Parkinson’s disease impacts more than a person’s health; it steals their independence, depriving those afflicted of the ability to rely on their own faculties. But, while there is no known cure, patients diagnosed with Parkinson’s are not powerless.
Through education and physical therapy, Parkinson’s disease patients can learn to manage symptoms, sometimes remaining active for years following their diagnosis.
Parkinson’s affects the cerebellum and central nervous system. Neurons begin to break down, leading to a range of symptoms that impact almost every aspect of the patient’s life.
Common symptoms include:
Quality of life is the overriding concern of Parkinson’s disease and physical therapy. Though patients cannot reverse their symptoms, with the help of their therapist, they can remain independent and functional. By moving and staying active, they can make good days more productive and bad days less challenging.
Sadly, no amount of physical therapy can reverse Parkinson’s disease. Eventually, there will come a time when the patient cannot maintain their independence and will require someone to look after them full-time. Despite this, physical therapy still plays a useful role by reducing the burden of care.
Therapists can help patients re-learn basic physical skills, such as rolling over or raising their arms. Simple movements can make the patient more of a partner, able to assist their caregiver with the activities of daily living such as bathing, grooming, and dressing, improving outcomes for both caregiver and patient alike.
Parkinson’s disease and physical therapy needs are highly individual. For some, symptoms remain mild for a long time, while others experience a far more rapid progression. As a result, instead of working off a script, therapists try to meet patients where they are. During their initial meeting, therapists evaluate the patient’s physical abilities in order to determine their level of function.
Regardless of whether the patient is bed-bound or mobile, the goal is to help them do as much as they can on their own by working on three key areas: strength, balance and movement.
Parkinson’s patients frequently experience pronounced bodily weakness. They tire easily and strain lifting their arms and legs, increasing the likelihood they will suffer a fall and making ordinary activities like walking almost impossible.
Strength training helps patients push back and regain their stamina. Strong muscles let patients move freely while also reducing fatigue. They also improve posture and reduce the risk of osteoporosis, which often accompanies Parkinson’s.
Building muscle has mental benefits as well. It boosts production of dopamine, an important neurotransmitter. Low dopamine is endemic to Parkinson’s, responsible for tremors, rigidity, and weakness throughout the body.
Strength training is most effective when it is tailored to the individual. If symptoms do not progress far, patients might be asked to work with free weights. However, most are given simpler exercises, such as leg lifts, heel raises, arm raises, squats, seated marches, or wall push ups.
If the patient is doing well, the therapist might push them a little further by adding a heavier dumbbell or resistance band to their routines. Patients can also exercise sitting down if they feel shaky on their feet.
An alarming 70% of Parkinson’s patients fall at least once in the span of a year. To help keep them stable, physical therapists look for ways to challenge their balance, gradually making each exercise more strenuous as the patient improves.
These are the most common exercises used to help support Parkinson’s patients:
Regardless of the exercise, patients should go at their own pace, and should always try to work with specialized physical therapists who are sensitive to their unique needs. Because exhaustion affects productivity, therapists should always check with patients to ensure they’re not becoming overly tired during every session.
Slow movement is one of the hallmarks of Parkinson’s, but patients rarely perceive it. To them, they are moving and speaking the same way they used to. Learning to compensate is one of the biggest obstacles facing successful physical therapy efforts.
To help patients adjust to their new normal, therapists encourage patients to make wide, exaggerated movements, swinging their arms and legs further than what feels comfortable. In the same manner, they must also learn to write with what may seem like exaggerated lettering to ensure that people can read their words.
Therapists adopt the same approach with gait training. Parkinson’s patients move with small, shuffling steps. These are not only slow, but also dangerous. If they’re trying to step over an obstacle, like a sidewalk curb, they run the risk of tripping and falling. At times, mobility is so compromised that patients freeze in place without realizing it.
To correct this, instead of relying on their instincts, therapists teach their patients to walk in a rhythmic pattern. Patients may feel discomfort, or unnatural, but the only way to stay active is by developing a new sense of motion. To help them along, the therapist might hang a target on the front of the patient’s walker and ask them to kick it every time they take a step. They may also count a tempo and ask the patient to keep time as they walk.
Patients with Parkinson’s disease can choose to receive treatment in a clinic or at home. Clinics are generally more intense, and have more sophisticated equipment, but home settings may be more ideal for certain patients.
Depending on their insurance, patients can meet with their therapist in clinics up to five or six times a week. Most home healthcare agencies meet with patients two to three times per week; Parentis Health’s Home Care is unique because it offers light daily exercises that can be tailored to meet individual patient needs.
Home Care services are also inherently more personal than clinics. Because they are conducted in a familiar environment, therapists can focus on the specific skills that patients need every day, such as getting out of bed, navigating tight hallways, or walking downstairs.
Oftentimes, the patient will be living with a spouse or family member, which gives the therapist a chance to train them as well—an opportunity not typically available through a clinic.