Friday, June 14, 2024

Pt For Parkinson’s Disease

Parkinsons Home Exercise Program

Parkinson Disease: Treatment by a Physical Therapist

You dont need to join a gym or purchase expensive fitness equipment to stay active with Parkinsons disease. On the contrary, there are many great exercises that you can do from the comfort of your home, regardless of which stage of the disease you are in. Take a look at some great examples in the sections below.

How Does Physical Therapy Help Parkinsons Disease

Physical therapy cannot cure Parkinsons 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 theyre 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.

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Can You Apply The Results Of The Systematic Review To Your Own Patients

On the basis of the patient-intervention-comparison-outcome analysis, the results of the Cochrane review can be applied to patients such as Mr Jennings. Clinicians should, however, consider several limitations of the data. First, the outcomes were related to gait and balance but not to overall functional ability. This fact is important because improvements in gait do not necessarily lead to improvements in basic activities of daily living, such as dressing and hygiene, or overall household activities, such as cooking, cleaning, and managing laundry. Second, only short-term outcomes were examined. Parkinson disease is a progressive condition, and although short-term benefits are important, true benefits may be realized only if the patient develops the skills and strategies for long-term adherence to appropriate exercise and activity. Data regarding the best strategies for assisting patients in developing appropriate activity and long-term exercise habits are needed.

Furthermore, evidence is not yet available to determine the best intervention strategies on the basis of subgroups of PD or H& Y stages of PD. Finally, many patients have substantial comorbid conditions that should be taken into account in the design of a plan of care, both because of safety implications and because they can contribute to deficits in movement and function.

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Why Big Is Better

BIG has one primary focus: amplitude. It asks those following the program to move big, encouraging a vigorous range of movement and pushing participants to use all parts of the body, from the feet to the hands and fingers. In a BIG session, the patient mimics or mirrors the therapist through a series of large stepping or rocking movements with their arms moving in various directions.

In recent studies, the principles of LSVT BIG were applied to limb movement in people with Parkinsons disease. The documented results demonstrated improvements in amplitude that generalized to improve speed , balance, and quality of life. In addition, people were able to maintain these improvements when challenged with a dual task.

At Progressive Physical Therapy, our programs are designed to meet the individual needs of the patient and their ability in a safe and fun manner. This, combined with doing a home exercise program one to two times a day helps clients with Parkinsons Disease improve their skills. The goal is for patients to use their bigger movements automatically in everyday living and for long-term carryover of increased amplitude. The therapy can be used in a walking, standing or sitting position.

Recent Patient Survey Results Indicated That:

Parkinsons Patients Learning Power of Exercise
  • On average 100% of participants felt very satisfied with the overall quality of the treatment they received through telehealth services.
  • The overall all net promoter score was 80% favorable.
  • On average 100% of participants were very satisfied with the ease of scheduling and the technology they were using for Telehealth.

I love telehealth, I am able to make all my appointments as long as I feel well. I no longer need to cancel due to transportation issues or that I am worried about being sick and giving it to someone or my migraines that are coming on. This is great!

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Do I Have A Speech Or Voice Problem

Many people with Parkinsons use these statements to describe speech-related issues. Choose the response that indicates how frequently you experience the below .

  • It is difficult for people to hear me0 1 2 3 4
  • People have difficulty understanding me in a noisy room0 1 2 3 4
  • My voice difficulties restrict personal and social life0 1 2 3 4
  • I feel left out of conversations because of my voice0 1 2 3 4
  • My voice problem causes me to lose income0 1 2 3 4
  • I feel as though I have to strain to produce voice0 1 2 3 4
  • The clarity of my voice is unpredictable0 1 2 3 4
  • My voice problem upsets me0 1 2 3 4
  • My voice problem makes me feel handicapped0 1 2 3 4
  • People ask, Whats wrong with your voice?0 1 2 3 4
  • To find your score, add up your answers. A score of 10 or higher indicates you might have a speech or voice problem that is affecting your quality of life and you should ask for a referral to a speech pathologist.

    How To Talk To A Loved One About Parkinsons Disease

    These are some strategies that can be helpful while talking to a loved one about Parkinsons disease:

    • Check in regularly: Check in on the person regularly to ask them how theyre feeling and coping.
    • Use empathetic language: Parkinsons disease can affect a persons ability to go about their daily life. The person might find it challenging to do things they once did easily. This can be difficult and frustrating for them. Try to be empathetic when you speak to them, so they feel supported.
    • Offer assistance: As Parkinsons disease progresses, the person may not be able to drive, cook, clean, or care for themselves. Offer them your assistance and let them know they can count on you.
    • Encourage them to settle their affairs: If your loved one is in a position to make important decisions, it can be helpful to encourage them to settle their affairs.

