Parkinson’s disease is a neurodegenerative disorder marked by progressive disability. Mobility is impacted, and patients often come to experience gait and balance problems, difficulties with posture, slowness of movement (bradykinesia), and muscle stiffness. These symptoms make daily activities difficult and affect the patient’s quality of life.
Physical therapy under the supervision of a trained specialist aims to improve or maintain functional ability, helping patients to stay independent for longer and to lessen the likelihood of depression, fatigue and mood swings.
Physiotherapy for Parkinson’s disease
Physiotherapy is part of the multidisciplinary approach taken to manage Parkinson’s disease symptoms. Patients can benefit from two areas of physiotherapy: exercises to build and retain muscle strength, and conditioning to lessen difficulties with movement and to target problem areas like stiffness in the hands and legs, tremors, and balance.
After a thorough evaluation of evident disease symptoms, the doctor will refer the patient to a physiotherapist. A physiotherapist with experience in Parkinson’s disease will review the symptoms and plan an exercise program tailored to the patient’s abilities and disease status.
Starting physiotherapy early can help to slow Parkinson’s progression and symptom severity.
Types of physiotherapy
The duration and frequency of the physiotherapy session depend on the hospital or clinic, and the patient. In general, sessions run for 30 to 40 minutes, four to five days a week. Based on the symptom being addressed, the type of exercise and its routine can be adjusted.
A physiotherapist can guide the patient through gait training to improve posture and balance. Learning how to walk correctly can be challenging, and the patient should be constantly monitored during training. Simple yoga poses have also helped patients improve their posture and balance. Pilates is another form of physical training that can build core strength and improve balance.
Parkinson’s disease patients may experience difficulty in repetitive movements, such as arm swings while walking. These movements, called reciprocal patterns, can be improved by working on an elliptical machine or a cross-trainer. Large rhythmic movements of the arm and the leg can help build muscle memory and counteract the progression of symptoms. Some patients find that dance and Tai-Chi also help to improve hand swinging motions.
Muscles naturally weaken with age. But people with Parkinson’s experience muscle weakness at a faster than normal rate. Depending on the degree of disease progression, a physiotherapist may recommend exercises with resistance bands or light weights to improve muscle strength. Exercising in a swimming pool with water providing resistance so as to prevent joint injury is also often suggested.
A common symptom in Parkinson’s disease, muscle stiffness can be painful, and sudden stiffness can be a cause of frequent falls. Stretching at regular intervals throughout the day can help lessen muscle rigidity. Water aerobics involving large rhythmic movements can also be useful. Using hot packs may be recommended to relieve stiffness, but they must be used with caution.
In addition to physical activity and training, physiotherapy can also help improve mental health by alleviating depression, and easing fatigue.
A physiotherapist can also train patients in the use of an assistive device, like a wheelchair, for mobility.
Parkinson’s disease patients are prone to falls. A physiotherapist can guide patients in ways to recognize a fall, land safely, and get back up again.
It is essential that a physiotherapist specializing in Parkinson’s disease be consulted before starting any form of exercise, and that exercises be performed — at least initially — under specialist supervision. A physiotherapist can advise patients and caregivers as to exercises that might be performed in the home, and how best to go about them.
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