Parkinson’s disease (or PD) is a chronic neurological condition which causes a small area of nerve cells to die off affecting a person’s ability to make smooth, coordinated motor movements. The effects of these brain changes create symptoms in motor movements characterized by tremors, “freezing”, slow movement and/or muscle rigidity. This makes playing the hokey pokey a bit challenging, but not impossible! Exercise and medications can play a major role in keeping people with PD mobile and independent, however there may also be a need for more intense treatment in order to combat the motor symptoms associated with PD. Below is a brief description of the primary therapy services available that can help:
Physical therapy (PT) is often prescribed for patients to help with fall prevention, gait training and range of motion issues. A treatment program can improve strength, flexibility and physical function which can drastically reduce your risk of falls or other injuries. PT can treat the motor symptoms of PD—including tremor, rigidity, balance impairments and slowed movements (called bradykinesia). PT can provide tips on “freezing” and how to get moving again when these episodes occur (things like rocking back and forth on one foot to initiate a first step). Physical therapists can work with PD patients on developing specific strategies to get in and out of chairs and cars, standing and turning to change directions more efficiently, determining the need for an assistive walking device (i.e., standard or 4-wheel walker) and improving the smoothness and coordination of walking with changes that may need to be readdressed as the disease progresses.
Speech Therapy (ST) can help PD patients with the changes in speech such as low volume, altered tone or decreased intelligibility through training of vocal exercises that keep a patient can utilize throughout the course of the disease. Speech therapists are also skilled in treating cognitive impairments and difficulties with swallowing that may occur later in the disease process. Speech language pathologists guarantee that the effective instruments of communication are addressed and maintained over the course of the disease, including the possible use an augmentative alternative communication (AAC) device as one’s speech begins to worsen. These devices offer the latest in technology and can speak for the PD patient in up to full sentences by choosing words or pictures from the device screen. ST is also critical in the review and management of the safety and effectiveness of chewing and swallowing and can minimize the risk of choking during intake of food and liquids as muscle coordination falters.
Occupational therapy (OT) may be used to enhance people’s ability to work or maintain daily activities. They specialize in such things as improving fine motor dexterity, handwriting, bed mobility and personal care. Occupational therapy should be obtained for patients who require assistance in maintaining their jobs and family roles, improving or maintaining movement and mobility, and improving personal care activities such as eating, drinking, washing, and dressing. Treatment programs can target multiple impairment areas for PD patients in both the physical and cognitive realms. This can include training to learn effective strategies for getting in and out of bed or learning to turn over in bed more easily, in addition to improving the patient’s perceived functional capacity for the activities of daily life making the PD patient feel more confident in their abilities resulting in decreased feelings of despair over the loss of function. OT is also recommended for making environmental changes to improve safety and motor functions in or around the home or workplace and occupational therapists, like speech therapists, are qualified to address cognitive changes and treatment interventions as they arise.
Seeking the help of professionals is always considered an important step in ensuring the a person with Parkinson’s disease lives a happy and healthy life for as long as possible. While there is not currently a cure for PD, there are a variety of interventions that can slow the progression and allow the patient to maintain their independence, particularly in the early stages. Be sure to take an active role in the therapy services provided to get the most out of what is being addressed as carryover is the key to longevity. PD can leave you shaky and slow, but therapy will help you get up and go!
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