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    How To Exercise With Parkinsons

    Whether you’re a first-time exerciser or a lifelong athlete, the key to working out with Parkinsons is to safely and regularly move your body in a variety of ways. Your fitness regimen should include these four main categories of exercise:

    • Aerobic activity
    • Balance, agility, and multi-task exercises
    • Stretching

    People with Parkinsons should strive to perform aerobic activity at least three times weekly and to complete exercises from the other categories two to three times each week.

    In total, the Parkinsons Foundation suggests performing 150 minutes of moderate tovigorous exercise weekly.

    To help you achieve this goal, try these helpful tips:

    • Invest in a treadmill, elliptical, or exercise bike. This will make it convenient to perform aerobic exercise from your home, regardless of the weather.
    • Obtain a set of light hand weights from a local exercise shop or thrift store. These can be used for a wide variety of strength training exercises.
    • Follow along with one of the many online exercise classes on YouTube that are tailored to people with Parkinsons disease. The Parkinsons Foundation and the Davis Phinney Foundation offer many great online exercise videos.
    • Connect with a workout buddy by finding a local Parkinsons support group associated with the American Parkinson Disease Association

    Finding Expert Pd Physical Therapy

    Parkinson’s Disease Exercises: LSVT BIG Movements

    It is important to find a physical therapist who has specialty training and experience working with PD. You may find experienced physical therapists working in hospital outpatient departments, home health agencies, nursing homes or within the community close to your home. Ask your neurologist for a referral at your next appointment.

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    Physical Therapy For Parkinson’s Disease

    If you have been diagnosed with Parkinson’s disease your healthcare provider may refer you to many specialists to help you move and function better. A physical therapist is a movement specialist who can assess and treat the motor control and planning changes that occur with the disease.

    Limitations Of The Review

    The methodological quality and reporting of the majority of trials was variable, and often inadequate. Of 39 trials, only 18 provided information on the randomisation method and only five used a central randomisation procedure to ensure concealment of treatment allocation. Blinded assessors were used in 24 studies, and only nine reported using intention to treat analysis. The lack of information in many reports may not necessarily indicate poor implementation within the trial, but without this information, the level of bias within each trial is difficult to assess. The need for further improvement in the methodological quality of trials in physiotherapy for Parkinsons disease was noted in another recent systematic review.70 Future trials therefore need to ensure that their designs fulfil the requirements of a methodologically sound, large randomised controlled trial, and that the reporting follows the CONSORT guidelines.71

    Outcome reporting bias may have created a deceptively positive impression of the effectiveness of the studied interventions. Unfortunately, the proportion of outcomes that went unreported could not be assessed here, owing to a lack of information on trial protocol.

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    What Is Physical Therapy

    Physical therapy is a specialized form of health care that involves evaluating and treating a person with limited mobility. It is used to treat many conditions, including arthritis, amputations, injuries and Parkinson’s disease. Physical therapists are licensed professionals trained to apply individualized techniques to help patients regain mobility.

    Physical Exercise For Parkinsons Disease: Clinical And Experimental Evidence


    1Institute of Psichiatry, Federal University of Rio de Janeiro , Rio de Janeiro, Brazil

    2Castelo Branco University, Rio de Janeiro, Brazil

    1Institute of Psichiatry, Federal University of Rio de Janeiro , Rio de Janeiro, Brazil

    3Physical Activity Neuroscience, Physical Activity Sciences Postgraduate Program Salgado de Oliveira University, Niterói, Brazil

    4Physical Education Department, Faculty of Unidas de Campinas , Goiânia, GO, Brazil

    5Politechnique Institute of Porto, Healthy School, Porto, Portugal

    8Intercontinental Neuroscience Research Group, Yucatán, Mexico

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    Reach Out For Support

    It can be challenging living with Parkinson’s disease, but you do not have to manage the symptoms alone. If you find yourself feeling discouraged or frustrated, share your feelings with others. Spend time with supportive friends and family members, or consider joining a support group. You might also speak with a counselor to address depression, anxiety or any other mental health issues you experience. By taking care of your mental and emotional health, you will be better positioned to reach your physical health goals.

    Make It To Your Appointments

    The number of physical therapy appointments you need depends on your condition and goals. Generally, your first appointment will include an evaluation and exercise recommendations. In following appointments, your physical therapist will check your progress and add or modify exercises according to your needs. Make sure you attend all of your appointments to stay on track.

