Parkinsons is a progressive, neurodegenrative disorder. People with Parkinson’s don’t have enough dopamine in their body, as some of their nerve cells have died. Dopamine is a neurotransmitter, it helps transfer signals between nerve cells (neurons). It’s more common in people over the age of 50 but younger people can get it. Ageing is not a cause of parkinsons. Although generally the number of dopamine producing cells decreases with age, it’s estimated that one would need to live until 400 years old before developing Parkinsonism symptoms (Jones and Playfer, 2004).
What makes a diagnosis of Parkinsons Disease?
At least two of these have to be present to make a diagnosis :
- Bradykinesia : slowness of initiation and general movement itself. For example repetitive opposition touching the thumb and each finger in turn. This is something that will tend to improve with treatment.
- Rigidity : is a stiffness experienced by individuals with Parkinson’s. They may also experience pain with this. Upon assessment there would be resistance to passive movement, for example we would try to bend their knee with them relaxed and it would be met with resistance. This can vary from each patient.
- Tremor at rest : present in 70% of patients with Parkinson’s. Generally presents in one side of the body and can spread to the other side as the disease progresses.
- Postural instability : this develops later on the disease and the patient may be likely to fall forwards or backwards. The patients posture becomes stooped and the flexors muscle at the front become overactive.
How can Physiotherapy help Parkinsons Disease?
- Gait : reeducation on walking correctly, to help speed up movement and make it safe.
- Balance : working on various exercises to help improve balance
- Transfers : demonstrating and practising transfers to make life easier
- Posture : posture reeducation, release and various exercises to help posture
- Strengthening : Tailor made strengthening programs
- Flexibility : stretching is very important is keeping muscles as flexible and supple as possible
Exercise programs need to be tailored to suit your ability. We have neurological physiotherapists on our team that can assess you at home and then develop an exercise programme specifically to address your needs.
Written by Emma McCabe
Head of Orthopaedics