Parkinson’s Disease Physical Therapy Treatment

How Does Physical Therapy Help Parkinson’s Disease

Physical therapy cannot cure Parkinson’s disease, because at this time, neurological damage cannot be reversed. But therapy can help you compensate for the changes brought about by the condition. These “compensatory treatments,” as they’re called, include learning about new movement techniques, strategies, and equipment. A physical therapist can teach you exercises to strengthen and loosen muscles. Many of these exercises can be performed at home. The goal of physical therapy is to improve your independence and quality of life by improving movement and function and relieving pain.

Physical therapy can help with:

• Balance problems

Important note: Some physical therapists may apply diathermy to relieve muscle aches and pains. This could be dangerous to patients who have deep brain stimulators.

Are Unified Parkinsons Disease Rating Scale Scores A Valid Indicator Of Functional Performance

The UPDRS was originally developed to serve as an assessment of the severity of the disease. The UPDRS consists of 6 sections: IMentation , Behavior, and Mood IIActivities of Daily Living IIIMotor Examination IVComplications of Therapy Vthe Modified Hoehn and Yahr Stage Scale and VIthe Schwab and England Activities of Daily Living Scale. Sections I through III are scored on a 5-point Likert scale from 0 to 4, with 0 representing no impairment and 4 representing marked impairment. These 3 sections can be analyzed independently or combined with each other. The UPDRS total score reflects performance on these 3 sections , with lower scores showing less disability. Sections of the UPDRS are scored and reported separately.

Section II of the UPDRS asks the client to verbally rank his or her perceived ability in many areas, including falling , freezing when walking, and walking. Nine of the 14 items of section III of the UPDRS explore motor activity at the impairment level , rather than performance of functional abilities. The 5 items in section III that measure performance of functional abilities are speech, facial expression, rising from a chair, gait, and postural stability of these items, only the last 3 items are routinely addressed by physical therapists and relate to mobility concerns.

Physical Therapy For Parkinson’s Disease

If you have been diagnosed with Parkinson’s disease your healthcare provider may refer you to many specialists to help you move and function better. A physical therapist is a movement specialist who can assess and treat the motor control and planning changes that occur with the disease.

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Types Of Physical Therapy For Parkinson’s Disease

Parkinson’s disease is a nervous system disorder that affects over 1 million Americans. This disease involves the part of the brain that controls movement. The main symptoms include tremors, muscle rigidity and difficulty with coordination, balance and walking.

Although there is no cure for Parkinson’s disease, various treatments can relieve symptoms and help patients maintain their quality of life. Physical therapy is one form of treatment known to help individuals with Parkinson’s disease increase mobility, strengthen their muscles, improve coordination and balance, and ultimately, remain independent. This post explores the different types of physical therapy and how to make the most of a rehabilitation program.

Managing Symptoms With Our Nationally Recognized Therapy Program

To help you maintain your highest level of function and movement, the Ohio State Wexner Medical Center has a team of therapists ranked among the best in the nation by U.S. News & World Report. At our movement disorders center, youll be working with therapists who specialize in Parkinsons disease.

Your ability to move can be impacted by a range of issues, from motor skills to your cognitive abilities and mental health, so we have a variety of therapy options to keep you as safe, mobile and independent as possible.

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Promoting Physical Activity And Preventing Falls

Because PD is a chronic progressive disorder, it is probable that sustained exercise is necessary to maintain benefits. Indeed, follow-up data from a number of human exercise interventions have demonstrated a gradual return to baseline abilities after the supervised intervention is finished.7,25,38

Because weekly intervention with a physical therapist, throughout the entire course of PD, is neither realistic nor desirable, patients need to take responsibility for their physical activity and exercises. Methods have been developed, based on theories of behavior, for improving exercise habits. Strategies include exploration of the patient’s beliefs about exercise and barriers to regular exercise and discussing the possibility of looking at things differently to change beliefs and overcome barriers.4345 Together, the clinician and patient then establish reasonable goals that the patient thinks are attainable they build on those goals as exercise habits improve. Regular follow-up appointments also are important to monitor progression and provide support to the patient.

