Physical Therapy For Parkinson’s Disease

How Can Physical Therapy Help Parkinson’s Disease

Physical therapy is an important part of a treatment plan for Parkinson’s disease. It aims to help individuals with Parkinson’s disease remain active and independent as long as possible. According to a recent meta-analysis, physical therapy significantly improves symptoms related to motor skills. The Parkinson’s Foundation states that increasing physical activity to 2.5 hours a week or more can help people with Parkinson’s disease maintain their quality of life.

Overall, physical therapy can help with the following:

• Increasing endurance
• Reducing pain

Because physical therapy improves motor skills and decreases pain, you can expect it to help with many of your regular activities, such as getting up from a chair, climbing stairs and getting into and out of a car.

Physical therapy can also improve other symptoms associated with Parkinson’s disease, such as depression, anxiety and fatigue. Lastly, it can help with other health issues that impair mobility, like joint pain.

Doctors recommend beginning an evidence-based physical therapy program as soon as possible. Exercise can induce neuroplasticity, or the brain’s ability to change in response to behavioral changes. When you begin physical therapy, your brain learns new ways to move and think. Exercise also helps brain cells stay healthy. In other words, physical therapy may slow the progression of Parkinson’s disease.

Occupational Therapy For Parkinson’s Disease

Occupational therapy for Parkinson’s Disease incorporates the use of functional activities as part of the therapy process, including:

• ADL training: dressing, feeding, bathing, grooming, hygiene, toileting

• IADL training: leisure activities, social participation, caring for pets, participating in daily activities and routines

• Balance training to improve participation in tasks

• Training to manage tremors in the hands and upper extremities

• Safety and fall prevention including “fall proofing” of home environments

• Modification of tasks including recommendation of equipment, technology and adaptive strategies to improve independence

• Transfer training to improve ability to get up from a chair or toilet seat as well as in and out of bed or a car.

An occupational therapy program can help a client with Parkinson’s Disease to:

• Prevent falls and improve safety at home

• Improve coordination with tasks including buttoning, feeding and handwriting

• Manage tremors during functional tasks

• Continue to participate in social activities with modifications

• Maintain independence at home with improved safety

Pharmacological Advances: Charcot And Gowers

Early treatment of Parkinson’s disease. Prescription dated 1877 from the College of Physicians of Philadelphia Library. In treating Parkinson’s disease, Charcot used belladonna alkaloids as well as rye-based products that had ergot activity, a feature of some currently available dopamine agonists. Charcots advice was empiric and preceded the recognition of the well-known dopaminergic/cholinergic balance that is implicit to normal striatal neurochemical activity .

Everything, or almost everything, has been tried against this disease. Among the medicinal substances that have been extolled and which I have myself administered to no avail, I need only enumerate a few .

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Medicare And The Therapy Cap Removal

Historically, Medicare has limited the amount of physical, occupational and speech therapy a beneficiary could receive in a given year. In some years, Congress created an exceptions process that allowed individuals to access therapy above the cap if the services were deemed medically necessary, but this process needed to be renewed by lawmakers every few years, creating uncertainty and the potential for coverage denials.

The Parkinsons Foundation has worked with the PD community to address Medicare challenges related to services such as physical therapy, occupational therapy and speech-language therapy since 2011, including advocacy in 2014 to remove the Improvement Standard, which meant that people with Parkinsons could no longer be denied coverage for therapy solely for lack of improvement. In February of 2018, this exceptions process was made permanent, meaning people on Medicare can no longer be denied therapy if they need it to manage their health conditions.

Speech Therapy For Parkinson’s Disease

As per the Parkinsons Foundation, most people with Parkinsons disease will experience changes in speech, voice and swallowing at some point during the course of the disease. The same PD symptoms that occur in the muscles of the body tremor, stiffness and slow movement can occur in the muscles used when speaking and swallowing.

