- Difficulty with specific movements such as writing
- Difficulty in turning over in bed or rising from a low chair
- Excessive greasiness of skin
- Inability to raise voice or even cough effectively
- Chewing & swallowing problems
- Bowel/Bladder control problems
- Thinking difficulties (later stages)
- Sleep disorders
- Depression & emotional changes
- Posture – There is slight flexion (bending) at all joints while standing, shoulders rounded & head held forward with arms bent across the trunk. Patients may sump while sitting, sliding sideways to lean on the armrest & head may fall forward on the chest.
- Balance – There is a tendency to topple forwards & are unable to make quick compensatory movements to regain balance & are easily knocked over. Their pace is short & shuffling & may feel like they are ‘chasing’ their center of gravity while walking in order to avoid falling forward while walking.
- Voluntary movements – All movements are reduced in range & speed. Speech becomes slower & softer. Handwriting becomes smaller & after a point, slows down & becomes untidy.
- Involuntary movements – They are reduced or lost, such as swinging the arms while walking, automatic swallowing of saliva is impaired, & coughing is defective.
- Rigidity – Muscle tone is increased & there is resistance to passive movements. Rigidity is often the cause of muscle pain & relieving rigidity is a part of the treatment.
- Tremors – This occurs due to involuntary alternating contraction of opposite muscle groups & is present at rest.
Rehabilitation for Parkinson’s at Curezone Physiotherapy
Treatment of Parkinson’s patients must be multi-disciplinary & must cater to the individual cases depending on their disability or symptoms. Drug therapy & Physiotherapy are the most important forms of treatment for this condition. None of the drug therapy is effective unless the patient takes advantage of his improvement & returns to normal activity. They may be dependant on other due to their slowness & difficulties while walking & must be encouraged to be independent, get regular exercise & maintain an interest in hobbies & social activities.
Physiotherapy Treatment program should include the following:
- Analysis of functional difficulties – Treatment should be goal-oriented to help the patient to overcome their functional difficulties. The faulty patterns should be identified & corrected when possible, or alternative measures should be provided & practiced. Auditory & visual cues to be given to reinforce the correct movement patter. For example, the instruction ‘heels down’ helps in case of patients who have difficulty walking & freeze. This helps their center of gravity to return to a more normal position & thus maintain balance & prevent falls.
- Posture – Postural awareness must be encouraged & practiced so that they can correct their posture & return to correct posture while sitting or standing or lying down.
- Joint range of motion exercises – As the disease progresses, they become more rigid & hence, ROM exercises should be a part of their treatment to maintain proper range & length of joints & muscles respectively.
- Stretching – Both active & passive stretching should be done mainly to counter the rigidity due to increased muscle tone.
- Relaxation – Physiological relaxation is helpful to calm them down, treat anxiety & also bring more awareness to their posture & joint position.
- Memory exercises – Simple memory games are encouraged for patients so that they do not regress if not progress.
- Balance & co-ordination exercises – They help them to train themselves when they feel that they are being knocked over & can train them to correct their own posture when they loose balance.
- Breathing & speech exercises – They help to train the respiratory muscles to an extent & must be taught because patients have difficulty coughing & sometimes breathing (later stages). Some of the exercises that can be done are deep breathing, pitch glides, practicing pronouncing vowels, volume control (saying a word out loud at 5 different volume levels), reading aloud with proper intonation & clear pronunciation, exaggerating mouth movements, singing etc.
It is often helpful to conduct group exercise classes for patients with the disease so that they all feel familiar & normal. Patients with Parkinson’s often tend to isolate themselves from society & avoid going out due to the embarrassment of clumsy & slow movements. Group sessions can therefore help them to ease out the anxiety, be more active & something that they look forward to.
Make sure you book your appointment today and get assessed by our physiotherapist for the Treatment of Parkinson’s Disease.