Parkinsons Disease

What is Parkinson’s Disease

Parkinson’s Disease is a neurodegenerative condition where parts of the brain become progressively damaged. It presents itself generally in later life, with individuals showing slowness of movements, also known as bradykinesia, plus at least one other distinguishing symptom: tremor, rigidity and gait disturbance.

What causes Parkinson’s Disease?

Parkinson’s Disease is caused by a loss in nerve cells in the brain, more specifically in an area called the substantia Negra. These cells are responsible for producing a chemical called dopamine; dopamine is a neurotransmitter. This means it acts as a messenger between parts of the brain and the nervous system which helps control and coordinate movements. When the cells are damaged or die, the production of dopamine reduces. This impacts on the body’s ability to move and coordinate movements and as a result, bodily movements become slow and abnormal.

It is reported that a 50% loss in nerve cells activity in the substantia nigra leads to the development of the disease.

What are the signs and symptoms?

The symptoms of Parkinson’s Disease usually develop over time, they are mild at first but gradually progress. Although there are many different symptoms associated with Parkinson’s Disease, the severity and the development of these symptoms varies from person to person. Some individuals may experience more symptoms than others, but it is unlikely that an individual will experience all the symptoms associated with the condition.

Below are what are described as the main, or diagnostic symptoms of Parkinson’s Disease and are often referred to by doctors as Parkinsonism’s:

• Tremor – Types of tremors = resting, kinetic or postural
• Slowness of movement – Bradykinesia
• Muscle Stiffness – Rigidity – cogwheel rigidity/ lead pipe
• Gait Disturbance

However, there are other physical and cognitive symptoms which is important to be aware of.

Physical symptoms:

• Balance problems
• Loss of smell
• Nerve pain
• Urinary incontinence
• Constipation
• Erectile dysfunction
• Dizziness
• Excessive sweating
• Swallowing difficulties
• Problems sleeping

Cognitive symptoms:

• Depression and anxiety
• Memory problems and difficulties in planning and organization
• Dementia

If you are concerned about any of the symptoms, contact your GP and they will be able to assess your symptoms, review your past medical history and decide on the appropriateness for a referral to a specialist for further tests and assessments.

What treatments and help are available?

There is currently no cure for Parkinson’s Disease, but there are treatments and support available to help manage symptoms and help maintain your quality of life.

• Physiotherapy and Occupational Therapy
• Medication
• Surgery in some cases
• Support Groups and Websites

Parkinson’s UK is a great place to start, see link below:

How can physiotherapy help?

Physiotherapy plays a vital role in supporting people with Parkinson’s Disease. Physiotherapy can help support with physical difficulties people with Parkinson’s Disease experience. This can include helping with mobility, improving safety, and reducing falls risk, all of which contributes to the maintenance of an individual’s quality of life.

Sometimes, if undiagnosed, a physiotherapist may be the first person to notice parkinsonism’s and can be vital in identifying Parkinson’s Disease for patients. They can refer patients to their doctor for further assessments.

The main aim of physiotherapy is helping individuals with Parkinson’s Disease stay independent as long and as safe as possible. Physiotherapy can help people with mobility transfers, whether this is moving in bed, standing from a chair, or getting in and out the car. These transfers can become more difficult as the disease progresses, and physiotherapy can help support individuals to make these transfers as safe as possible whilst maintaining dignity and independence where possible.

They can also help in other ways such as prescribing exercises to help maintain fitness, balance, strength, and posture which are essential as the disease progresses to maintain a good quality of life. This also contributes to preventing and managing falls risks. Falls risk is high for people with Parkinson’s Disease especially with those who suffer from gait disturbances such as freezing and festinating gait patterns. A physiotherapist can teach verbal cueing techniques to overcome gait freezing and reduced stride length.

Please see our blogs on falls prevention for other additional tips that you can deploy around your own home to prevent falls.

Parkinsons Disease can lead to a multitude of physical pain. A physiotherapist can use a variety of techniques including manual therapy, acupuncture, and exercises such as stretching to help ease musculoskeletal pain. However, it is important to remember that not all the pain experienced may be Parkinson’s Disease related and could be another condition such as arthritis. A good explanation of symptoms experienced to the physiotherapist will ensure they can provide you with good and effective treatment.