Occupational Therapy Benefits On Patient With Parkinsons Disease
This article was reviewed by Lindsey A, DPT.
What is Parkinsons Disease?
It is a chronic progressive neurological disease that is linked to decreased dopamine production in the substantia nigra and presents typically with symptoms of tremor of resting muscles, rigidity, slowness of movement, impaired balance, and a shuffling gait.
What are the Characteristics of Parkinsons Disease?
Movement related symptoms include flexed forward posture, shuffling steps, reduced arm swing while walking, impaired balance, tremor, and bradykinesia . In addition, Parkinsons disease can present with non-motor symptoms including apathy, depression, constipation, sleep behavior disorders, loss of sense of smell and cognitive impairment. All these symptoms can cause difficulty with ADLs i.e bathing, toileting, dressing, grooming, and eating in addition to other functional tasks. This decreased ability to participate in daily life tasks is therefore the reason for an OT referral.
How can Occupational Therapy help?
In addition to physical exercises that increase flexibility, motor coordination, and strength, occupational therapists often recommend interventions or modifications that can enable individuals to perform ADLs with increased independence and confidence .
OT Modifications/Interventions:
Adaptive Equipment Recommendations:
Suggest dressing aides including sock aides, reachers, and button aides:
How Aquatic Therapy Helps Manage Parkinsons Symptoms
Hydrotherapy treats a wide range of illnesses and orthopedic or chronic disorders. Among them are many conditions related to strength and balance. While aquatic exercise for Parkinsons disease does not reduce all risks of falls which is a key concern among many Parkinsons patients it can be beneficial by strengthening the core and improving muscle memory.
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Using An Adaptive Keyboard
There are adaptive keyboards and specific software programs that can help to decrease typing mistakes and make the process of typing on a computer easier. There are also speech-to-text options which allow you to dictate what you want to write and eliminate the need for typing altogether. An OT consultation can help set you up with these options.
One trick that I recommend frequently which helps people use their computer is changing the cursor setting so that it tracks more slowly across the screen when you use your mouse. Slowing down the cursor can help make it easier to see and control. In addition, you can change the sensitivity of your mouse to make it easier to control.
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How Do I Find An Occupational Therapist
Referral procedures depend on where you live and treatment may or may not be accessible through your countrys national health system.
In some countries occupational therapy is prescribed by medical doctors but in others people with Parkinsons can contact an occupational therapist direct without going through their doctor.
Training and accreditation varies throughout Europe so it is best to check the experience of anyone you consult. It is helpful to be seen by someone who has experience of Parkinsons, and always ask for references and the likely costs before treatment commences.
Best Practice Guidelines are available online for occupational therapists working with people who have Parkinsons. ParkinsonNet also provides evidence based guidelines in English.
Your national Parkinsons organisation may be able to provide information based on members experiences. See also, Other Parkinsons organisations.
Tell Us About Your Fathers Parkinsons
Let me first say that my parents are my heroes, and my 88-year-old father has always been bigger than life! Since my dads Parkinson’s diagnosis four years ago, I have had an insiders view of his daily life and struggles with Parkinsons. He was a very strong man but developed severe back problems and the back pain became debilitating as he aged.
Unfortunately, Dad experienced complications after surgery that confined him to a wheelchair. Many hours of therapy and exercise enabled him to walk short distances, care for his own basic needs, and return home. As an occupational therapist, I recognize that each person responds differently to obstacles and therapy. As a daughter, I am just so proud of his hard work and determination.
His Parkinsons, particularly tremors, has slowed his progress but medications are helpful. We remain flexible because what works for Dad today might need to be changed next month. I have been known to hear of a new product at a conference, find it online, and get it shipped to Dad before I leave the meeting. He is a good sport and will try each new item and give his review.
