Symptoms
1. Tremors
2. Rigidity
3. Bradykinesia
4. Postural instability
What type of aerobic training can be used in Parkinsons patients?
Walking and stationary bike
What neurons are affected in the brain in Parkinson patients?
Dopaminergic neurons
What is the second most common cause of Parkinsonism?
Drug-Induced Parkinsonism
- due to side effects of medications that affect dopamine levels
- Drugs that block dopamine levels used to treat Psychotic disorders (schizophrenia) and neuroleptic drugs ( dementia)
Purpose of mental imagery treatment?
Engages occipital, temporal, and prefrontal cortex and results in improvement of motor self awareness and kinesthetic and proprioceptive awareness.
Affects hands but can be seen in the foot and jaw.
How can you improve writing skills in individuals with Parkinsons disease?
Often Occupational therapist can use weighted pens, visual cues, adjust speed of writing, writing in different sizes, and external cues to improve writing difficulty in patients.
What location in the brain are Parkinson patients normally affected?
Substantia nigra
What is the second most common cause of dementia in elderly individuals?
Dementia with Lewy bodies
- Caused from buildup of proteins deposits called alpha -synuclein ( Lewy bodies)
- Dementia will always appear first before motor symptoms that resemble parkinsons disease.
How can an OT improve cognitive difficulties in patients with Parkinsons disease?
By task based activities, memory aids including smartphone reminders, white boards and calendars.
What technique is noticed in tremors?
Pill rolling technique
- Shows as rhythmic back and forth motion often between the thumb and forefinger.
- Implementing safety techniques to reduce risk of falls
- Medication management and recognizing when medication is affecting a persons daily function
- Maintaining activity levels including walking, stationary bikes, and mobility activities.
What protein can build in the brain and cause a blockage and reduce dopamine production in the brain?
Lewy bodies ( alpha- synuclein)
What type of Parkinsonism affects multiple systems of the body?
Multiple System Atrophy ( previously known as Shy-Drager syndrome)
- Affects the movement system of the body and and autonomic system
- Progresses faster than Parkinson's disease.
- autonomic functions including BP, HR, sweating, bladder functions, sexual problems, and breathing are more severe.
What aids can improve dressing difficulties in individuals with Parkinson disease?
Button aids and sock aids
Define the typical Parkinson's gait
Flexed posture, shuffling of feet, festination, reduced arm swing and freezing of gait.
What are 3 interventions to improve anticipatory and compensatory postural adjustments?
1. External perturbations
2. Ball catching
3. Tandem walking
What's the percentage of dopamine producing cells lost in individuals with Parkinson's by the time symptoms appear?
60%-80%
What type of Parkinsonism is identified from a buildup of the protein called tau on the brain cells?
Progressive Supranuclear Palsy
- Eye movements are affected with complaints of blurred vision and inability to focus eyes.
- Presents with loss of balance and tendency to lean backwards.
- does not respond well to medications
- Speech and swallowing deficits appear quicker and more severe
In postural stability dopaminergic neuronal deficits can cause
Decrease balance reaction, flexed posture, and decreased trunk rotation
What are some external cues to help improve gait and reduce freezing episodes?
Visual cues before gait training and visual feedback can improve overall gait.
Rhythmic auditory stimulus during gait training such as metronomes and music can help with consistent feedback while completing the gait training task.
President George H.W. Bush suffered from this type of Parkinsonism
Vascular Parkinsonism
- Due to multiple mini strokes that causes clotting in the brain
- Symmetrical lower body symptoms including shuffling gait and unsteadiness on the feet.