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    Maintaining Or Improving Effective Breathing

    Parkinsons can cause stiffness in your chest muscles and make them weaker. This may lead to chest infections. A physiotherapist can use positioning therapy or other techniques, which focus on your posture, to help clear phlegm and keep your chest clear.

    Speech and communication issues in Parkinsons are common and can often relate to your breathing. A physiotherapist can teach you how to strengthen your chest muscles, and provide breathing exercises to improve your breathing pattern and volume. This can also help if your voice has become softer.

    If you find that you have specific problems with your voice, a speech and language therapist can help.

    Physical activity is good for you and its particularly good for you if you have Parkinsons. Being active for 2.5 hours a week can help manage Parkinsons symptoms, and has a positive impact both physically and mentally.

    The activity you do can suit you and your condition. An intensive group exercise class could help manage mild symptoms or chair-based exercises at home could target complex issues.

    A physiotherapist with expertise in Parkinsons can give you advice and support about what will help you. They could give you an exercise programme to follow at home if you prefer to exercise alone. Or, they may give you advice on sports you can do, like golf, or an exercise class you could join, like yoga or tai chi.

    What Kind Of Physical Therapist Do I Need

    Neurology – Topic 13 – Parkinson’s disease female patient

    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 search for physical therapists in your area with these credentials and clinical expertise through Find a PT, a tool built by the American Physical Therapy Association.

    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.
    • 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.

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    Update Of Latest Evidence

    For our guideline , literature published until October 2003 was reviewed. We have repeated the literature search for all studies published until June 2006. Several papers have appeared since the publication of the guideline.- An analysis of these studies demonstrates that the level of evidence of the recommendations provided in our guideline is not altered by the results of these studies.

    About Dr Sarah King Pt Dpt

    Sarah is a passionate Parkinsons advocate who founded Invigorate Physical Therapy & Wellness, an online wellness practice 100% specialized in Parkinsons disease, to help her clients get out of overwhelm and into action by connecting them with the tools and support they need to thrive over the course of their Parkinsons journey. She lives in Austin, Texas with her husband , Matt.

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    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.

    Helping You Stay Independent


    People with Parkinsons say certain movements become more difficult as the condition progresses. These include turning in bed, walking, and sitting down and standing up . Your physiotherapist can teach you techniques to help make these movements easier.

    A physiotherapist or an occupational therapist can also give advice on daily living equipment you could use or alterations you could make to your home to make it easier and safer to move around.

    Always check with a therapist before you buy any piece of equipment or assistive device. Parkinsons affects everyone differently, so what might work for one person may not suit another.

    Equipment may also help your carer. See our last section for more information.

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    Foods High In Saturated Fat

    Although the specific role of saturated fat in Parkinsons is still being studied, research suggests that a high dietary fat intake may increase your risk of this disease .

    Generally speaking, diets high in saturated fat have been linked to chronic conditions like heart disease. As such, you may wish to keep these foods in moderation (

    • palm oil
    • some baked and fried foods

    Conversely, a very small study notes that the keto diet which is high in fat is beneficial for some people with Parkinsons. However, a low fat diet also showed benefits. Overall, more research is needed .

    Do Your Part Outside Of Therapy

    It is vital to practice the exercises you learn in physical therapy at home. Doing exercises at home will help you reap the most benefits from physical therapy and keep you strong. Your physical therapist will show you activities that are safe for you to do outside of therapy sessions.

    In addition to doing planned exercises, consider ways to increase general physical activity. For example, doing housework, gardening or walking around a store are ways to increase physical activity every day.

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    How Did The Physical Therapist Apply The Results Of The Cochrane Review To Mr Jennings

    Mr Jennings physical therapist posed the following question: Will a physical therapist program improve the physical functioning of a 54-year-old man in H& Y stage 2 of PD? Findings from the Cochrane systematic review completed by Tomlinson et al were applied by use of the patient-intervention-comparison-outcome approach, as follows.


    The review included people in H& Y stages 1 to 4 of PD, with a mean age of 67 years, and 6 years after diagnosis. Mr Jennings was in H& Y stage 2, was younger than the mean age , and had been diagnosed 4 years earlier. Thus, Mr Jennings fit the overall criteria but was younger and had had the diagnosis for a time shorter than the mean time for the people in the studies reported in the review.


    Comparison and alternate approaches


    The review indicated that all interventions, including general physical therapy and exercise, resulted in small, short-term beneficial changes in gait, balance, or functional mobility measures for people with PD. Some of the outcome measures used for Mr Jennings were consistent with those reported in the review.

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