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To Learn Techniques For Improving Sleep
The American Sleep Association reports 50-70 million people in the U.S. report sleep difficulty. People with Parkinsons are no exception and may experience sleep difficulty in greater numbers that those without Parkinsons. Sleep related issues are reported in 75% of people with Parkinsons. When we dont sleep well, we dont function well. Parkinsons symptoms are worsened by emotional and physical stressors. Fatigue is a physical stressor that can cause difficulty with movement and cognition. Balance, tremor, and thinking difficulties are likely to be exacerbated from poor sleep. Poor sleep causes daytime fatigue. Occupational therapists use a non-medication approach to improve sleep for people with Parkinsons. Your therapists will analyze your day and night time habits and make recommendations to improve your ability to get restorative sleep at night. Your therapist will also make recommendations for daytime rest, when needed. When you rest, how you rest and how long you rest will be a part of your treatment plan.
Some of the recommendations made by your Parkinsons OT , to improve your sleep, may include:
Avoid caffeine late in the day
Maintaining a consistent bedtime routine
Stop using electronic devices, phones, tablets, computers or tvs, 30-60 minutes prior to bedtime
Do not watch tv in bed.
Sleep in a cool dark room
Utilize the bed for sleep and sexual activity only
Exercise early in the day
A healthy balance of exercise, activity and sleep
To Learn Strategies That Combine Activities And Parkinsons Medication Timing For Success
Establishing a routine that aligns your Parkinsons medication timing with activities can significantly improve your success with the things you do daily. The medication prescribed for your Parkinsons symptoms can improve your ability to move and function. These medications can reduce muscle stiffness, decrease muscle cramping, decrease tremor and improve overall ease of movement. Taking your medication before certain tasks like exercising, bathing, dressing, etc may help you complete these with less effort. However, if you are getting too much movement after taking your Parkinsons medication then certain tasks that require refined movement, like shaving, may be better performed before the medication is fully on. Your occupational therapist will help you establish a routine of daily activities that works in conjunction with your Parkinsons medication schedule that was prescribed by your neurologist.
Key points:
Take your medication on time. Make every effort possible to take your Parkinsons medication on the schedule your neurologist prescribed. This is how the medication works best to help you function at your best. Phone alarms can be helpful in reminding us when it is medication time.
Your Parkinsons trained OT will help you lay out a daily plan connecting your medication regime with your activity and exercise routine.
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Help With Funding For Adaptations
Occupational therapists can advise and help arrange funding for minor home adaptations if you need them, such as fitting grab rails or hand rails by steps and stairs.
If you need advice about more expensive home adaptations, such as stairlifts, or accessible bathing facilities, you should speak to an occupational therapist based in a social services department, or the health and social care services of a local authority. They may advise you on any funding available. However, major home adaptations, such as installing a level-floor shower are often subject to means testing.
Who Is Lisa Warren
Lisa Warren graduated from the University of Texas Medical Branch with a B.S. in occupational therapy. She received a Masters of Health Science from the University of Florida. She has more than 30 years of experience as an occupational therapist. Lisa is the rehabilitation site manager for the UF Health Norman Fixel Institute for Neurological Diseases. She has been a member of this team since 2010. This rehab clinic provides occupational therapy, physical therapy and speech therapy evaluations and treatment for persons with neurological disorders. Lisa has lectured healthcare providers locally, nationally and internationally on therapy for Parkinsons Disease, Huntingtons Disease, dystonia, essential tremor and other neurological disorders. She frequently speaks to support groups, teaches therapy students and provides community workshops.
Lisa has lectured locally and nationally on therapy for Parkinsons Disease, Huntingtons Disease, dystonia, essential tremor and other neurological disorders. She frequently speaks to support groups and at community workshops. She has established a quarterly meeting of therapists across the US and Canada for information sharing on the treatment of patients with neurological disorders. She is considered a world expert on OT for Parkinsons disease.
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Parkinsons Disease Treatments Covered
Parkinsons disease can come with a wide range of motor and nonmotor symptoms. The symptoms of this condition can be different for different people.
