over time. However, people usually do not die from PD.

The severity and symptoms of PD can vary widely. Some people have the disease for 20 to 30 years. They tend to experience a slow decline in mobility and thinking over a long period of time. Others, for whom the disease progresses more quickly, experience problems with movements and thought processes much earlier .

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How A Parkinsons Nurse Can Help

In the initial stages of Parkinsons, a Parkinsons nurse can provide advice and support to help you come to terms with the diagnosis. They can educate you and your family about the various symptoms of Parkinsons and can suggest strategies to manage symptoms. As Parkinsons progresses they can offer guidance on managing medications. A Parkinsons nurse can also refer you to other health care professionals for more specialist advice.

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What Are The Common Difficulties Associated With Parkinsons Disease

Figure 1 from Occupational Therapy to Optimise Independence in ...

The symptoms of Parkinsonâs can be categorised under three main headings and below are some of the functional difficulties they may cause.

  • Tremors â such as a trembling or shaking in the hands. This can affect the ability to write, eat, drink, prepare meals or use door keys
  • Slow movement due to muscle stiffness â this can mean that carrying out daily tasks such as getting out of bed, on and off the toilet, washing, dressing or using the stairs all become challenging
  • Difficulty walking this can mean an increased risk of falling and a decreased ability to carry out daily activities

If you would like to learn more about how we as occupational therapists can help people overcome common difficulties associated with Parkinsons Disease, you will find some useful links at the bottom of this page.

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How Aquatic Therapy Helps Manage Parkinsons Symptoms

Hydrotherapy treats a wide range of illnesses and orthopedic or chronic disorders. Among them are many conditions related to strength and balance. While aquatic exercise for Parkinsons disease does not reduce all risks of falls which is a key concern among many Parkinsons patients it can be beneficial by strengthening the core and improving muscle memory.

Occupational Therapy And Carers

Occupational therapists can advise your carer and family how to support you in staying independent. They can also advise on ways to look after their own health.

It is important that your family and carers are also involved in, and understand, any changes the occupational therapist recommends to your usual routines. Getting help and advice from an experienced therapist can reduce the amount of help you need from your family or carer and so alleviate any pressure they may feel.

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Help With Funding For Adaptations

Occupational therapists can advise and help arrange funding for minor home adaptations if you need them, such as fitting grab rails or hand rails by steps and stairs.

If you need advice about more expensive home adaptations, such as stairlifts, or accessible bathing facilities, you should speak to an occupational therapist based in a social services department, or the health and social care services of a local authority. They may advise you on any funding available. However, major home adaptations, such as installing a level-floor shower are often subject to means testing.

Use Your Personal Strengths

EXERCISES FOR PARKINSON’S DISEASE | Occupational therapy | home exercises

How can you build on your strengths and minimize your limitations? For example, if you have the strength of helping children enjoy reading, you could exercise that strength by reading to your grandchildren, by listening to them as they read, or by playing a reading game that stimulates both your imagination and theirs.

One of your strengths may be thinking skills. One thinking skill is imagining doing the activity before doing it. For example, imagining writing big can actually help you write big. Another thinking skill is speaking the steps out loud. When combing your hair, try saying hold and comb, to avoid dropping the comb.

Make sure you are exercising. Improving strength, balance and endurance through exercise supports your participation in all sorts of activities. Whether it is dancing or walking to a neighbors house, find an enjoyable way to exercise.

Lastly, be positive. Think, I will do rather than Ill try to and you may be more successful.

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How To Exercise With Parkinsons

Whether youre a first-time exerciser or a lifelong athlete, the key to working out with Parkinsons is to safely and regularly move your body in a variety of ways. Your fitness regimen should include these four main categories of exercise:

  • Aerobic activity
  • Balance, agility, and multi-task exercises

People with Parkinsons should strive to perform aerobic activity at least three times weekly and to complete exercises from the other categories two to three times each week.

In total, the Parkinsons Foundation suggests performing 150 minutes of moderate tovigorous exercise weekly.