Differences Between Physical Therapy And Occupational Therapy

While physical therapy and occupational therapy may be seen as interchangeable, there are some differences between the 2 practices. PT focuses on the physical rehabilitation of people recovering from injuries or disease. The goal of PT is to restore mobility. Physical therapists also educate people on managing their condition to maintain long-term benefits.3

OT also deals with rehabilitation and motion. However, it is focused more on enabling the person to engage in daily activities as seamlessly as possible. Occupational therapists also suggest adaptations and modifications to the persons environment.3

Physical therapists focus primarily on anatomy and the persons strength, functional capacity, and motor development. Occupational therapists combine physical aspects with mental health. They design exercises that teach people coping and management skills within their limits.3

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How Can Physiotherapy Benefit Those With Parkinsons Disease

Apart from medication and surgical procedures, it has been established that physical therapy for Parkinsons disease yields great results. Physiotherapy can benefit a patient suffering from Parkinsons in resisting the regressive changes that follow this disease and in recovering from it.

Physiotherapy can have many positive effects on patients with Parkinsons disease:

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Occupational Therapy For Early Onset Parkinsons

Occupational therapists are similar to physical therapists, but they focus on more specific goals related to functioning. In other words, occupational therapist help us function to the best of our ability. For people with early onset Parkinsons disease, routine tasks such as walking, running, standing up from a chair or moving into and out of bed can become difficult occupational therapists are trained to evaluate these kinds of difficulties and help the person and/or the environment adapt as needs and abilities change.

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• Parkinsons Disease: Physical and Occupational Therapy

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Training Future Physical Therapists In Parkinsons Disease

Did you know the Parkinsons Foundation is working to better educate physical therapy students across the country to ensure better PD care for everyone?

The Parkinsons Foundation Physical Therapy Faculty Program is improving Parkinsons physical therapy care by training faculty leaders across the U.S. so they can, in turn, educate physical therapy students. The intensive course allows physical therapy educators to immerse themselves in learning the latest evidence-based findings in Parkinsons research and care. Physical therapy educators can make a great impact on the lives of people with PD by bringing this knowledge back to their students, our future practitioners.

The Importance Of Physical Therapy For Parkinsons

Since Parkinsons disease causes such an impact on the body, physical therapy can make a big difference. Even though the nerve damage caused by the disease cant be reversed, you can improve your physical capacity and learn how to compensate for impairments.

Working with a physical therapist can help improve your balance, your gait, and your daily movements, among other skills. You can also build strength and cardiovascular capacity with aerobic and strength training.

Early on, your physical therapist can help you maintain your current functioning and favorite activities. In later stages, the therapist can help you relearn how to perform your daily activities or work around the changes in your body.

One of the main goals of physical therapy for Parkinsons disease is to enhance your wellbeing through timely interventions and education. You should feel better as a result of the benefits of physical therapy, which include:

• Improved strength

Therapeutic interventions help you stay active and maintain your independence. Without physical therapy, you risk greater disability, more fall risk, worsening physical ability, and poorer quality of life.

Early intervention is particularly imperative as you have a vital window to address issues early on, even before you notice changes. Your physical therapy sessions are a critical part of your care.

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Physical Therapy For Patients Suffering From Parkinsons Disease

Physical therapy exercises that challenge patients to change tempo, activity, or direction benefit those with Parkinsons disease. It is important to keep variety in exercise activities, this is necessary because individuals with Parkinsons disease often have difficulty in shifting from one activity to another. Exercises that require balance and preparatory adjustment of the body are also important along with rhythmic activities such as dancing, skipping and cycling.

Parkinson disease is the second most common degenerative brain disorder, after Alzheimers disease. More common in men than women, Parkinsons disease is related to loss of nerve cells in the brain that produce dopamine, which plays important role in controlling movement. PD symptoms typically include stiffness , shaking , slowness with movement, and balance problems. Treatment may include medication and physical therapy.

