April is Parkinson’s Disease Awareness Month
Parkinson’s disease is a progressive, degenerative neurologic disease that affects the brain’s ability to produce specific chemicals that allow normal, smooth movement and motor planning. It affects approximately 50,000 people in the United States every year with about 1 million people currently affected. The average age of onset for Parkinson’s disease is in the early to mid-60s, though can begin in early adulthood (less common).
Parkinson’s disease causes the part of the brain responsible for movement planning and execution to slowly die off, causing various changes in a person’s posture, resting muscle tone, speed and amplitude of movement, balance, and general joint mobility. The four cardinal signs of Parkinson’s disease include: resting muscle tremor, rigidity, bradykinesia, postural instability, though there are many other possible presentations/symptoms that may occur.
There are two typical dominant sub-types of Parkinson’s disease: tremor dominant or postural instability dominant. Those with tremor dominant sub-type typically have a better prognosis regarding balance and postural stability, while those with the postural instability sub-type are at a significantly higher risk for falls/injuries due to their difficulty with balance.
Why does it matter?
Over time, these changes to a person’s posture, movement, and muscle tone can have detrimental effects to their overall well-being. This can lead to general stiffness of the body’s joints, decrease ability to participate in normal daily activities or ADLs, and when severe enough can impact a person’s cognition and mental state. The effects on the motor control centers of the brain have a direct impact on fine motor skills, object manipulation, transfers, and walking.
How can physical therapy help?
While there is no known cure for Parkinson’s disease, exercise and moderate to vigorous physical activity has been shown to positively impact the symptoms of the condition. Working with a physical therapist will not change your diagnosis. However, a physical therapist can teach you how to retrain your body and mind to decrease the effects of your condition utilizing larger, higher amplitude movements to compensate for symptoms like bradykinesia (decreased movement) and rigidity.
As a person with Parkinson’s disease ages, coordination with a physical therapist becomes even more important. Due to the progressive nature of the disease, symptoms can eventually become debilitating for those affected. Significant negative changes in a person with Parkinson’s disease occur in the balance and proprioception systems which greatly increases their risk of falling and injuring themselves further. Many falls typically occur with tasks as simple as reaching overhead, standing up or sitting down in a chair, or navigating between furniture in the home.
What kind of interventions can you expect?
Manual therapy is an excellent intervention when treating Parkinson’s disease. Due to the various changes in spinal alignment and postural awareness, you may have tight muscles in the neck/shoulder, low back, hips/glutes, knees/calves or stiff joints throughout your spine limiting motion. A licensed physical therapist may utilize soft tissue mobilization or joint mobilization/manipulation to decrease pain and restore normal motion.
As balance is commonly significantly affected in those with later stages of Parkinson’s disease, you will likely receive training to improve it. Balance is like a muscle, and the more you work it the better it gets. Walking combined with different activities to challenge your cognitive and motor systems can also help improve general mobility.
Being able to safely get in and out of a bed or chair is something that may eventually become extremely difficult to perform without ending up on the floor. Your physical therapist will teach you safe and efficient movement strategies for various transfers and daily tasks, allowing you to navigate your home and the community safely. A physical therapist can also teach you how to use various assistive devices to safely negotiate your surroundings.
If you or someone you know has been diagnosed with Parkinson’s disease, schedule an evaluation with a Doctor of Physical Therapy to be assessed and begin your journey to a healthier, safer, and more active lifestyle!
