Exercises and Rehabilitation program for Parkinson's disease

Parkinson's disease is a neurological progressive disorder of the brain where there is degenerative changes in the basal ganglia and substantia Nigra which causes to decrease in dopamine levels. Dopamine helps in sending signals to the brain.

Normally in the starting stage of the disease the patient can find himself in slowing movements ( Bradykinesia) and hand gripping difficulties and some other 
SIGNS AND SYMPTOMS like 
Urine incontinence
Freezing movements
Balance problems
Tremors
Drooling of saliva
Difficulty in swallowing
Poor muscle strength
Gait disorder 

Stiffness in the joints 

Rigidity

Flexed posture

Reduced arm Swing 

Dementia ( forgetting names of people close to them)

Decrease interest in activities and trouble making choices.

Depression

Laryngeal disfunction

Autonomic dysfunction

Kyphosis leads to cardiopulmonary impairment.

Decrease sense of smell

Sleep problems 

Difficulty in making facial expressions

Fatigue

Anxiety 

Causes of Parkinson's disease has been linked to the

 

> Use of pesticides, herbicides and proximity to industrial plants.

> Oxidation and generation of free radicals causing damage to the thalamic nuclei.

> Genes, the risk of Parkinson's disease in siblings increased if one member of the family has the disorder.

Treatment

Neuro physician will assess and plan the treatment according to the symptoms. Only symptomatic treatment is there to control the symptoms.
Tablets to increase dopamine levels in the brain
Rehabilitation team is needed for Parkinson's patients

Physiotherapist:
Will take proper assessment and plan the treatment program accordingly to maintain and improve levels of function and independence which will help to improve a person's quality of life.

1. Strengthening exercises improve physical parameters such as balance, gait, and physical performance.
2. Balance  training exercises
3. Gait training :

 Visual cueing - a focus point to step over and initiate gait, strips of tape on the floor to initiate walking through areas that cause slowing or freezing.

Auditory cueing - counting numbers 1, 2,3 to initiate walking, stepping to the beat of a specific music at a specified cadence to continue rhythm of walk.

Attention - Thinking about taking a big step, making a wider arc turn. This is applicable in case of correcting a bad habit such as walking with stiff hip or hip hiking.

Proprioceptive cueing- rocking from side to side ready to initiate a step, taking one step backwards as a cue ready to then walk forwards.

4. Coordination Exercises

5. Cardio respiratory muscle training

6.Resistance exercises include: cycle ergometer, weight machines, therapeutic putty, elastic and weight cuffs

7. Executing a dual task: talking while walking is often difficult in patients with Parkinson's. Training with motor cognitive dual task training improves dual task ability and might improve gait, balance and cognition.

8. Music based movement therapy improve motor function, balance, walking velocity, freezing of gait. 

9.Aerobic exercises should be initiated early in the disease process. It helps to slow the decline in physical condition.

10. Community based exercises: Improve cognition and mental health 

Occupational therapist:
1. For toilet training and for swallowing problem.
2. For dressing and eating food

Speech therapist:
For speech and swallowing problems

Orthotist
For external devices

 Parkinson's cannot yet be cured, treatment can improve symptoms but the quality of life is often poor.