Frequently Asked Questions:
What are the goals for rehabilitation in patients with Parkinson’s Disease?
The aim is to maintain function and fitness in the face of this progressive disease. Studies have suggested that multidisciplinary rehabilitation benefits functionality and mobility in patients irrespective of medication adjustments for Parkinson’s disease.
What kinds of exercises are beneficial for patients with Parkinson’s Disease?
Regular aerobic and moderate strengthening programs improve fitness and reduce the likelihood of falls and should be a part of Parkinson’s disease management. Treadmill training may improve stride length, and external cues or conscious focus may reduce freezing and festination. Likewise, mental imagery and facilitative techniques may improve the ability to rise from a chair or bed. Stretching and range of motion exercises help maintain mobility and minimize rigidity effects. Because task-specific training is most effective, activities that are most important to the patient remaining at home should be identified. All the patients and caregivers should receive instruction in a home exercise program specific to that patient’s needs.
What kinds of supportive measures can be taken to preserve functionality?
Patients with hypokinetic (slowed) speech often benefit from referral to a speech-language pathologist for therapy, emphasizing breath and rate control while increasing volume. Those with suspected swallowing issues should be referred for further assessment and compensatory strategies such as diet consistency modification and proper head positioning. As the disease progresses, modification of the home environment (i.e., grab bars, raised toilet seats, removal of high pile rugs, and other adaptive equipment may be needed. A rolling walker generally works better than a standard walker because patients are usually unable to incorporate lifting of a standard walker into their gait pattern.
What are some non-motor features seen in patients with Parkinson’s Disease?
Along with the typical features of tremor, rigidity, and slowing of movements, non-motor symptoms can also develop. Examples include autonomic dysfunction, difficulty maintaining normal and steady blood pressure, and slowed gastrointestinal motility (slowed digestion and excretion of foods leading to constipation). Sleep disturbances, cognitive impairment, and depression are also often seen.