Parkinson’s Disease

Parkinson’s disease (PD) is a chronic, progressive neurodegenerative disorder that affects movement. It occurs due to the loss of dopamine-producing neurons in the substantia nigra of the brain.

Causes
Exact cause unknown (idiopathic in most cases)
Possible factors:
Genetic predisposition
Environmental toxins (pesticides, heavy metals)
Aging-related neuronal degeneration
Symptoms
Main Motor Symptoms (TRAP):
Tremor (resting tremor – “pill-rolling”)
Rigidity (muscle stiffness)
Akinesia/Bradykinesia (slowness of movement)
Postural instability (balance problems)
Other Signs:
Mask-like face
Shuffling gait with stooped posture
Soft or slurred speech
Drooling, difficulty swallowing
Fatigue and depression
Non-motor Symptoms:
Sleep disturbances
Constipation
Memory and cognitive changes
Diagnosis
Clinical diagnosis based on history and symptoms
Neurological examination
MRI/CT to rule out other conditions
Good response to Levodopa supports the diagnosis
Medical Management
Levodopa + Carbidopa (most effective)
Dopamine agonists (e.g., pramipexole, ropinirole)
MAO-B inhibitors (e.g., selegiline)
Deep Brain Stimulation (DBS) in advanced cases
Physiotherapy Management

1. Goals: Improve mobility and balance Reduce rigidity and bradykinesia Maintain posture and coordination Enhance functional independence
2. Techniques & Exercises: Mobility & Balance Training Gait training with visual or auditory cues (e.g., stepping over lines, rhythmic beats) Marching, large amplitude movements (LSVT BIG therapy) Static and dynamic balance exercises Flexibility & Relaxation Stretching neck, trunk, and limbs Gentle rhythmic movements to reduce rigidity Strengthening Strengthen postural and extensor muscles Functional exercises (sit-to-stand, step-ups) Coordination & Posture PNF techniques Mirror exercises and cueing for alignment Breathing & Speech Breathing control and chest expansion exercises Coordination with speech therapy (for hypophonia) Home & Lifestyle Encourage daily activity Fall prevention education Support from caregivers and family Prognosis Progressive disease; symptoms can be managed, not cured Physiotherapy and medication help maintain independence and quality of life Head trauma

Written by : Dayana Onkarappa Senior Physiotherapist at Advanced Physiotherapy Clinic and Homecare
https://physioji.com/