Introduction
- Parkinson’s Disease is a progressive disorder of the central nervous system along with symptoms of motor and non motor
- The affected motor symptoms are rigidity, brady kinesia, tremor and postural
- The non motor symptoms are loss of sense of smell, constipation, rapid eye movements, sleep disorders, mood disorders, orthostatic hypertension are in early stages of Parkinson’s Disease.
- The Parkinson’s Disease is 1st described by James Parkinson in 1817 he named the condition as ‘shaking palsy’.
- The term parkinsonism is used to describe a group of disorders with primary disturbance in the dopamine system of basal
Incidence
- Annual incidence – 20 persons affected in 100000
- Sex incidence – male affected more then female
- Age of onset – the disease affects in above 50
Aetiology
The Parkinson’s Disease divided into
- Primary Parkinson’s Disease
- Secondary Parkinson’s Disease
- The causes of primary Parkinson’s Disease is unknown. Its come from idiopathic More then 70% of cases will affected by the primary Parkinson’s Disease.
- Secondary Parkinson’s Disease will be occurred by various causes includes virus, toxin, drugs.
Clinical features
- The tremor will be present in the early 1stits started from hands then its spread into all the four limbs.
- Rigidity
- Cogwheel rigidity Lead pipe rigidity
- The patient thumb will move forward and backwards during rest time its disappear during
- Brady kinesia – slowness of movement
- Akinesia – loss of spontaneous
- The gait becomes shuffling and festinant
- Kyphosis with head leans forward
- Stooped posture
- Mainly the flexor muscles are shortened
- Mask like face, the facial expressions are loss
- Hand writing reduces in size
- Dysarthria (slurred speech)
- Dysphagia (swallowing difficulties)
- Sialorrhea (excessive increase of saliva)
- Eye movements may be affected
- Depression occurs about 50% of cases
- anxity
Investigation
The diagnosis of Parkinson’s Disease in early stage is difficult
- SPECT(Single photon emission tomography)
- PET(positron emission tomography) it should be conform the disease
- Hoehn-yahn classification of disability scale
- Unified Parkinson’s Disease rating scale
Special test
- Romberg test
- Multi directional reach test these test for asses the static balance.
Management
Medical management
- Levadopa,carbidopa
- Dopamine agonist
- Monoamine oxidase B inhibitors
- Anti cholinergics
- Amantidine
- Deep brain stimulation
Physical Therapy management by Neo Physio
- Relaxation exercise- relaxation of excessive tension of muscle
- Flexibility exercises – increasing range of motion
- Mobility exercise- to improve functional activity
- Balance exercise
- Resistance exercise – to strengthening the muscle
- Co ordination exercise
- Gait training
- Breathing exercise
- Aerobic exercise
- Home exercises
- Physiotherapy for parkinson’s in Coimbatore can be treated at home at your comfort by Neo Physio
Nutritional Management
The parkinson’s disease affected patients are generally advice to follow a high calories low protein diet.