Speech Therapy for Parkinson’s Disease includes a variety of therapeutic treatment forms including:

• – Muscle strengthening

• – Improve coordination and smoothness of oral motor movement for speech & swallowing

• – Improve breath support & control for speech

• – Develop a daily exercise program & carryover skills to outside therapy sessions

• – maintain highest quality of life throughout progression of disease

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Putting On Your Jacket

Getting dressed takes a lot of flexibility, balance and coordination. You have to be able to twist and reach into that jacket or shirt hole. You need some serious balance to lift one foot up to put inside a pant leg without having to sit on the edge of the bed. Exercise, in combination with smart clothing strategies, can save you a lot of time and frustration every day.

If youre struggling with getting clothes on your body, your Parkinsons physical therapist can help break down the movement into various exercises so you can get back to doing more on your own. If you struggle with the buttons, zippers and laces, make sure to include an occupational therapist in your treatment program and practice your hand exercises regularly.

Occupational Therapy For Early Onset Parkinsons

Occupational therapists are similar to physical therapists, but they focus on more specific goals related to functioning. In other words, occupational therapist help us function to the best of our ability. For people with early onset Parkinsons disease, routine tasks such as walking, running, standing up from a chair or moving into and out of bed can become difficult occupational therapists are trained to evaluate these kinds of difficulties and help the person and/or the environment adapt as needs and abilities change.

LEARN MORE

• Parkinsons Disease: Physical and Occupational Therapy

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What Kind Of Physical Therapist Do I Need

All physical therapists are prepared through education and experience to treat patients with PD. You may want to consider:

• A physical therapist who is experienced in treating people with neurological disorders. Some physical therapists have a practice with a neurological focus.
• A physical therapist who is a board-certified clinical specialist or who has completed a residency or fellowship in neurologic physical therapy. This physical therapist has advanced knowledge, experience, and skills that may apply to your condition.

You can find physical therapists who have these and other credentials by using Find a PT, the online tool built by the American Physical Therapy Association to help you search for physical therapists with specific clinical expertise in your geographic area.

General tips when you are looking for a physical therapist :

• Get recommendations from family, friends, or other health care providers.
• When you contact a physical therapy clinic for an appointment, ask about the physical therapists’ experience in helping people with PD.

During your first visit with the physical therapist, be prepared to describe your concerns in as much detail as possible, and let the physical therapist know what you would like to accomplish by going to physical therapy.

How Can Physiotherapy Benefit Those With Parkinsons Disease

Apart from medication and surgical procedures, it has been established that physical therapy for Parkinsons disease yields great results. Physiotherapy can benefit a patient suffering from Parkinsons in resisting the regressive changes that follow this disease and in recovering from it.

Physiotherapy can have many positive effects on patients with Parkinsons disease:

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Write Down Your Goals

Before you meet with a physical therapist, write down all the goals you want to accomplish. Writing your goals can help you organize your thoughts and focus on what is most important to you. When listing your goals, consider the areas you are struggling with and would like to improve most. Your goals will provide direction for your treatment and help you stay motivated. You can adjust your goals or create new ones as needed.

Good Days And Bad Days

Parkinsons symptoms fluctuate. Some days, the patient will be able to move quickly, smoothly, and confidently, like their old self has returned. Other days, they will hardly be able to move, eat, or talk. It is a seesaw and the only way to cope is to approach each day as its own. Determine where you are and make it work as best you can. If it is a bad day, focus on rest and recovery, knowing you will be ready to take advantage of good days when they come.

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The Importance Of Physical Therapy For Parkinsons

Since Parkinsons disease causes such an impact on the body, physical therapy can make a big difference. Even though the nerve damage caused by the disease cant be reversed, you can improve your physical capacity and learn how to compensate for impairments.

Working with a physical therapist can help improve your balance, your gait, and your daily movements, among other skills. You can also build strength and cardiovascular capacity with aerobic and strength training.

Early on, your physical therapist can help you maintain your current functioning and favorite activities. In later stages, the therapist can help you relearn how to perform your daily activities or work around the changes in your body.

