Primarily, most cases of PD will be managed by the administration of drugs designed to increase the levels of dopamine in the brain (such as Levodopa), drugs to increase the production of dopamine supplements in the brain (dopamine agonists) and drugs to reduce the breakdown of dopamine in the brain (e.g. MAO-B / COMT inhibitors).
In more extreme interventions, when dopamine supplementation no longer help, people with PD also have the option of undergoing deep brain stimulation surgery (an implant which increased under active parts of the brain influencing PD symptoms) or lesional surgery (to remove / cut overactive parts of the brain influencing PD symptoms) (NCGC, 2006).
Although PD itself is progressive, loss of function is only associated with PD in the early stages. This means that loss of function is not necessarily progressive too. With ongoing management, interventions such as physiotherapy can help.
Physiotherapy for parkinson’s can help in many ways. Manual therapy and exercise prescription (including treadmill training (Yun-Hee, 2015)) can help to reduce symptoms and maintain function, as well as preventing onset (Ahlskog, 2011). At Physioimpulse in Bath we provide you with bespoke exercise guidance to ensure your self-management is appropriate for your symptomatic level.
The following video helps to explain why exercise is important in PD management:
NICE guidelines (2006) for PD highlights the ways in which physiotherapy can help people with PD, at any stage of progression:
At Physioimpulse we focus on the following outcomes for people with Parkinson’s, with particular focus on balance attention and cueing strategies and continual diagnosis to ensure any co-morbidities are highlighted and managed effectively with continual support and encouragement (O’Brien’s et al., 2016; Wong-Yu & Mak, 2015) :
Physiotherapy and exercise alone are by no means the ultimate solution to managing PD. Low outcome expectation from exercise, lack of time to exercise, and fear of falling are often concerns with PD and so careful approaches are needed to manage PD successfully (Ellis et. al, 2013). This is unsurprising given the longevity of rehab in PD with outcome effects taking up to 4-16 months to show major results in late stage PD with ongoing exercise management (Schenkman et al., 2012). Patience can be one of the most important factors of managing PD symptoms at times.
At Physioimpulse we take the time and care to ensure that you are managed effectively and with compassion. Move4parkinsons (2016) highlight how no one intervention alone is suggested for the complete management for PD, but instead all elements of emotional and physical wellbeing:
For further information and support, please see the following websites:
To book an appointment or speak to our physio team about Parkinson's management please contact us:
What is Parkinson’s Disease (PD)?
Parkinson’s disease (PD) (or idiopathic / primary parkinsonism) is a progressive disease of the nervous system marked by tremor, muscular rigidity, and slow, imprecise movement, chiefly affecting middle-aged and elderly people. It is associated with degeneration of the basal ganglia of the brain and a deficiency of the neurotransmitter dopamine (Oxford University Press, 2016). Dopamine is one of the neurotransmitter in the brain used to send signals from one cell to another; without it, reactions are significantly slowed.
Idiopathic, or primary, PD is both spontaneous and of an unknown cause and accounts for over 70% of all Parkinsonism (Macphee, 2001). Parkinsonism can also arise in the form of Secondary Parkinsonism, which can be caused by a variety of influences which affect the body at a pathological level. These can include: infection, drugs, toxins, trauma and vascular disease (Jones and Playfer, 2004).
One person in every 500 has PD. That's about 127,000 people in the UK and sadly there is currently no cure. (Parkinson’s UK, 2016). There are, however many ways available to manage the symptoms of PD. (Physio-pedia, 2016a)
People with PD are known to be limited by the following symptoms:
-Tremor of the hands, arms, legs, jaw and face
-Bradykinesia or slowness of movement
-Rigidity or stiffness of the limbs and trunk
-Postural instability or impaired balance and coordination
(Parkinson's Disease Foundation, 2016)
However, PD can also influence other problems, particularly concerning mobility and balance as the majority of people with PD are of an advance age (Aragon et al., 2007).
The most common additional disorders associated with PD are those that affect the cardiorespiratory system, the neuropsychiatric problems, infections, and metabolic and musculoskeletal processes, but it has also been known to affect sleep and bladder/bowel function (Hierrezuelo Cortina n.d; Rodríguez Díaz, 2009).
If left untreated, PD can halt your walking within 8 years and leave you bedridden by 10 years (Poewe, 2006). Luckily, not many people with PD are left untreated and there are many management options available.
(Greenline senior care, 2016)
Physioimpulse Chartered Physiotherapists