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Flashcards in Evidence Based Practice - Parkinson's Disease Deck (23)
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1

Why should large-amplitude, whole-body movements be performed?

Makes patients perform bigger, faster and more precise movements

Improves proprioception due to patients mentally focusing on the amplitude of the movement

Helps to restore normal movement patterns if performed intensively - by reversing hypokinesia

2

What areas of education should be highlighted in Parkinson's Disease

Self-management strategies

Prevention of inactivity

Prevention/fear of falling

Disease-specific education

3

Why does education improve treatment outcomes?

Empowers patients to take a role in their care
Improves engagement and self-efficacy

4

What is the goal of exercise in early-stage Parkinson's?

Improve stability
Improve activity levels

5

What is the goal of exercise in late-stage Parkinson's?

Improve Transfers
Improve mobility
Improve postural control

6

What type of exercises should be implemented?

Endurance training
Resistance training
Balance training (e.g. tai chi, dancing)

7

Why does exercise improve treatment outcomes?

Maximises functional activity
Limits deconditioning
Reduces risk of secondary complications

8

What type of endurance training is required and why?

Intensive, complex and powerful endurance training - i.e. high repetitions of difficult movements

Important as has a neuroprotective effect if initiated soon after diagnosis

9

Why is balance re-training important?

Helps to prevent falls which will improve QoL and reduce risk of secondary complications

10

How many repetitions and why?

As high as possible (100s of reps) - as it improves the fluency of the motor skill via motor learning

11

Why should exercises be context/task-specific?

Improves engagement and therefore improves motor leaning

12

why are dual tasks important?

increased complexity of the task --> increased cognitive engagement --> improves motor learning

13

what is an example of dual-task in Parkinson's?

walking and talking

14

how does mental imagery help with tasks?

Utilises the visual cortex to access the motor pathway - therefore reducing the reliance on basal ganglia

15

how is whole-part-whole effective for Parkinson's disease?

Breaking the task down into individual segments requires cognitive problem-solving. The patient is then given a defined sequence to complete the task - under conscious control - reduces the automaticness of movements

16

what type of cues can be given?

visual (e.g. a strip on the floor)
auditory (e.g. metronome to step to)
tactile (e.g. rocking from side to side before taking a step)

17

How to cues help with movement in Parkinson's disease?

Compensation for the lack of internal generation of movement - use of the premotor & parietal cortex and the cerebellum to generate movement

18

what is an attentional strategy?

asking the patient to actively focus on the task (e.g. think about taking a bigger step, or think about making a wider arc as you turn)

19

what is the benefit of attentional strategies?

Compensation - the movement is generated by the executive process - using the frontal and prefrontal pathways

20

Why is group exercise beneficial?

1. Improves social interaction between patients who may be withdrawn due to their illness

2. Allows patients to discuss and ask questions about their symptoms & management strategies with their peers

3. Shows newly diagnosed patients the importance of exercise

21

what type of strength training should be employed?

Strength training against an external resistance (cycle ergometer, weight machines, therapeutic putty, elastic band, weight cuffs)

22

How should posture be improved?

Encourage upright standing by strengthening the back and hip extensors

23

why should posture be trained?

Stooped posture increases the risk of falls - by improving posture we can reduce the risk of falls