One of the main goals of physical therapy for Parkinsons disease is to enhance your wellbeing through timely interventions and education. You should feel better as a result of the benefits of physical therapy, which include:

• Pain relief
• More energy
• Improved strength

Therapeutic interventions help you stay active and maintain your independence. Without physical therapy, you risk greater disability, more fall risk, worsening physical ability, and poorer quality of life.

Early intervention is particularly imperative as you have a vital window to address issues early on, even before you notice changes. Your physical therapy sessions are a critical part of your care.

Lsvt Big & Loud Program For Parkinson’s Disease

The LSVT BIG Program is a specialized program that focuses on the unique movement impairments associated with Parkinson’s Disease. The BIG Program uses repetitive and exaggerated movements to help improve gait, mobility, decrease “freezing” and other symptoms associated with PD. Clients who participate in the BIG Program attend 4 – one hour sessions per week for 4 weeks.

LSVT LOUD is an evidenced based speech & voice treatment program created by Dr. Lorraine Ramig for people living with Parkinsons Disease and other neurological conditions. LSVT has been scientifically studied and seen to effectively train people with PD to use their voice with a habitual loudness while speaking with familiar and unfamiliar partners in various settings ranging from quiet conversation to more demanding events. The main goal of the program is to recalibrate the voice through a series of exercises to a loudness level that is appropriate to achieve effective, easy and functional communication.

Available: In Our Garden City Office and Select Offices

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Physical Therapy Exercises For Parkinsons Disease

It is common for Parkinsons patients to completely give up exercising due to the pain involved in moving muscles and joints. Unfortunately, doing so actually worsens the pain. Thus, patients are stuck in a vicious cycle of avoiding exercise to avoid pain but actually causing more pain by not exercising.

Parkinsons disease makes it difficult for patients to perform complex motor programs. However, the loss of automatic response in patients can be countered with exercises that demand attention, repetition, progression of difficulty and promote learning.

Symptoms of Parkinsons disease get worse over time but physical therapy can help to make them more manageable. A trained physiotherapist will develop an exercise program to help patients handle day-to-day chores and activities as well as address balance issues, lack of coordination, fatigue, pain, gait, posture, immobility and weakness.

A physical therapy plan for a patient with Parkinsons disease involves a combination of exercises that promote posture, biomechanics, increased strength and flexibility and stimulates cognitive abilities in patients.

Here are some examples of exercises a physiotherapist may develop to help a patient with Parkinsons disease:

Occupational Therapy For Parkinsons

When you have Parkinsons disease, limited mobility can make simple tasks like getting dressed or taking a shower much harder. Occupational therapists teach you the skills you need for daily life whether youre at home, work, or out with friends.

A therapist will evaluate your home, office , and daily routine to pinpoint areas where you could use help. Some things an occupational therapist can teach you include:

• how to use a walker, cane, and other walking aids if you need them
• how to keep your balance when you walk
• tips to stay focused when you walk to avoid falls
• easier ways to get in and out of bed, and out of the shower or tub, without falling
• tricks to get dressed, bathe, and do other self-care tasks with the help of grabbers and other assistive devices
• tips to make daily activities such as cooking, eating, and housecleaning easier

An occupational therapist can also recommend useful changes to your home. These changes will make your home safer. Examples of these changes include:

• a roll-in bathtub if you use a wheelchair
• lower counters

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Exercise And Physical Therapy

Research has shown that regular exercise benefits people with Parkinsons disease.

Exercise:

• reduces stiffness
• improves mobility, posture, balance and gait

Aerobic exercise increases oxygen delivery and neurotransmitters to keep our heart, lungs, and nervous system healthy. General exercise may also reduce depression. Learning-based memory exercises can also help keep our memory sharp .

What types of exercise are best for people with Parkinsons disease?

There is increasing evidence that aerobic and learning-based exercises could be neuroprotective in aging individuals and those with neurodegenerative disease. Facilitating exercise programs that challenge our heart and lungs as well as promote good biomechanics, good posture, trunk rotation and normal rhythmic, symmetric movements are the best. Dancing to music may be particularly good for decreasing stiffness.

