Physical Therapy and Parkinson's disease

Parkinson's disease is a chronic progressive neurological disorder resulting from deficiency of dopamine in the brain.It manifest with the triad of-
1. Rigidity or stiffness in the body
2. Bradykinesia or slowness of the movements
3. Resting tremors and postural instability.

Other manifestations include- Intellectual impairment in form of dementia, communication problems due to dysarthria and hypophonia, dysphagia and silorrhea, muscuoskeletal problems due to disuse and inactivity and festinating gait pattern.

Physical therapy management of Parkinson's disease include-

1.Increasing activity levels-Increase overall mobility, do some stretching exercises to elongate muscles and involve patient in a regular walking program.

2.Decreasing rigidity and bradykinesia-Incorporate PNF patterns(specially D2F for upper extremity and D1E for lower extremity) with emphasis on trunk rotation patterns and rhythmic initiation technique.Relaxation exercises in form of gentle rocking can be used to reduce muscle tension.Deep breathing exercises can also be used.Daily stretching and ROM exercises are important.

3.Improving gait pattern-Emphasize high stepping, broad based gait with arm swing and contralateral trunk rotation.Toe wedge can be used to counteract festination.

4.Improving balance-Weight shifts in standing,stepping movements forward and backward, walking and marching in place can be helpful.

5.Improve strength-Focus on lower extremity strengthening in order to improve gait and posture.Trunk extension exercises are also important.

6.Walking aids in form of canes can be used to improve gait and balance