Management Of Parkinson’s Disease With Physiotherapy

Published on: 2018/05/01

Dr. M. G. Mokashi, B.Sc, DPT; FIAP; Ph.D. Professor Emeritus, Physiotherapy.


In Parkinson’s disease, multiple system atrophy, and progressive supranuclear palsy, the main regulators of the caudate nucleus and putamen (dopaminergic substantia nigra and glutaminergic caudal intralaminar nuclei), as well as the cortical projection from the pre-supplementary motor area, degenerate.

Degeneration of the major basal ganglia circuit neurons also occurs in multiple system atrophy, while degeneration of the subthalamus and a widespread loss of inhibitory interneurons within the extrapyramidal system occurs in progressive supranuclear palsy.

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Parkinson’s disease, physiotherapy

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Management of Parkinson’s disease

Parkinson’s is now a fairly common progressive disease which affects the neurological system of the brain that controls movements. This condition is characterized by degeneration of the Substantia Nigra, which is responsible for controlling the movement of the body. This part of the brain produces dopamine, which controls movement. There is a gradual reduction of dopamine with age, but in the case of Parkinson’s disease, the reduction is rather quick.

What are the symptoms of Parkinson’s disease?

When the patient loses about 60-70% of the cells, Parkinson disease sets in. The symptoms start gradually like small tremors in one hand and then move on to stiffness or slowing down of movement. Parkinson’s disease usually affects the population who are 60 yrs or above. The disease so far has no cure, but medications have been found to slow down the pace of degeneration.

Symptoms and signs of Parkinson’s disease include tremors, slowed movement, rigid muscles, bad posture or balance issues, loss of movements such as blinking, swinging of arms as you walk, changes in speech and writing. Scientists have been working on ways to identify biomarkers that can lead to a faster diagnosis. As of now, the therapies or medications used to treat Parkinson’s only help by improving the symptoms without slowing down the disease. Many times, Parkinson’s disease cause depression, constipation, sleep disorders, loss of sense of smell or other cognitive impairments.

Management of Parkinson’s disease with physiotherapy

Parkinson’s disease is the most common movement disorder, which causes progressive loss of muscle control leading to stiffness, slowness, and loss of balance. The effects of Parkinson’s disease vary from person to person. Some lead long, productive lives and some get disabled very quickly.

Patients experience an increased dependency on others as a result of deteriorating body functions. For patients with Parkinson’s disease, rehabilitation therapies must be included in the treatment in addition to pharmacological and neurosurgical treatments.

Physiotherapy and Parkinson’s disease

Physiotherapists can be of great assistance in the management of the Parkinson’s disease. Physiotherapy focuses on upper limb functions, balance, gait, and maintaining of the physical capacity. Patients are taught exercise to maintain or increase independence, safety and manage their quality of life.

There has not been substantial evidence that links Parkinson’s disease and physiotherapy leading to a poor availability of physiotherapy services. Over the last 5 years, there has been growing evidence that links the benefits of physiotherapy to Parkinson’s disease.

Management of Parkinson’s disease through physiotherapy helps to maintain and improve the quality of life as exercise helps improve mobility, it corrects and improves abnormal movement patterns. It helps to maximize muscle strength and joint flexibility, the risk of falls can be minimized by improving posture and balance. Physiotherapists help by educating the caregivers and family members. Exercise is also known to enhance the effects of medicines taken.

Apart from improving mobility and balance, physiotherapy focuses on strengthening the body to carry out daily activities like getting in or out of bed, climbing stairs etc. Physiotherapists can also give advice on how to carry out day to day activities with or without the aid of assistive devices for patients with Parkinson’s disease.

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