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Parkinson’s Disease (PD), the second most common neuro-degenerative disorder, has considerably increased, with six million people getting affected globally. Physiotherapy can play an important role in helping patients live a better quality of life.
With a prevalence of 51-439 per 1 lakh and an annual incidence of 2-28 per 1 lakh, the disease mainly presents itself in later life with generalised slowing of movements.
It is a progressive, neurodegenerative disorder occurring due to a decrease in the production of dopamine, a chemical found in the brain that regulates the body’s movement. This dopamine imbalance leads to two main physical manifestations – tremors and postural instability.
The common symptoms include slowing movements, resting tremors, stooped posture, and stiffness, which progressively results in social isolation and significantly affects the quality of life.
Individuals diagnosed with Parkinson’s Disease initially start with medical management to maintain the correct dopamine levels in the nervous system. Despite medical therapies and surgical interventions for Parkinson’s, patients develop progressive disabilities.
The role of physiotherapy is to boost functional ability and reduce complications through movement rehabilitation. The ultimate objective is to promote independence, safety and well-being, thereby enhancing quality of life.
Exercise is rather beneficial for Parkinson’s patients. But physical therapy, in particular, offers a promising solution. A professional equipped with the right skills can guide you through the right movements to increase mobility, strength and balance.
Parkinson-specific evidence-based physiotherapy protocols have been proven to achieve better outcomes.
A couple of training interventions have proven to be effective in Parkinson’s Disease, include
1. Conventional PT, including a free range of motion and active exercises, have been found to improve the gait of PD patients by improving the walking ability, speed, and cadence
2. Treadmill training with beneficial effects on movement outcomes, including walking ability and speed
3. Strategy training, including cueing, was found to be effective in improving balance
4. Aerobic exercises (exercises improving oxygenation of muscles) help in balance and gait training, and Hydrotherapy (exercises performed in water have beneficial effects on fear of fall and balance)
5. Virtual reality and the use of computer-based games in a virtual reality environment have shown to increase patient motivation and engagement
6. Graded resistance exercise training increased the muscle strength of PD patients with sarcopenia (loss of muscle mass). Research has shown that 30 to 40 minutes of resistance exercise had positive effects on leg muscle strength, transfers and walking speed.
An exercise regimen should be selected for each patient after consulting a physiotherapist who will help design the appropriate treatment plan according to the disease stage and progress. As Parkinson’s Disease is chronic and progressive, patients should be equipped with the necessary skills to perform the exercises in home-based or community-based settings in the long run so that the therapeutic effects can be sustained.
The article has been authored co-authored by Dr Raghuveer Raghumahanti, Associate Professor, Gitam School of Physiotherapy, GITAM (Deemed to be University) and Dr Anishma Chungath, Assistant Professor, Gitam School of Physiotherapy, GITAM (Deemed to be University).