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Parkinson's disease

Parkinson's Disease (PD) is a progressive neurological disorder which causes problems with movement. A loss of a particular chemical in the brain leads to a disruption in the normal processes that control movement of the body. This includes walking, talking and writing.

Physiotherapists are qualified to assess and treat the symptoms of Parkinson's Disease whether newly diagnosed or in the later stages of the disease. Specialist neurological physiotherapists use a combination of skills to educate about the disease to encourage self-management and to promote and maintain independence.


What is PD?



Parkinson's Disease is a progressive neurological condition which affects an individual's ability to move easily and at a normal speed. The disease was identified by Dr James Parkinson in 1817.

It is estimated that PD affects one individual in every 500 and men are statistically more likely to develop PD than women. The risk of developing it rises with age with the majority of those diagnosed being over the age of 50 although it can occur at any age.

PD affects each person differently and can be very unpredictable with people experiencing both good days and bad.

The disease itself is not fatal but it does become worse over time. The timescale for the disease differs for each individual but it can take over 20 years for symptoms of PD to progress meaning that management of the disease throughout these years is very important to maintain function and independence.

Early symptoms of PD are subtle and they usually begin on one side of the body and progress to involve the whole body over time.





Treatment for Parkinsons disease from one of our specialist neurological physiotherapists.Above: Treatment for Parkinsons disease from one of our specialist neurological physiotherapists.



Signs and symptoms of PD



The 3 main symptoms of PD are:

Tremor

A PD tremor often begins in times of stress and characteristically involves a 'pill-rolling' tremor involving the thumb and forefinger. Tremor may also begin in the foot or jaw, during sleep or after movement.

Rigidity

This is a resistance to movement where the muscles are constantly under a state of tension leading to feelings of stiffness and weakness. Your rigidity may be described as 'cogwheel' which refers to the jerky feeling of your muscles when your body is moved by someone else.

Bradykinesia

This is the slowing down of movement in general. You may notice that initiating a movement becomes less automatic and activities may take you longer than normal.

Alongside the physical symptoms you may also experience fatigue, depression and irritability and difficulty sleeping.


What causes PD?



The cause of Parkinson''s disease is, as yet, unknown. There are research projects being carried out around the world with the sole intention of pinpointing the causes of PD but, while there is progress being made, we do not yet know the definite cause.

Existing research suggests that there is a reduction of cells in the area of the brain responsible for controlling voluntary movement of the body. The section of the brain responsible for this is the substantia nigra which is found within the basal ganglia of the brain. The substantia nigra usually produces a chemical named dopamine which helps to transmit signals from the brain to the body. In PD, the cells within the substantia nigra die meaning that the levels of dopamine drop so movement within the body cannot be controlled properly.

It is known that the symptoms of PD only begin to show when approximately 70% of the dopamine producing cells in the brain have died. The symptoms then increase as more of these cells die over time.

Research is focussed on finding out what triggers the progressive death of these brain cells. At the moment it is believed that a combination of genes and environmental factors hold the key.





Our physiotherapist facilitating a few simple stretching exercise to help a patient with Parkinsons disease.Above: Our physiotherapist facilitating a few simple stretching exercise to help a patient with Parkinsons disease.



How is PD diagnosed?



Parkinson's Disease currently has no definitive test which means that diagnosis is made by a specialist after evaluating your symptoms and history.

A doctor will go through your medical history with you and assess you clinically looking for symptoms and tell-tale signs of PD. These include tremor, bradykinesia, rigidity, difficulty with your handwriting and a reduction in facial expressions.

If it is suspected that you have PD, the doctor may give you medication used to help treat the disease in order to see whether it reduces your symptoms. PD can then be diagnosed if the medication works.


What problems caused by PD can physiotherapy help with?



There are many problems physiotherapy can improve for people with PD. Whilst it is not possible to cure PD, physiotherapy plays a key part in treating the symptoms of the disease by helping you to maintain your function and independence for as long as possible.

Our specialist neurological physiotherapists have a special interest in disorders of the nervous system such as PD. They play an important role in managing the effects of your symptoms from diagnosis through to the later stages of the disease.

Some of the symptoms physiotherapy can help you with are:
  • Reduced muscle strength
  • Muscle spasm
  • Poor posture
  • Reduced balance
  • Falls
  • Difficulty walking
  • Difficulty initiating movement
  • Pain



Our physiotherapist helping to decrease any stiffness through gentle upper limb movement.Above: Our physiotherapist helping to decrease any stiffness through gentle upper limb movement.



PD affects each individual in different ways and the symptoms may progress a lot faster in some people than others. Our physiotherapists are able to teach you about managing your own symptoms and enable you to minimise the physical impact of the disease as much as possible.


How does physiotherapy help PD?



Physiotherapy helps PD in a number of different ways. Our physiotherapists are trained specifically to assess and treat PD at any stage of the disease whether recently diagnosed or towards the later stages of life.

Physiotherapy will help to educate you about your condition and manage your symptoms as they progress throughout the course of your life.

In general, physiotherapy helps to:
  • Educate you and your family about PD
  • Educate you around managing your symptoms
  • Achieve functional goals
  • Increase self confidence
  • Increase quality of life
  • Maintain or improve your mobility
  • Increase or maintain your quality of life
Our physiotherapists are able to help you with these aspects of your life through using a combination of therapies, education and home exercise programmes tailored to suit your needs whatever your current symptoms.


What would physiotherapy treatment for PD involve?



The treatments available for Parkinson's Disease vary depending upon the stage of your disease and your current levels of activity.

Most treatments for PD would involve the following:
  • Full neurological assessment
  • Strategies to improve movement patterns
  • Manual therapy
  • Exercise programmes
  • Gait assessment and education
  • Medical Reports
Following a full assessment with one of our physiotherapists a treatment plan would be created taking into account your own requirements and personal goals.


How do I arrange a physiotherapy appointment for PD?



Physiotherapy can be of benefit at any stage of Parkinson's Disease so whether you've been diagnosed recently or have been living with PD for a number of years please do contact one of our specialist physiotherapists at office@liverpoolphysio.co.uk or on 0151 558 0077.'


Summary



Parkinson's Disease is an advancing neurological condition which cannot be cured. Loss of dopamine in the brain can lead to any or all of the three main symptoms: tremor, rigid muscles and the slowing down of voluntary movement. Maintenance of a good quality of life can be sustained for as long as possible through a combination of drug management and physiotherapy in order to reduce the impact of your symptoms.

To book an appointment for yourself, a friend or relative e-mail office@liverpoolphysio.co.uk or call 0151 558 0077.

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