Recommended Exercises for PD include:

As one ages, more exercise must be performed to maintain muscle mass. Muscle mass and strength allow an individual to complete daily chores and to maintain balance.

To Maintain Muscle Mass Try These Alternative Strength Exercises:

• Activities in a standing position strengthen legs

• Pushing up to rise on the toes

• Modified squats

• Repetitively rising and sitting from a chair

• Wearing ankle and wrist weights around the house or out on a walk

• Push-ups or wall push-ups for arms

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Physical Therapy For Parkinsons

Physical therapy is a program that helps you build strength, flexibility, balance, and coordination. It starts with an evaluation of your current abilities to locate the areas of movement causing you problems.

The therapist will teach you exercises and other techniques to improve your strength, coordination, balance, and movement. During physical therapy sessions, you might learn to:

• get in and out of bed or a chair more easily
• stretch your muscles to improve your range of motion
• walk more smoothly, without shuffling
• go up and down stairs
• use a cane or a walker to help you get around

To get the most out of your physical therapy sessions, find a therapist with experience treating Parkinsons or similar disorders. Therapists who are board-certified neurologic specialists should have this type of training. Ask your neurologist to recommend someone.

Certain types of physical therapy can help with movement issues caused by Parkinsons disease. Here are a few of them.

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Forced Exercise In Parkinsons

An important study in 2009 by researchers at the Cleveland Clinic compared two types of exercise groups: forced exercise and voluntary exercise. Forced exercise is different than voluntary exercise in that forced exercise involves a slower, more consistent pace for a longer duration whereas voluntary exercise involves a rapid pace and shorter duration. The study showed that forced exercise elicits improvements in motor function in Parkinsons disease patients. Forced exercise can be done on a tandem bike, using an able-bodied person as a pace-setter, pedaling at 80-90 revolutions per minute . Using forced exercise, patients can work up to 30% harder than they would work on their own.

The forced exercise groups showed a 35% improvement in motor function scores, including improvements in upper-extremity dexterity after 8 weeks of training. This effect was not noted in the group that participated in the voluntary exercise. Both groups had improvements in their aerobic fitness, as both worked at 60-80% of their heart rate max. Both groups also showed similar or improved levels of rigidity and bradykinesia after exercise. These positive changes lasted for about four weeks.

Getting The Most Out Of Physical Therapy

Physical therapy will teach you the right exercises to target the symptoms you want to make better. Exercise is crucial for improving Parkinson’s disease symptoms and maintaining general health. Even if you do not have mobility or pain issues, start an exercise program as soon as possible to delay the disease’s progression.

Once you start a program, your physical therapist will guide you and help you reach your goals. Still, it is in your power to make the most of your treatment. Here are tips to maximize the benefits of physical therapy:

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How To Find Your Expert Physical Therapist For Parkinsons Disease

It is important to find a physical therapist who has specialty training and experience working with PD. You may find experienced physical therapists working in hospital outpatient departments, home health agencies, nursing homes or within the community close to your home. Ask your neurologist for a referral at your next appointment.

The Parkinsons Foundation Helpline at 1-800-4PD-INFO can help you locate an experienced physical therapist near you who is trained to work with people with PD, and provide questions to ask a potential physical therapist to assess their experience.

Among Benefits Lesser Reliance On Pharmaceutical Treatments

Results showed that LEDs significantly decreased with a long-term rehabilitation or exercise program, indicating patients were generally able to lower their medication doses.

A subgroup analysis of each exercise type found that no individual exercise led to significant motor gains when anti-parkinsonian medications were not being used. Only resistance training was associated with motor improvements in the absence of medications, and it was the finding of a single study.

Multidisciplinary rehabilitation, which mainly consisted of physical therapy with some visual and auditory guidance training to improve gait and posture, was linked to improvements in daily life activities and a reduction in LED.

