Physical Therapy helps People with Parkinson’s Disease

Physical therapy helps people with Parkinson’s disease over the short term, researchers from the University of Birmingham, UK, reported in the BMJ (British Medical Journal).

In the USA, the term is Physical Therapy. In the United Kingdom, Ireland, and Australasia people say Physiotherapy.

Parkinson’s disease management has traditionally been centered on drug therapy. Recently, however, doctors have been progressively embracing rehabilitation therapies, including physical therapy as a supplement to medications and neurosurgical treatment.

Dr Claire Tomlinson and team set out to determine what effect rehabilitation therapies might have on patients with Parkinson’s disease. They gathered data from 39 randomized trials involving 1,827 people. Within those studies they assessed a wide range of physical therapy methods that were used to treat patients, including dance, treadmill training, exercises and physical therapy.

The researchers assessed 18 physical therapy outcomes, which showed clear improvements in nine areas.

They detected three especially positive outcomes from physical therapy treatment in the following areas:

  • Gait speed
  • The Berg balance scale – this test was developed to measure balance among elderly people with balance function impairment by assessing the performance of functional tasks
  • A clinician-rated disability scale

The authors found evidence that the improvements in these areas are “meaningful” for Parkinson’s disease patients.

Parkinson’s patients demonstrated that they were able to walk faster or maintain their balance more effectively, and without intervention, after undergoing physical therapy sessions.

Dr Tomlinson, said:

“This study indicates that physiotherapy could provide clinically meaningful benefits in the short term for people with Parkinson’s disease. Further improved studies are needed; these will shed more light on how beneficial physiotherapy can be for patients in the longer term. Once a larger and better quality of evidence is achieved, there might be scope for a recommendation for change in practice to be made.”

What are the signs and symptoms of Parkinson’s disease?

Parkinson’s disease causes several problems; physical therapy may be able to help with a few of them. A person with Parkinson’s will experience problems with movement, cognition, neurobehavior, as well has having sleep and sensory difficulties. The symptoms usually start subtly and develop gradually, and sometimes randomly (in no set order).

Each patient suffers in a different way and has a unique set of symptoms. Severity of symptoms varies enormously from person-to-person. Some may experience tremor as their primary symptom, while for others it may be balance. The disease may develop slowly for some, and rapidly for others.

Below are the four main signs and symptoms, known medically as the primary motor symptoms:

  • Bradykinesia– refers to slowed motion, slowness of movement. The patient finds it harder to begin getting up from a chair, everyday tasks become harder to do. There may also be a lack of coordination. The problem is not only with doing the movement, but also initiating or planning it.Frequently, elderly patients accept bradykinesia as a normal milestone of aging. Many of them are eventually diagnosed with Parkinson’s disease as the symptoms get worse.
  • Resting tremor – shaking, one of the hallmark signs of Parkinson’s, often starts in one hand. Tremor may begin on one side of the body or a foot. Less commonly, the jaw or face may be affected. Tremor is more noticeable and is more likely to occur when that part of the body is resting. Anxiety or stress may make the tremor worse.
  • Rigidity – refers to muscle stiffness. The patient may find it difficult to do everyday tasks, such as rolling over in the bed, using body language effectively, getting out of a chair, or making fine finger movements. The limbs and the neck are most commonly affected. In some cases there is pain.
  • Posture and balance – when standing the patient may experience instability. Balance and coordination are commonly impaired. Problems with posture, balance, plus bradykinesia make the sufferer much more prone to falls.

 

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