Parkinson's treatment ideas

Parkinson's treatment ideas (Full Version)

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samlin -> Parkinson's treatment ideas (January 14, 2002 4:29:00 AM)
Hi I might be treating a MR/DD patient with Parkinson's. I looked into some textbooks, I is there really any thing we can do as PT for patients with Parkinson. Should I even take the "case"? Any treatment ideas?

Mark Hirsch -> Re: Parkinson's treatment ideas (January 14, 2002 7:00:00 AM)
what is MR/DD? Thanks Mark

samlin -> Re: Parkinson's treatment ideas (January 14, 2002 8:16:00 AM)
Mental retardation/Developmental Delayed

Mark Hirsch -> Re: Parkinson's treatment ideas (January 14, 2002 9:00:00 AM)
How old is the patient? Is this young onset PD? Has he had any falls? How mentally retarded is he? Mark

PTupdate.com -> Re: Parkinson's treatment ideas (January 14, 2002 4:01:00 PM)
I say go ahead and treat him...give him the benefit of the doubt. You may find that he suffers simple rigidity and inflexibility, and may be quite capable of performing his own ROM exercises. If not, try to create something for him, using a Swiss gym ball or the like. I rarely turn down a patient prior to treatment, and at least see the person once to see what their problem is and what luck I will have addressing it.

Mark Hirsch -> Re: Parkinson's treatment ideas (January 16, 2002 4:38:00 AM)
If you patient has equilibrium deficits or muscle strength benefits, balance and resistance training are extremely helpful and it has been shown that balance and resistance training improve postural control and lower extremity muscle strength in persons with PD. Hence, my question, does the patient have balance problems? Recent research has shown that strength training also has the potential to improve gait parameters in PD patients. Also Margaret Schenkman has shown that a program of spinal flexibility improves axial control. So PT is definately worthwhile for the PD population. I can give you the citations if you are interested. With all due respect, putting a PD patient on a swiss ball is tantamount to doing nothing at all. Mark [This message has been edited by Mark Hirsch (edited January 16, 2002).]

barbarabanwell -> Re: Parkinson's treatment ideas (January 20, 2002 10:45:00 AM)
[QUOTE]Originally posted by samlin: Hi I might be treating a MR/DD patient with Parkinson's. I looked into some textbooks, I is there really any thing we can do as PT for patients with Parkinson. Should I even take the "case"? Any treatment ideas?[/QUOTE]I distribute and have available 2 excellent Exercise Videotapes for People with Parkinson's Disease--one a land program and the other an aquatic program--they were done by WaterArt (Canadian) and have been used in many programs--available for $20.00 plus $5.00 S&H--can be used either as a complete program or as an adjunct or home program--would be perfect for a client with Parkinson's/MR-DD--easily followed and fun. Contact me at BBanwell@voyager.net--

adhi_pt -> Re: Parkinson's treatment ideas (March 15, 2002 8:47:00 PM)
hello i am adhi,a PT now treating a PD pt male, 63, diagnosed 4 years before the problem is he severe neck rigidity & tilted neck to the left side do u have any idea of maitaining the normal position [QUOTE]Originally posted by samlin: Hi I might be treating a MR/DD patient with Parkinson's. I looked into some textbooks, I is there really any thing we can do as PT for patients with Parkinson. Should I even take the "case"? Any treatment ideas?[/QUOTE]

amelia -> Re: Parkinson's treatment ideas (May 23, 2002 11:37:00 AM)
hey Mark I totally agree with you, I have seen PD pts literally freeze on a ball, whats needed would be relaxed small range movements on a stable surface, to get rid of the abnormal postural stabilisation the patient resorts to. I also have a questn how old is this patient, I have never seen anyone with MR and DD and then PD, what signs have you seen in this patient to give you the impression of PD? Amelia

JSSSH -> Re: Parkinson's treatment ideas (August 24, 2002 10:30:00 PM)
I learned in school that we can set up exercises to improve gait (arm swing, greater hip and knee movement). e.g. practise stepping over obstacles in a hallway, practise walk and stop on command.

joseinus -> Re: Parkinson's treatment ideas (October 28, 2002 5:27:00 AM)
I have been a PT for a support group for PD patients and have quite a few children with PD.The most deblitating problem with kids are the side effects of leavadopa.You can always work with these patients when they are in the "on"Phase of the drug.You will have to concentrate to intiate movement and extension ex's.I have found it very helpfull to make the patient do ex's on hands and legs on the mat.regarding a patient with neck bradykinesia which is very common.perform active rom ex's for the neck and simultaniously stretch the back muscles as a severe kyphosis can produce neck stifness its the charactrestic simean posture in PD patients.I can assure you that PD patients will do great if you concentrate on all aspects and with a bit of motivation and counselling.Gait is very important with frequent episodes of freezing tell the patient to rock from leg to another and tell them to lift the leg and walk as if there is water in front and they have to aviod stepping on water.Posture re education is very important in front of a mirror.Please post more topics on PD i would like to put in my 2 cents worth.I am a new memeber to rehab edge. cheers, Joe

