Parkinsons disease is a movement disorder caused by depletion of a chemical neuro-transmitter in the brain called Dopamine. Dopamine is intricately involved in many aspects of how we move. It allows us initiate and maintain movement, move smoothly with fluidity and to change speed, direction and force. Parkinson’s disease is characterised by four key symptoms:
- Slowness in movement
- Postural instability (balance impairment). This is a feature as the condition progresses.
Parkinsons Disease in Ireland
In Ireland it is estimated that 7000 to 8000 people have PD. Although often thought of as an elderly person’s disease Parkinson’s Disease can affect people at much younger ages
Although often considered a condition that affects the elderly at the Dublin Physiotherapy Clinic we have experience helping people of all ages diagnosed with Parkinson’s disease. We see people from initial diagnosis through the course of the condition guiding them to manage their symptoms and maintain their lifestyle.
Parkinsons Disease Symptoms
A person with PD often present with a variety of complaints ranging from:
- general stiffness
- loss of flexibility
- stooping posture often listing to one side
- slower balance reactions
- lack of hand dexterity
- loss of confidence
- mood changes
Impact on Daily movements
These symptoms can impact on performance of everyday functions we take for granted e.g.
- turning in bed,
- standing up from a low chair,
- buttoning a shirt,
- turning pages of the paper,
- Walking:- can become slow and shuffling. Freezing can occur when turning, in narrow spaces or in public places.
Pain can develop as the condition progresses. It is most commonly seen in the neck or lower back due to poor posture and faulty movement patterns. It is not uncommon for people to experience pain in the feet due altered foot mechanics secondary to muscle rigidity.
Parkinsons Disease Treatment
Medication and Neurophysiotherapy are the foremost treatments of choice in managing Parkinsons disease and its associated symptoms.
The focus of physiotherapy has shifted from general exercise to more structured individualised treatment, goal orientated in nature. The benefits of this are that symptoms specific to Parkinsons can be addressed (freezing, stiffness, altered posture, muscle weakness) with a more positive and long lasting effect on functional performance.
The first step is early referral to a Neuro-physiotherapist. Having specialist training and an
in-depth understanding of the condition we can identify any deterioration in musculoskeletal integrity, (e.g. muscle weakness, stiffness), highlight potential postural and movement impairments that may need immediate attention and instigate an appropriate treatment plan to address these. Guidance towards exercise appropriate to prevent de-conditioning and optimise fitness is also an essential part of the management approach.
No two cases that present to our clinic are the same. Therefore for each person a detailed history and individualised clinical examination of presenting symptoms and functional difficulty is vital to design an appropriate management strategy. Indeed in many cases following assessment, provision of an appropriate treatment plan with periodic review maybe sufficient to monitor and maintain a satisfactory lifestyle. Again this will vary with each individual, their goals and needs.