To help you achieve this goal, try these helpful tips:

  • Invest in a treadmill, elliptical, or exercise bike. This will make it convenient to perform aerobic exercise from your home, regardless of the weather.
  • Obtain a set of light hand weights from a local exercise shop or thrift store. These can be used for a wide variety of strength training exercises.
  • Follow along with one of the many online exercise classes on YouTube that are tailored to people with Parkinsons disease. The Parkinsons Foundation and the Davis Phinney Foundation offer many great online exercise videos.
  • Connect with a workout buddy by finding a local Parkinsons support group associated with the American Parkinson Disease Association

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What Other Services Does Physical Therapy Provide

Recommendations. A physical therapist can make recommendations for physical therapy at home, at an outpatient facility, or at a nursing or rehabilitation facility.

Work capacity evaluations. Many physical therapists can perform functional capacity evaluations to provide more information for disability claims based on physical performance. This functional capacity evaluation can be useful when the Social Security office denies disability to a person who is unable to work for an eight-hour day.

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Make Daily Activities Simpler

Simplifying your daily activities may help you to save your energy for activities that really demand it. It also may help to adjust your daily schedule so that your routine is less stressful or tiring.

Physiotherapists, occupational therapists, other people who have the disease, and the people who care for them may be good sources of help and support.

Add Aqua Therapy To Your Parkinsons Patients Treatment

Systematic Review of the Effectiveness of Occupational TherapyâRelated ...

HydroWorx offers a variety of products specifically designed to help facilities, just like yours, bring the benefits of aqua therapy to Parkinsons patients and many others. We can work with you to identify your patients needs to determine the ideal hydrotherapy solution from our versatile family of products.

Not only can we help you identify the best possible equipment for your facility needs, but also unique and creative ways to integrate aquatics into your Parkinsons patients current treatment routines. When you have the equipment onsite, it becomes simpler to make adjustments, especially when you take advantage of features enhancing the experience like adjustable-floor therapy pools and variable-speed underwater treadmills.

The use of aquatic therapy, underwater treadmills and resistance jet technology for Parkinsons patients can do the following and more:

  • Help regain trunk balance
  • Improve ambulation
  • Encourage confidence

All of the above are critical when encouraging Parkinsons patients to exercise for their health and to reduce the severity of their symptoms.

Aquatics offers a full range of exercises patients can do without a fear of falling to hold them back. Whether youre working with Parkinsons patients, Alzheimers patients or patients with a host of other physical and neurological conditions, hydrotherapy can be an effective tool for promoting overall physical fitness and good health.

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Physical Therapy Strategies For Parkinsons Disease

PT can improve daily functioning for people living with PD by:4

  • Improving gait, or the way a person walks
  • Improving transfers, like going from stillness to activity
  • Improving balance
  • Strengthening joints and muscles to improve physical capacity

One of the ways physical therapists help improve gait is through the use of cues. Cues are stimuli from the environment or generated by the person that they can use to facilitate repetitive movements, like walking. Cues can be:4

  • Auditory, like using a metronome or music
  • Visual, such as stepping over stripes on the floor
  • Tactile, like tapping on the hip or leg
  • Cognitive, like using a mental image of the length of a step

Help Them Feel Normal

A disease like Parkinsons can interfere with the normalcy of someones life. Because people may focus so much on the disease and its symptoms, your loved one may start to lose their sense of self. When you talk to your loved one, dont constantly remind them that they have a chronic disease. Talk about other things like their favorite new movie or book.

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How Long Does The Lsvt Program Last

The LSVT BIG program is 16 sessions: four consecutive days per week for four weeks. Each session lasts one hour. There is daily homework practice as well. Once a person graduates from LSVT BIG with the skilled therapy sessions, the recommendation is to continue the exercises daily.

At our clinic, we have occupational therapy, physical therapy and speech-language pathology all under one roof. Occupational and physical therapy combine to provide the frequency of services each week, which allows us to address a vast number of a persons concerns in that four-week period.

