Parkinson's disease (PD) is a neurological disorder that affects normal movement and movement planning. It is a chronic, progressive disease with no known cure. People with PD may have difficulty with movement of the hands, arms and legs. These movement difficulties make basic functional tasks like reaching, walking and speaking difficult.
Parkinson's disease is caused by a decrease in the production of a chemical called dopamine in the brain. This chemical is a neurotransmitter that works in an area of the brain called the basal ganglia. The basal ganglia is responsible for movement planning and coordinating movement, thus a decrease in dopamine causes functional motion to become abnormal.
Who Gets Parkinson's Disease?
There is currently no known cause of PD. It typically affects people above the age of 50. About one in 20 people with Parkinson's are below the age of 40. People with a close relative with PD have a slightly increased risk of developing the disease, but there is no known genetic component in PD. Males are more often affected than females.
Signs and Symptoms of Parkinson's Disease
The diagnosis of Parkinson's disease is largely made by clinical observation. Since the area of the brain affected coordinates movement for many systems in the body, many different clinical signs may be present. These are typically motor control changes and can affect different parts of the body. If you have PD, you may have difficulty with speech, swallowing, hand motion, leg motion and walking. Some of the clinical signs of PD include:
- Rigidity. Rigidity refers to increase stiffness around a joint in the body. You may find it difficult to easily bend or straighten your arms, hands, or legs.
- Tremor. Tremor is a rhythmic, uncontrolled oscillation in a body part. Most often tremor is seen in the hand or hands of someone with PD. Tremor at rest is often the first sign of PD.
- Lack of movement or slowness of movement. Since the area of the brain that controls movement planning is affected in PD, there often is a lack of movement with the disease. Slowness of movement may also be present.
- Freezing phenomenon. This refers to the difficulty with starting or continuing movement. Some movements affected may be handwriting, speech or walking. You may be suffering from the freezing phenomenon if you are walking and suddenly stop for no apparent reason. You may then have difficulty starting to walk again.
Physical Therapy for Parkinson's Disease
If you have been diagnosed with PD, you doctor may refer you to a physical therapist to evaluate you and offer treatment to help you move and function better. The physical therapy evaluation and treatment for PD may include many items, such as:
- Postural assessment
- Endurance assessment
- Gait evaluation
- Strength measurements
- Measurements of flexibility and range of motion.
- Breathing function
Since so many different body functions can become altered with PD, your doctor may also refer you to other specialists such as a speech therapist or occupational therapist. It is important that all healthcare providers communicate with each other and your doctor to ensure that you receive the best care possible.
It is a good idea to also include family members in your care planning, as they can help provide assistance when necessary.
While physical therapy will not provide a cure for PD, you may be able to function better and maintain movement longer by following the guidance of your physical therapist and doctor.
Parkinson's disease can cause major neurological deficits and movement dysfunction. If you are experiencing signs of PD or suspect you may have PD, you should contact your doctor immediately. He or she can help you get the proper treatment, including physical therapy, to ensure that maximal function is maintained as long as possible.
Carr, J. H. (2000). Neurological rehabilitation: optimizing motor performance. Oxford: Butterworth Heinemann