Since it is a progressive disease, symptoms can change over time. Medicare covers a range of different treatments, medications, and services that you may need to manage Parkinsons disease throughout your life.
How An Occupational Therapist Helps Seniors With Parkinson’s
Parkinsons disease is a disorder that damages the nervous system and affects movement. Its a progressive disease that affects a persons ability to carry out ADLs and IADLs in a normal fashion.
- ADLs: Activities of daily living, such as getting out of bed, taking a shower, dressing and eating
- IADLs: Instrumental activities of daily living, such as caring for a pet, cooking, driving
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Systematic Review Of The Effectiveness Of Occupational Therapyrelated Interventions For People With Parkinsons Disease
Erin R. Foster, OTD, MSCI, OTR/L,Mayuri Bedekar, MS, OTR/L,Linda Tickle-Degnen, PhD, OTR/L, FAOTA,
Erin R. Foster, Mayuri Bedekar, Linda Tickle-Degnen Systematic Review of the Effectiveness of Occupational TherapyRelated Interventions for People With Parkinsons Disease. Am J Occup Ther January/February 2014, Vol. 68, 3949. doi:
What Is Parkinson’s Disease
Parkinson’s Disease is a progressive, neurological condition where nerve cells in the brain stop working over time, and therefore cannot produce the chemical dopamine. Dopamine sends signals to the brain triggering it to produce smooth, fluid and controlled movement. Without dopamine, movement can become slower and more difficult.
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Add Aqua Therapy To Your Parkinsons Patients Treatment
HydroWorx offers a variety of products specifically designed to help facilities, just like yours, bring the benefits of aqua therapy to Parkinsons patients and many others. We can work with you to identify your patients needs to determine the ideal hydrotherapy solution from our versatile family of products.
Not only can we help you identify the best possible equipment for your facility needs, but also unique and creative ways to integrate aquatics into your Parkinsons patients current treatment routines. When you have the equipment onsite, it becomes simpler to make adjustments, especially when you take advantage of features enhancing the experience like adjustable-floor therapy pools and variable-speed underwater treadmills.
The use of aquatic therapy, underwater treadmills and resistance jet technology for Parkinsons patients can do the following and more:
- Help regain trunk balance
- Improve ambulation
- Encourage confidence
All of the above are critical when encouraging Parkinsons patients to exercise for their health and to reduce the severity of their symptoms.
Aquatics offers a full range of exercises patients can do without a fear of falling to hold them back. Whether youre working with Parkinsons patients, Alzheimers patients or patients with a host of other physical and neurological conditions, hydrotherapy can be an effective tool for promoting overall physical fitness and good health.
How Can Occupational Therapy Help
OT intervention can assist the individual to function optimally in their activities of daily living and facilitate their engagement in occupations most meaningful to them. Four main areas targeted by OT intervention are:
- Activities of daily living: teaching the use of adaptive techniques and tools to reduce the impact of tremors, and provide strategies to assist with managing medication routines. This may also include gait and balance-based activities
- Sensorimotor: facilitating joint movement, maintaining range of motion and preventing contractures through impacted joints, and improving motor planning and task execution
- Psychosocial: providing group-based interventions to enhance overall functioning and social participation in a supportive environment, providing education in self-management skills , promoting engagement in productive activities and leisure, exploring and discussing roles within the family and home unit, and providing education to individuals, families, and carers
- Environment: assessing for and implementing appropriate assistive technologies and home modifications to enhance safety and accessibility within the home and community, assisting clients, families and caregivers to explore the community for support groups and resources
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Physical Therapy For Parkinsons Disease
Its well-known that exercise of all kinds is beneficial for patients with Parkinsons disease. But physical therapy, in particular, is key. Why? A professional can guide you through the right moves to increase mobility, strength and balance, and help you remain independent, says Denise Padilla-Davidson, a Johns Hopkins physical therapist who works with patients who have Parkinsons. Here are things a therapist may work on:
Note: Please discuss any exercise program with your physician/neurologist and get a referral to a physical therapist or trainer with expertise in Parkinsons disease before starting any specific program.
