By: Aleacha Wallington, PT
Parkinson’s disease (PD) is a chronic progressive disease that affects the motor component of the central nervous system. In simpler terms this means that the brain does not send correct signals to muscles for accurate body movements. It is a movement disorder characterized by rigidity, tremor, and slowness of movement. Other symptoms may include: shuffling while walking, lack of facial expression, small handwriting, excessive saliva, difficulty swallowing, difficulty speaking, frequent falls, and freezing. The cause is unknown but there are possible links to genetic mutations and environmental exposure to toxins or viruses. Recent studies have suggested that treatment should not only include medication but also exercise. The medication for PD helps treat the symptoms by increasing the brain’s supply of dopamine. Dopamine is the chemical or messenger in the brain that is decreased with PD. A recent study by Dr. J Eric Ashlskog suggested that an intense exercise program can have positive modifying effects slowing the progression of the disease. Physical therapists are uniquely qualified to design an exercise program for individuals with PD whether a person is newly diagnosed or has been diagnosed for years.
Physical therapists can improve an individual’s confidence and function while promoting safety with daily functional activities. Ideally, physical therapy should begin as soon as an individual is diagnosed, but gains can also be made in the later years of PD progression. The early stages are the best time to begin a program that is specially tailored to improve or slow down the progression of movement symptoms. The goal of therapy is to teach an exercise program that can be performed on a daily basis and become a lifelong routine.
A good exercise program for an individual with PD will be challenging and address functional limitations. These functional limitations can be as simple as rolling over in bed or getting up out of chair and as challenging as playing golf or performing work activities. Exercises should focus on several different factors including improving spinal mobility, balance, posture, strength, and speed of movements such as walking. Physical therapy will also include education and evaluation for assistive devices and home modifications to prevent falls. For an exercise program to have the most benefit it is important to think of it as a daily medication. We do not want to miss a dose of medication because we know it will have negative effects. Missing a dose of exercise is similar in that we will not see maximum benefits (and may not be able to slow the progression of PD) if it is not performed on a daily basis.
Rehabilitation of individuals with PD is different than treatment of patients with other neurological diseases and it is important for these patients’ to see a therapist familiar with specialized PD treatment.
Aleacha Wallington, DPT is a licensed physical therapist at HPT Physical Therapy Specialists in Huntington, WV. She specializes in treatment of patients with Parkinson’s disease and other neurological conditions. She can be reached at 304-525-4445 or awallington@hptservices.com.