The researchers suggested that a multidisciplinary approach has more treatment modes and improves the functional impairment of the patients more widely, which could account for daily life gains not seen with other approaches. But they noted that a small number of studies for each intervention type limits their analyses.

Still, overall findings support that at least six months of physical therapy for people with mild-to-moderate Parkinsons could effectively improve the motor symptoms of patients whether combined with antiparkinson drug therapy or not, the researchers wrote.

Such gains boost the confidence of Parkinsons patients and make them pay more attention to and adhere to long-term physical therapy, they added.

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How Physical Therapy Can Help With Parkinson’s Disease Symptoms:

People with Parkinsons often have trouble with balance, with initiating walking, feel stiff in their trunk, and have difficulty moving quickly. Physical therapists can help with all of that and more. Below are some examples of common treatments that someone with Parkinsons can have if they come into CBPT:

Can Physical Therapist Intervention Help This Patient

Mr Jennings, a 54-year-old financial planner currently in H& Y stage 2, had been diagnosed with PD 4 years earlier. His symptoms had begun 7 years earlier with weakness and tremor on his left side. He had not received physical therapist for PD. Medications and supplements included pramipexole, selegiline, amantadine, coenzyme Q10, a multivitamin, and fish oil containing omega-3 fatty acids. He had no significant comorbid conditions. His goal was to engage in a therapeutic exercise program to prevent decline related to aging and PD. Mr Jennings did not report any falls but reported feeling stiff, moving slowly, and being concerned about balance and walking, particularly in crowded environments.

The physical therapist evaluation included measures of function and an assessment of underlying impairments that could limit current or future abilities with balance and gait. Several of these measures, including the TUG, the FRT, and the 6-minute walk test, were reported in the Cochrane review. Additional measures of balance and gait included the Five-Times Sit-to-Stand Test and the Functional Gait Assessment . His score of 25 of 30 on the FGA indicated a mild fall risk . He was able to ascend and descend a full flight of stairs without the use of a railing, indicating good lower extremity strength. This finding was further confirmed by his ability to perform the FTSST in 10 seconds and without the use of hands.

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Get Your Parkinsons Plan Of Attack

If youre looking for help in getting your daily Parkinsons exercise program off the ground, you can get your Parkinsons Plan of Attack Foundations Checklist here. Designed to help you wake up each day confident and excited to take control of your Parkinsons and live well, the checklist will remind you of the actions you can take each day to live with greater health, energy and joy.

How Many Physical Therapy Visits Will I Need

Treatments in physical therapy often can be completed in one to three office visits. The first appointment includes an evaluation and recommendations for exercises. The following appointments check your progress and review and expand your home program. Most hospitals can provide additional sessions of outpatient therapy if needed.

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Parkinsons Physical Therapy Exercises Improve Balance Coordination Strength

Parkinsons Disease has a wide range of symptoms that generally begin with tremor, stiffness, and slowing of movement. As the disease progresses, PD motor symptoms can include foot-dragging, freezing, less-pronounced movements, and facial expression. Treating Parkinsons with physical therapy is recommended to reduce stiffness and discomfort and to allow patients to continue to perform daily tasks and retain independence.

Parkinsons physical therapy should be the first medicine in the treatment of PD. Properly trained physical therapists can address issues beyond just the conditions motor symptoms. Specific exercises targeting PD can have a large impact, and PD experts agree that physical activity is beneficial to PD patients at all stages of their disease, including at early diagnosis. Physical therapists trained in treating neurological conditions recommend exercises for people with PD aimed at improved balance and coordination, flexibility, endurance, and strength.

Researchers have found that during Parkinsons physical therapy, the frequency of a workout is more important than the type of exercise a patient engages in. In fact, patients who exercise at least 2-1/2 hours per week experience a slower decline in quality of life.

Each person with PD is affected differently, and specialists in Parkinsons treatments should take an individualized approach to managing the disorder. Read on for our Physical Therapy for PD Q & A.