Wednesday, February 28, 2024

Ot Interventions For Parkinson’s Disease

How Do I Find An Occupational Therapist

Occupational Therapy & Parkinsons Disease

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.

Occupational Therapy For Parkinsonian Patients: A Retrospective Study

Giuseppe Frazzitta

1Department of Parkinsons Disease, Movement Disorders and Brain Injury Rehabilitation, Moriggia Pelascini Hospital, Gravedona ed Uniti, Italy

2Istituti Clinici Scientifici Maugeri IRCCS, Department of Biomedical Engineering of the Montescano Institute, Italy

3MIRT ParkProject, Livorno, Italy


1. Introduction

Hand dysfunction is a common symptom in Parkinsons disease and is characterized by poor manual dexterity, deficits in fine motor movements, inability to control grip force output, and difficulty in performing movements with normal amplitude, speed, and coordination .

Hand dysfunction leads to difficulties in activities of daily living , such as eating, dressing, washing, and writing , with loss of independency and poor quality of life .

These abilities are acquired through motor learning processes that are related to executive functions .

Despite the presence of deficits in hands functionality and the reduced autonomy in ADL , these disturbances are often ignored because the majority of rehabilitation programs are focused on gait and balance problems . Therefore, patients are usually referred to an occupational therapist in the later disease stages, when they are experiencing a significant level of disability .

OT aims at treating hand impairment to reduce dependency or recover the patients autonomy in ADL , and it should be considered as an important aspect of a multidisciplinary approach.

2. Materials and Methods

2.2. Outcome Measures

What Are The Common Difficulties Associated With Parkinson’s Disease

The symptoms of Parkinson’s can be categorised under three main headings and below are some of the functional difficulties they may cause.

  • Tremors – such as a trembling or shaking in the hands. This can affect the ability to write, eat, drink, prepare meals or use door keys
  • Slow movement due to muscle stiffness – this can mean that carrying out daily tasks such as getting out of bed, on and off the toilet, washing, dressing or using the stairs all become challenging
  • Difficulty walking this can mean an increased risk of falling and a decreased ability to carry out daily activities

If you would like to learn more about how we as occupational therapists can help people overcome common difficulties associated with Parkinsons Disease, you will find some useful links at the bottom of this page.

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Study Design And Participants

We retrospectively identified PD patients, hospitalized at the Department of Parkinsons disease and Movement Disorder Rehabilitation of Moriggia-Pelascini Hospital in Gravedona ed Uniti , from January 2015 to June 2018, to undergo a 4-week Multidisciplinary Intensive Rehabilitation Treatment .

  • Eligibility criteria were as follows: diagnosis of idiopathic PD according to the UK Brain Bank criteria Hoehn and Yahr stage 2 to 4 ability to perform both the OConnor finger dexterity test and the Minnesota manual dexterity test .

  • Exclusion criteria were as follows: diagnosis of atypical parkinsonisms, psychosis, auditory and visual dysfunctions, and comorbidities impairing autonomy in ADL.

The study design and protocol were approved by the local Ethics Committee and were in accordance with the code of Ethics of the World Medical Association . All patients signed an informed written consent form for the use of their clinical data for scientific purposes. This trial was registered on website }NCT03763955.

Add Aqua Therapy To Your Parkinsons Patients Treatment

Occupational Therapy And Parkinson

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.

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How Can Occupational Therapy Help People With Parkinson’s Disease

Occupational therapists can work with people with Parkinson’s Disease and their families to provide advice, support and guidance during their journey. For some they may require advice on a specific item of equipment whilst for other clients we are involved in more substantial home modifications and support as their needs change with the progressing condition. Below are some ways that an occupational therapist can help:

How we can help

We aim to solve the difficulties associated with Parkinsons Disease. Some of the common ones we treat are listed below.

Health Economic Evidence Statements

The found no significant difference in mean increase in annual costs between groups from the year before the study to the second year of the study. This mean annual cost estimated the provision of nurse care to cost £200 per person per year and excluded the cost of apomorphine. The mean annual cost in the specialist nurse group increased from £4,050 to £5,860 and from £3,480 to £5,630 in the group based on 1,859 people from 438 general practices in nine randomly selected health authority areas of England.

It is not always clear whether care is substituting some or all of the consultant care or is serving as additional care. By varying the cost-savings of other health professional costs by PDNS care, costs for 1 year of PDNS care range from an additional cost of £3,289 to cost-savings of £4,564. Full details of these analyses are shown in .

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How Does Physical Therapy Help Parkinson’s Disease

Physical therapy cannot cure Parkinson’s disease, because at this time, neurological damage cannot be reversed. But therapy can help you compensate for the changes brought about by the condition. These “compensatory treatments,” as they’re called, include learning about new movement techniques, strategies, and equipment. A physical therapist can teach you exercises to strengthen and loosen muscles. Many of these exercises can be performed at home. The goal of physical therapy is to improve your independence and quality of life by improving movement and function and relieving pain.

Physical therapy can help with:

  • Balance problems
  • Immobility
  • Weakness

Important note: Some physical therapists may apply diathermy to relieve muscle aches and pains. This could be dangerous to patients who have deep brain stimulators.

