Did you know April is Parkinson’s Awareness month? The Parkinson’s Disease Foundation is working to help educate and shatter the myths around the disease.
Parkinson’s disease (PD) is a chronic and progressive movement disorder, meaning that symptoms continue and worsen over time. Nearly one million people in the US are living with Parkinson’s disease. The cause is unknown, and although there is presently no cure, there are treatment options such as medication and surgery to manage its symptoms. Parkinson’s generally develops after age of 65, but about 15 percent of patients have a young onset form of the disease that can appear before age 50.
The disease involves the malfunction and death of vital nerve cells in the brain, called neurons. Parkinson’s primarily affects neurons in an area of the brain called the substantia nigra. Some of these dying neurons produce dopamine, a chemical that sends messages to the part of the brain that controls movement and coordination. As PD progresses, the amount of dopamine produced in the brain decreases, leaving a person unable to control movement normally.
The specific group of symptoms that an individual experiences varies from person to person. Primary motor signs of Parkinson’s disease include the following.
- tremor of the hands, arms, legs, jaw and face
- bradykinesia or slowness of movement
- rigidity or stiffness of the limbs and trunk
- postural instability or impaired balance and coordination
Physical therapy for Parkinson’s is multifactorial. First and foremost would be fall prevention including assistive device training and decreasing their gait deviations. These patients tend to have a shuffled gait pattern with poor posture and high fall risk. They often “freeze” in doorways, thresholds, etc and need gait training to improve their safety. Other interventions would be strengthening to improve transfers and increase independence. And a hallmark of Parkinson’s treatment is repetitive, rhythmic movement which can decrease their common rigidity and increase ease of movement.
Physical therapy can help Parkinson patients with:
- Balance problems
- Lack of coordination
While occupational therapy for Parkinson’s patients generally provides assessment, treatment, and recommendations in the following areas:
- Arm and hand therapy
- Handwriting aids
- Home modification information
- Driver evaluation and vehicle modification information
- Cooking and homemaking adaptations
- Eating and dinnerware adaptations
- Ways to make the most of your energy
- Computer modifications
- Workplace or work equipment modifications
- Leisure skill development
- Manual or electric wheelchair use
- Bathtub and toilet equipment use
- Dressing and grooming aids
Common Parkinson’s Myths and the Facts
Myth: All individuals with Parkinson’s disease have tremors, and tremors are always caused by Parkinson’s disease.
Fact: While tremor is the most recognized symptom of Parkinson’s disease, many Parkinson’s patients do not have tremors but have rigidity and slow movements. Thirty percent of patients do not have tremors at the onset of the disease. Tremors can be caused by many other conditions.
Myth: Parkinson’s disease causes individuals to have extra, uncontrolled movements.
Fact: The extra movements — called dyskinesia — associated with Parkinson’s disease aren’t caused by Parkinson’s. They’re actually a side effect of the medication used to treat the disease.
Myth: Only one part of the brain, the substantia nigra, is involved in Parkinson’s disease.
Fact: The latest findings suggest that Parkinson’s disease affects multiple areas of the brain.
Myth: Parkinson’s disease is strictly a movement-related disease.
Fact: Because Parkinson’s disease affects multiple areas of the brain, it has an array of non-motor symptoms, including swallowing disturbances, whispering, loss of smell, cognitive difficulties, depression, loss of impulse control, sleeping problems and bladder problems/constipation.
Myth: Parkinson’s disease is caused by genetics.
Fact: There is no known cause of Parkinson’s Disease. There seem to be many factors at play, including environmental and genetic factors. Only 5-10 percent of cases have a true genetic link.
Myth: Parkinson’s disease is curable.
Fact: There is currently no cure for Parkinson’s disease, partly because we still don’t understand the causes. We need to further examine the non-motor symptoms as possible key indicators in identifying causes and cures.
Myth: Medication is the only treatment.
Fact: There are options to treat and manage symptoms. Parkinson’s disease patients are initially treated with medication, but over time it becomes less effective. The next line of treatment is deep-brain stimulation, which involves placing electrodes in the brain to regulate abnormal brain impulses. Deep-brain stimulation can be a life-changing therapy to improve quality of life and restore order to an otherwise chaotic world.