Types of exercises that do this:

• Walking outside or in a mall
• Dancing

Types of exercises that promote cardiopulmonary fitness:

• Paced walking
• Hiking using walking sticks
• Swimming with different strokes with the eyes open and closed not only challenge motor learning but also increase heart rate and provide good cardiopulmonary conditioning.
• New bodyweight-supported treadmills can also be helpful to protect from falling, and to facilitate easier coordinated movements for fast walking with a long stride or jogging.

Types of exercise that do NOT challenge motor planning:

Is there any value in strength training?

Search The American Physical Therapy Association Directory

The last resort would be to find a physical therapist at a practice specializing in neurology using the APTAs Find a PT tool. Select Neurology under Practice Focus or Find by Specialist.

Still no luck?

It would be well worth your time to plan a road trip to the closest Parkinsons physical therapist, even if its a significant commute. Call ahead and let them know your situation. Ask them if they can condense your treatments into one to three extended sessions . Plan a day trip and ask a friend or family member to come along. The effort will be worth it in the end.

Finally, visit a physical therapy clinic in your area and ask them if theyd consider paying for one of their physical therapists to attend a Parkinsons training course. It would improve their value to the community and boost their business!

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Want More Practical Articles Like This

Much more can be found in our latest edition of Davis Phinney Foundations Every Victory Counts® manual. Its packed with up-to-date information about everything Parkinsons, plus an expanded worksheets and resources section to help you put what youve learned into action. Request your copy of the Every Victory Counts manual by clicking the button below.

Getting Out Of The Car

Does the idea of running errands make you cringe because you hate having to get out of the car at each stop? Youre not alone. Getting out of the car requires a surprising amount of strength and flexibility in your hips and core. And, if youre gone all day running errands, you need endurance too!

Not only can your Parkinsons physical therapist help you regain the strength you need, but they can also give you some tips and strategies that will give you an advantage over gravity and rewire your brain-body connection for success.

Dr. Claire McLean, PT, DPT leads a PWR!Moves routine that helps with car transfers

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Find A Post Acute Medical Center Near You

Parkinson’s disease is a complex disorder that affects every person differently. If you or a loved one have Parkinson’s disease, you can still enjoy life and engage in fun activities. An individualized physical therapy program can help keep you on your feet and enhance your overall well-being.

At Post Acute Medical, our compassionate physical therapists are trained to help individuals with Parkinson’s disease improve their symptoms and reach their goals. To learn more about our comprehensive Parkinson’s disease rehabilitation program, contact a Post Acute Medical facility near you.

What Are The Physical Effects Of Parkinsons Disease

Parkinsons disease causes nerve cell damage in the brain, resulting in lower dopamine levels and brain function and movement problems. During its beginning stages, its effects can go unnoticed because it causes unseen changes in the brain. However, the nerve cell damage can eventually show up as physical symptoms, such as:

• Balance problems
• Muscle stiffness

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What Can Be Advised Based On The Results Of This Systematic Review

Findings from the systematic review demonstrated that people with PD achieve greater short-term improvements in gait and balance with physical therapy intervention than with placebo or no physical therapy intervention. Because PD is a progressive condition, short-term benefits are important, but true benefits may be realized only if the patient develops the skills and strategies for long-term adherence to appropriate exercise and activity. Furthermore, the results were obtained with a range of intervention approaches, including general physical therapy, exercise, cuing, treadmill, dance, and martial arts. Hence, clinicians can consider any of a range of intervention approaches when working with people with PD, especially in the early and middle stages of PD, and can take into account people’s preferences. This finding is important given that people with PD likely need to develop long-term exercise habits to sustain benefits. People are most likely to adhere to an exercise regimen if they are doing something they enjoy. Furthermore, some people may be more likely to develop sustained exercise habits if they can vary their approach. At the same time, clinicians are cautioned to consider the impairments that are most limiting to their patients when deciding which intervention approaches to use.