What Should I Expect At An Appointment
You may meet your occupational therapist in a variety of places, including in your own home, a hospital, a Parkinson’s clinic, a rehabilitation unit, an outpatient clinic, or in a residential or nursing home. In some countries it is possible to meet an occupational therapist at a Parkinson’s support association office.
Appointments usually last between 30 and 60 minutes, and therapists may recommend a short course of occupational therapy usually once a week, for a month or two.
At the first appointment, an occupational therapist will ask about your daily activities, in particular how you look after yourself, your work and your leisure interests. For example, you may have problems preparing meals, dressing, shopping, walking in crowded places, doing a leisure activity, using a computer, or reading.
Collaboration is essential to successful treatment. Therefore, you need to tell your occupational therapist about your situation, how you cope on a daily basis and problems you experience. Then together you will be able to discuss goals for both you and your family and how you achieve them.
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How Occupational Therapy Helps Parkinsons
Parkinsons disease is a degenerative disorder of the brain that impairs nerve cells that control movement. This leads to symptoms like shaking, stiffness and difficulty with walking and talking, that gradually worsen over time. Approximately 60,000 Americans are diagnosed with Parkinsons each year, with men being 1.5 times more likely to have the disease than women.
Healthy Outlook spoke with occupational therapist Lorinda Hagstrom from Overlakes Outpatient Rehabilitation Services to learn more about this treatment.
Occupational Therapy Modifications For People With Parkinsons
Along with physical exercises, occupational therapists often recommend modifications to help people living with PD maintain function and continue participating in daily activities. Modifications may include:1
- Changing the nature, time, and duration of an activity
- Simplifying activities by breaking complex actions into simple tasks
- Arranging items to reduce situations that involve time pressure, like moving the telephone to an accessible location
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Occupational Therapy And Carers
Occupational therapists can advise your carer and family how to support you in staying independent. They can also advise on ways to look after their own health.
It is important that your family and carers are also involved in, and understand, any changes the occupational therapist recommends to your usual routines. Getting help and advice from an experienced therapist can reduce the amount of help you need from your family or carer and so alleviate any pressure they may feel.
What Other Services Does Physical Therapy Provide
Recommendations. A physical therapist can make recommendations for physical therapy at home, at an outpatient facility, or at a nursing or rehabilitation facility.
Work capacity evaluations. Many physical therapists can perform functional capacity evaluations to provide more information for disability claims based on physical performance. This functional capacity evaluation can be useful when the Social Security office denies disability to a person who is unable to work for an eight-hour day.
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How Many Physical Therapy Visits Will I Need
Treatments in physical therapy often can be completed in one to three office visits. The first appointment includes an evaluation and recommendations for exercises. The following appointments check your progress and review and expand your home program. Most hospitals can provide additional sessions of outpatient therapy if needed.
Treating Parkinsons Disease With Aquatic Therapy
Physical therapy and exercise regimens, like hydrotherapy, are quickly becoming prominent methods for treating a variety of illnesses, including neurodegenerative disorders like Parkinsons. Hydrotherapy adds specific advantages for many Parkinsons patients. As someone who owns or manages a physical therapy clinic, you can introduce aquatics for your existing Parkinsons patients. It may even help you attract new Parkinsons patients to your facility.
After Alzheimers disease, Parkinsons disease is the second most common neurological condition American adults face. Physicians often treat the disorder with heavy medications, which potentially yield unintended or unwanted side effects.
You may be wondering, Is aquatic therapy effective for Parkinsons? Hydrotherapy offers an alternative form of treatment which can be used in combination with drug therapies to produce improved results.
Aquatic therapy has been used to help people like Virginia Bishop, who suffered from Parkinsons disease as well as multiple sclerosis. She used aquatic sessions to increase her activity levels, improve core strength and build stamina. Her results included regaining the ability to tend to daily tasks, as well as play the piano.
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