bharvey -> Re: Parkinson's treatment ideas (October 30, 2002 8:16:00 AM)
May I suggest you look into a training device, new to the market, called the Galileo 2000. It is a vibration training device with FDA approval in the neuromuscular markets. Please see the attached poster presentation to the AAPM&R. “Motor rehabilitation of spinal cord dysfunction by means of whole body vibration” John G. Gianutsos, PhD Liisa C. Oakes, BA Vincent Siasoco, MD Stacy Appelblatt, MS, PT Juliana Hamel, MS, PT Joan T. Gold, MD (NYU School of Medicine, New York, NY) Disclosure: None. Objective: To explore (1) the efficacy of whole body vibration (WBV) in inducing reflex standing and, specifically, (2) the progress of persons with spinal cord dysfunction of 3 differing etiologies. Design: Case series. Setting: Rehabilitation center in a metropolitan area. Patients: Persons with spinal paralysis of various etiology who were otherwise unable to stand without the use of long-leg braces locked at the knee. Case 1: a 21-year- old man who underwent laminectomy at T2–9 for resection of an intramedullary tumor. Case 2: a 12-year-old boy presented with quadriplegia secondary to transverse myelitis. Case 3: a 24-year-old man with C5 American Spinal Injury Association class A tetraplegia for 5 years secondary to a fall. Interventions: WBV to produce rapid, mechanically delivered repetitive stretches to the lower extremities, thereby resulting in involuntary muscle contraction. Main Outcome Measures: Standing time with and without WBV, degree of volitional movement, trunk, and body control, ability to transfer, and carry over to voluntary standing and walking. Results: All 3 patients were able to stand with minimal assistance and to increase progressively the length of standing time. Eventually, 2 were able to walk independently using various ambulatory aids. Conclusions: WBV represents a promising modality for use in the rehabilitation of persons with motor dysfunction of spinal origin. In our sample, WBV successfully induced reflex standing in all 3 patients and standing was followed by ambulation in 2 cases. Key Words: Rehabilitation; Spinal cord dysfunction; Motor function. If anyone would like information, let me know.

rseric -> Re: Parkinson's treatment ideas (December 11, 2002 10:44:00 PM)
I am a research student, which my research targets are people with idiopathic Parkinson's disease. Some points I want to raise here. If you found a patient with profound neck rigidity without severe rigidity in other parts of the body(e.g. arms, legs), then a diagnosis of PD is in doubt. Usually it is PSP (progressive supranuclear palsy), which presents with symptomes similar to those of PD, but is hard to differentiate clinically. Of course, you can still treat the patient in the same way, without knowing the possible effects of the treatments which do work well for patients with PD. Balance problem is quite cardinal for mid to late stages of PD. But as far as I know, there are no definite exercise which can improve the balance performance of patients with PD, because it's a very complex problem concerning many different systems of the body. Gait is another big problem. Recently several treatment methods have be incorporated for people with PD. Some authors tried Partial weight bearing walking for people with PD, but it doesn't seem to have obvious effect. Other authors tried using visual cues or audio cues, which showed a encouraging results in improving the patients' gait performance, especially the stride length. But I think for all the a aforementioned modalities, a high level of conciousness and attention are required. So as for a patient with MR/DD, they might not be appropraite. However you can still give a try and see if they work. Eric [QUOTE]Originally posted by samlin: Hi I might be treating a MR/DD patient with Parkinson's. I looked into some textbooks, I is there really any thing we can do as PT for patients with Parkinson. Should I even take the "case"? Any treatment ideas?[/QUOTE]

Mark Hirsch -> Re: Parkinson's treatment ideas (December 12, 2002 3:22:00 AM)
Hello rseric, good to hear someone with expertise and interest in PD...I would like to be in email contact with you about the balance training for PD -- there are three studies (2 of them with a randomized prospective design) suggesting a program of high intensity resistance training for the lower extremity, coupled with "balance exercises" enhances postural control in older adults with IPD -- I coauthored those papers and would be happy to share the results with you -- two have been published in peer reviewed journals and a third is accepted for publication -- so if you are interested I would be happy to share those with you...please send me an email [IMG]http://www.rehabedge.com/forums/smile.gif[/IMG] Mark

rseric -> Re: Parkinson's treatment ideas (December 16, 2002 9:20:00 PM)
Dear Mark, Thank you, I've already sent you an email. It's very nice to see that someone's willing to share their experience here. Eric [QUOTE]Originally posted by Mark Hirsch: Hello rseric, good to hear someone with expertise and interest in PD...I would like to be in email contact with you about the balance training for PD -- there are three studies (2 of them with a randomized prospective design) suggesting a program of high intensity resistance training for the lower extremity, coupled with "balance exercises" enhances postural control in older adults with IPD -- I coauthored those papers and would be happy to share the results with you -- two have been published in peer reviewed journals and a third is accepted for publication -- so if you are interested I would be happy to share those with you...please send me an email [IMG]http://www.rehabedge.com/forums/smile.gif[/IMG] Mark[/QUOTE]

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