Individualized Occupational Therapy Interventions

Effective Parkinsons Disease Exercises | Occupational Therapy

Two Level 1b RCTs provide evidence related to guidelines-based, comprehensive, individualized occupational therapy interventions to address IADL function in people with PD. A large, multicenter, pragmatic RCT tested occupational therapy based on the U.K. National Health Service guidelines that was provided in an average of four 1-hr sessions over 8 wk in community and outpatient settings . The intervention focused on transfers, dressing, grooming, sleep, fatigue, indoor mobility, household tasks, and other environmental issues and had no significant effect on clinician-rated IADL performance. A multicenter assessor-blind RCT tested occupational therapy following the Dutch national practice guidelines that was provided for an average of eight 1-hr sessions over 10 wk in the home . The intervention included self-management, coaching, and skills training for compensatory strategies, task and routine simplification, adaptive equipment, and environmental modification and had significant effects on reported IADL participation but not on IADL performance. Together, these studies provide moderate strength of evidence that comprehensive individualized occupational therapy interventions can improve IADL participation but low strength of evidence that it can improve IADL performance.

S5: S3 OR S4

S6: S1 AND S2 AND S5

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Never Underestimate Your Patients Potential

When you evaluate a person who has had PD for a long time, one of the first things you might notice is a flat affect, followed by a bit of difficulty in getting up from a chair, a slow, shuffling gait and flexed posture. It would be easy to make a quick judgment about that patients potential , but time and time again, we are surprised at what can be magically unlocked with therapy.

I remember a gentleman who arrived for his first OT appointment with a less than enthusiastic facial expression says Erica. He was walking very slowly with a quad cane and had a propulsive, shuffling gait pattern. After evaluating him, it was apparent to me that he was able to move bigger and better when cued, so I knew hed be a good candidate for LSVT BIG.

Over the course of the of intensive LSVT BIG treatment, four times a week for four weeks, his attention to amplitude greatly improved his safety with functional mobility to the point where was able to walk again with complete confidence and without a cane. I was shocked not only by his potential to improve his mobility, but also by the profound effects it had on his mood and facial expression. I realized that I had initially misjudged his ability and motivation based upon his facial masking, but was glad I decided to give him the benefit of the doubt!

Video Gait in a man with PD before and after LSVT BIG

2. Dont Be Afraid to Push Your Patient


4. Functional carryover is key!

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Parkinsons Disease And Occupational Therapy: Helping People To Live Better With Their Pd Symptoms

If youre living with Parkinsons Disease an Occupational Therapist may be able to help you achieve your goals so you can perform better to live better.

Whether youre frustrated by your ability to perform everyday tasks, had a fall or perhaps youve experienced a decline in confidence to manage at home?

Whatever your situation, these are all very real and all too common experiences many people affected by PD, maybe much like you, have on a regular basis.

We would like to help.

No intervention can reverse or cure Parkinsons disease. This has been real frustration for many people, maybe much like you as well as David Norris our Senior OT who is passionate about providing Parkinsons Disease occupational therapy services.

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How Can Occupational Therapy Help People With Parkinson’s Disease

Occupational therapists can work with people with Parkinson’s Disease and their families to provide advice, support and guidance during their journey. For some they may require advice on a specific item of equipment whilst for other clients we are involved in more substantial home modifications and support as their needs change with the progressing condition. Below are some ways that an occupational therapist can help:

How we can help

We aim to solve the difficulties associated with Parkinsons Disease. Some of the common ones we treat are listed below.

What Should I Expect At An Appointment

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You may meet your occupational therapist in a variety of places, including in your own home, a hospital, a Parkinsonâs clinic, a rehabilitation unit, an outpatient clinic, or in a residential or nursing home. In some countries it is possible to meet an occupational therapist at a Parkinsonâs support association office.

Appointments usually last between 30 and 60 minutes, and therapists may recommend a short course of occupational therapy usually once a week, for a month or two.

At the first appointment, an occupational therapist will ask about your daily activities, in particular how you look after yourself, your work and your leisure interests. For example, you may have problems preparing meals, dressing, shopping, walking in crowded places, doing a leisure activity, using a computer, or reading.

Collaboration is essential to successful treatment. Therefore, you need to tell your occupational therapist about your situation, how you cope on a daily basis and problems you experience. Then together you will be able to discuss goals for both you and your family and how you achieve them.

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How Much Does In

The fees associated with private in-home Parkinsons support services vary depending on the level of care required. The Australian Government and various state governments offer a number of support packages for those living with Parkinsons disease, including those that fall under the Commonwealth Home Support Program, Home Care Packages, and more.

For more information and to work out a care plan for in-home Parkinsons disease support, get in touch with our friendly team today.


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