L30: Physiotherapy Assessment of Parkinson's Disease

Question 1

_______ can vary throughout the day for PD patients.

Answer 1

Movement disorders

Question 2

What is the on and off phase for PD?

Answer 2

Assess at maximum dose “on” phase and 15 minutes before next dose “off” phase

Question 3

What are the 2 things for the minimum data set for PD?

Answer 3

1. Subjective Assessment
2. Objective Assessment

Question 4

What is the minimum data set?

Answer 4

Minimum assessment to do.

Question 5

What are 5 characteristics of of the subjective assessment for PD?

Answer 5

1. Hoehn & Yahr stage of disease
2. Disease subtype
3. PD medication dose and frequency
4. Name & specialty of the doctor managing their PD
5. Limitations of activities & impairments

Question 6

What are 5 characteristics of of the objective assessment for PD?

Answer 6

1. TUG: Comfy, fast, count, words
2. Timed straight walk (10 m)
3. Marsden pull
4. Hold & release
5. Spiral test of hand function

Question 7

What are 8 characteristics of functional assessment (measure time taken to perform functional movements) for PD?

Answer 7

1. Gait
2. Balance
3. Manipulation
4. Sit to stand
5. Turning
6. Stair climbing
7. Dressing
8. Bed mobility

Question 8

What are 7 characteristics of functional assessment (look for the influence of the critical movement disorders) for PD?

Answer 8

1. Hypokinesia
2. Akinesia
3. Dystonia
4. Tremor
5. Rigidity
6. Postural instability
7. Dyskinesia

Question 9

What are 4 gait tests for functional assessment for PD?

Answer 9

1. 10m walk test
   
   • Velocity
   • Stride length
   • Cadence
2. TUG, TUGM, TUGC: Dual task TUG to determine influence of secondary task
3. Dynamic gait index

Question 10

What are 4 balance tests for functional assessment for PD?

Answer 10

1. Observe use of balance strategies
2. Functional objective balance tests
   
   1. External perturbation (must do!): Hold & release, Marsden pull
   2. Timed quiet stance
   3. Functional reach
   4. BBS
   5. Mini-BEST test
3. Identify common activities associated with falls: e.g.Turning, dual task, confined space, crowds
4. Home assessment
   
   • Identify risk areas
   • Improve home safety

Question 11

What are 4 grades of UPDRS #29 (gait)?

Answer 11

Question 12

What are 4 grades of UPDRS #30 (postural stability)?

Answer 12

Question 13

What are 7 other assessments of PD?

Answer 13

1. Freezing of gait: N-FOG-Q
2. Fine motor: 9 hole peg test, shirt buttoning (timed)
3. Posture: Kyphosis - measure distance from occiput to wall
4. Muscle strength: 5x STS, MMT/dynamometry
5. Joint AROM & PROM
   
   • Habitual posture forward F + IR
   • Limited hip & knee E, shoulder ER, spine E
6. Fitness: 6 min walk test
7. Respiratory function: FEV1 and FVC, Respiratory pattern