It is a long term degenerative disease of CNS that mainly affects the motor system. Caused due to substantia nigra, cells that make the chemical dopamine start to die. Dopamine acts like a messenger that tells another area of your brain when you want to move a part of your body.The typical appearance of parkinson’s patient is
EPIDEMIOLOGY
CAUSES
Oxidative Stress
Lewy bodies
Increasing age
Genetics mutations in the LRRK2, PARK7, PINK1, PRKN, or SNCA gene
Environmental factors
PATHOPHYSIOLOGY
CLINICAL FEATURES
PHYSICAL EXAMINATION AND DIAGNOSIS
Physical examination includes Medical history, Signs, posture, gait, appearance etc discussed below
Imaging techniques applied includes
MRI, CT scan, PET, SPECT Imaging Testings and Dopamine transporter imaging are used to confirm parkinson’s disease
DIFFERENTIAL DIAGNOSIS
Idiopathic parkinson’s
Essential tremor
Huntington disease
Multi system atrophy
PHYSIOTHERAPY MANAGEMENT
Medical management includes use of drugs that increase dopamine levels like combination of Carbidopa-Levodopa, Dopamine agonists, MAO-B inhibitors, COMT inhibitors.
Physiotherapy management includes Exercises that require balance and preparatory adjustment of the body important along with rhythmic activities such as dancing, skipping and cycling that can maintain the ability to perform reciprocal movements. Finally, exercises that promote attention and learning are beneficial.
Types of exercises that do this:
Walking
Dancing
Yoga classes
Tai Chi classes
Stepping over obstacles
Marching to music with big arm swings
Sports (ping pong, golf, tennis, volleyball)
Aerobic/Jazz exercise classes
The European Guideline provides a section that describes the use of motor learning. It takes the form of cued functional and dual task training, compensatory strategy training uses external cues, self-instruction and attention. Examples include:
Visual cueing
Auditory cueing
Attention
Proprioceptive cueing
Along with the same proper gait training, use of assistive devices like walkers rollators etc, balance and posture training and Movement strategy training are also prescribed
Rollators for Parkinson’s
