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Parkinson’s Disease: How Physical Therapy Can Help

Contributions by Megan Mar - PT, DPT at Complete Balance Solutions - Seal Beach

 

Complete Balance Solutions Seal Beach, CA: Pictured is one of our patients undergoing gait and aerobic training with our treadmill harness, along with a device to monitor heart rate and oxygen saturation for cardiac function.

Signs and Symptoms of Parkinson’s Disease

Parkinson’s disease (PD) is a progressive disorder that affects the nerve cells in the part of the brain called the basal ganglia, an area of the brain that controls movement.[1] When these nerve cells lose their function, they are unable to produce an important neurotransmitter called dopamine, which causes movement problems such as:

  • Slowed movement (bradykinesia)
  • Tremors, or the involuntary and rhythmic movements of the hands, arms, legs and jaw
  • Rigidity and stiffness
  • A stooped, flexed posture
  • Balance problems
  • Unsteady walking, or often feeling a foot catch on the ground during walking
  • Difficulty swallowing, often coughing after drinking a liquid
  • Lowered speaking volume (hypophonia)
  • Gradual loss of spontaneous movement, such as decreased facial expression

Since early signs of Parkinson’s occur gradually and subtly, they often go unnoticed by the person affected and/or are recognized more so by friends and family first. For example,

  • Lowered speaking volume (hypophonia)
    • Those with hypophonia may think their significant other is losing their hearing, when actually their lowered speaking volume makes it difficult for their partner to hear them.
  • Slowed movement (bradykinesia)
    • Those with bradykinesia often complain that their significant other walks too fast, when actually they are having difficulty keeping up.

Other symptoms may include depression and other emotional changes; urinary problems or constipation; and sleep disruptions.

Treatment

Although there is no cure for Parkinson’s disease, there is effective treatment for lessening the signs and symptoms. In addition to family and friends, a well-rounded healthcare team supports the best course for an optimal quality of life. An effective medical team may include medical doctors, physical therapists, speech therapists, occupational therapists, and psychologists.

How Physical Therapy Can Help

Physical therapy (PT) is an effective, evidence-based intervention to improve movement affected by Parkinson’s disease and slows disease progression.[2] Exercise and physical activity led by skilled physical therapists can be neuroprotective, meaning they protect brain and nerve function by maintaining its use a.k.a. “Use it or lose it!”. As physical therapists, we have helped many people with PD to balance better, walk more efficiently, have improved posture, and increase mobility. Neurologic physical therapists have the most experience in helping those with PD, specializing in addressing neurological disorders.

Physical therapy always starts with a thorough evaluation to assess an individual’s specific functional mobility, gait (walking), balance, strength, range of motion, posture, coordination, activity endurance, and/or fall risk. Then, a specific plan of care is developed to address the individual’s needs.

Physical therapy care plan can include:

  • Gait training
    • Teach better stepping balance and coordination for safer walking
    • Increase walking speed
    • Practice walking balance over different types of ground and environments
  • Balance training
    • Practice balance activities in standing, getting up, stepping over obstacles, etc.
  • Aerobic exercise
    • Safely building endurance with respect to cardiac function
  • Resistance training
    • Strengthening
  • Task-specific training
    • Skilled physical therapy to address patient’s goals: Turning around, getting up from chair, reaching for something overhead

Community exercise programs for Parkinson’s disease are also beneficial to improve function, quality of life, and depression.

Benefits of Physical Therapy

For impairments related to Parkinson’s Disease, research has shown physical therapy can:

  • Improve walking speed, capacity, and safety
  • Reduce motor decline
  • Improve balance
  • Improve function
  • Improve strength
  • Improve quality of life
  • Improve cognition and depression

Since physical therapists see their patients on a regular basis, we are usually one of the first to recognize response to activity and fluctuations in health, and then closely communicate with the patient’s doctor as part of a well-rounded healthcare team to support the patient’s optimal quality of life. 

If you are interested in pursuing physical therapy for your Parkinson’s Disease, ask for a referral from your neurologist or primary care physician, who may know of a local PT who is experienced in treating people with neurological disorders. Or, search for a neurological physical therapist in your area to best address your needs.

In Southern California, Complete Balance Solutions are physical therapy clinics part of the PRN family, who specialize in treating neurological disorders and balance issues. Reach out to us today!

https://www.completebalancesolutions.com/

Look out for another post from us, where one of my patients shares her story about how physical therapy helped with her Parkinson’s related impairments.

 

Complete Balance Solutions Seal Beach, CA: Pictured is an example of an obstacle course we set up based on our patient’s needs during physical therapy, to train their balance and dynamic walking skills for safer mobility in their home and community settings.

[1] https://www.nia.nih.gov/health/parkinsons-disease

[2] Osborne, Jacqueline, et al. "Physical Therapist Management of Parkinson Disease: A Clinical Practice Guideline From the American Physical Therapy Association." Oxford University Press (2021).

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