Data Sources And Search Strategy

Parkinson’s Disease Thinking Changes: Engaging Occupational Therapy

This study was carried out according to the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions . The systematic literature search was conducted using Pubmed , Excerpta Medica dataBASE , Cochrane Central Register of Controlled Trials , the Oriental Medicine Advanced Searching Integrated System , and Chinese medical databases . The articles reported until December 2016 were searched, and there was no language limitation. Various exercise terms and MeSH terms were used for searching. The search strategies used in each database are presented in Table 1.

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Ot Encompasses Several Different Areas:

  • Activities of Daily Living . These are the basic self care skills of eating, dressing, grooming, bathing, toileting and toilet hygiene and personal care devices .
  • Instrumental Activities of Daily Living . These include the care of others, care of pets, financial management, driving and community mobility, health and medication management, meal prep and clean up, religious and spiritual activities, shopping, safety and emergency maintenance, etc.
  • Functional Mobility. This includes getting around your home and environment to perform your daily activities, transfers to bed, toilet, bathtub/shower, couch, recliner chair, wheelchair and car, etc.
  • Adaptive Equipment. This includes long handle utensils to reach your feet or back, tremor management eating utensils, non skid mats, button hook, lidded cup with straw, scoop dish, adaptive pen, etc.
  • Work Activities. This includes work station set-up/ergonomics, adaptive devices to make it easier to perform work tasks .
  • Cognition. This includes activities to stimulate cognitive function to maximize performance .

Use Your Personal Strengths

How can you build on your strengths and minimize your limitations? For example, if you have the strength of helping children enjoy reading, you could exercise that strength by reading to your grandchildren, by listening to them as they read, or by playing a reading game that stimulates both your imagination and theirs.

One of your strengths may be thinking skills. One thinking skill is imagining doing the activity before doing it. For example, imagining writing big can actually help you write big. Another thinking skill is speaking the steps out loud. When combing your hair, try saying hold and comb, to avoid dropping the comb.

Make sure you are exercising. Improving strength, balance and endurance through exercise supports your participation in all sorts of activities. Whether it is dancing or walking to a neighbors house, find an enjoyable way to exercise.

Lastly, be positive. Think, I will do rather than Ill try to and you may be more successful.

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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:

Training Of Trial Therapists


Before the start of the trial, the participating occupational therapists follow a three-day training to inform them about the study procedures and to train them to treat the patients and caregivers according to the OTiP intervention protocol. Special attention is given to enhancing the therapists skills in coaching and motivational interviewing and in eliciting and collaboratively defining meaningful, individualized goals with the patient and caregiver. Ways to achieve sufficient treatment intensity in ten weeks are discussed. Halfway through the inclusion period a booster training session is planned. Therapists can use a secure online platform to share issues and experiences and can consult an expert OT to discuss the intervention.

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Parkinsons Disease Therapy: Is Movement Medicine And Are You Taking The Right Dose

With todays growing evidence this is now a solid truth: Functional and intensive exercise can promote and help sustain independence, cardiovascular fitness and reduce the risk of falls in people affected by movement disorders, especially Parkinsons Disease.

But, despite this we still see programs out there not being lifted to their true potential.

So, What Is Right For You?

Whether youre having difficulty with walking, turning, freezing or just cant move quick enough in and out of bed, a chair or the car, perhaps getting dressed is your big bug bear for you- especially those buttons!.

What ever your situation, weve seen too many people opt out of living the life they want because of these mounting challenges, and we would like to help.

What Is Occupational Therapy

In life with PD, you may have encountered speech or physical therapists. Where does occupational therapy fit in and how is it different? First, note that the word occupation in OT means activity. Our job in OT is to identify strategies that will allow you to continue doing activities that are important to you. Each person with PD will have different goals based on his or her symptoms and disease progression, as well as individual lifestyles, interests and priorities. Whether you have been living with PD for one month, five years or 20 years, and whether your goal is playing tennis or spending time with family, our approach is the same: to find ways to match your personal strengths with activities and an environment that will help you reach your goal.

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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 Parkinsonâs 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 Parkinsonâs 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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Find An Occupational Therapist

Parkinson’s Disease Exercises: LSVT BIG Movements

Are you looking for a more personalized plan? If so, request a referral for occupational therapy from your neurologist or movement disorder specialist. Ask them if they can recommend an occupational therapist with knowledge of PD. You can also contact your state OT association, or local rehabilitation facility or home care agency, to find an OT. You can find more information on the American Occupational Therapy Association website at

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Preparing Meals And Navigating The Kitchen

Consider where things are located in your kitchen. You might want to reorganize or rearrange things in your kitchen so that frequently needed items are the easiest to access. Plan ahead and break down the steps of your meal prep so that it is more manageable.

There are lots of tricks and tips that OTs have to help in the kitchen such as sliding heavy pots of water along the countertop instead of carrying them or sitting at the kitchen table to chop vegetables instead of standing. If you enjoy cooking, there are likely lots of suggestions an OT can make to help you be safer and more independent in the kitchen.

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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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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How Occupational Therapy Helps Parkinsons

Occupational Therapy and Parkinson

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.

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