Parkinson's Disease (PD) Flashcards
(31 cards)
What are some common difficulties in gait with patients who have Parkinson’s disease?
- Reduced walking speed / Shuffling steps
- Bradykinesia
- Freezing
- Festination
- Difficulty turning
- Reduced arm swing
- Weakness
- Sensory loss
What is the 2nd most common neurodegenerative disorder in the world?
Parkinson’s disease
Is Parkinson’s disease more common in men or women?
Men
What is Parkinson’s disease?
Complex & progressive disorder characterised by various motor and non-motor symptoms
What are some features of Parkinson’s disease?
- Resting tremor
- Rigidity
- Postural instability
- Bradykinesia
What part of the brain does Parkinson’s disease affect?
Basal Ganglia
What are the (3) different dopamine pathways?
- Mesocortical
- Nigrostriatal
- Mesolimbic
What does the mesocortical dopaminergic pathway effect?
-Cognition
- Memory
- Attention
- Emotion
- Behaviour
- Learning
What does the nigrostriatal dopaminergic pathway effect?
Movement Control
What does the mesolimbic dopaminergic pathway effect?
- Pleasure
- Reward seeking behaviours
- Addiction
- Emotion
What are some of the main criteria to be diagnosed with Parkinson’s disease?
- Bradykinesia
- Stiffness
(and/or) - Tremor
- Balance & gait disorder
What are the (3) stages of Parkinson’s disease?
- Preclinical: neurodegeneration presentbut asymptomatic
- Prodromal Parkinson’s Disease:motor and non-motorsymptoms arepresent with clinical diagnosis
- Clinical Parkinson’s Disease: dopamine-responsive with bradykinesia
How is gait affected in Parkinson’s Disease?
- COG anterior
- Short steplength
- Flexed posture
- Reduced arm swing
- Hypokinetic
- Festinating
How does bradykinesia present in Parkinson’s Disease?
Slowness of movement:suppression of movement in the cortex due toincrease inhibition
How does rigidity present in Parkinson’s Disease?
Stiffness: typicallylead-pipeor cogwheelin the presence of a tremor, due to depletion of dopamine
How does a tremor present in Parkinson’s Disease?
Primarily resting ‘pill rolling’
How does postural instability present in Parkinson’s Disease?
Flexed posture
What are some of the less recognised early presentations of Parkinson’s disease?
- Handwriting
- Loss ofsmell
- Slow initiation
- Freezing
- Festination
- Dyskinesia
- Dystonia
What are some non-motor features of Parkinson’s disease?
- Neuropsychiatric symptoms: Depression, Anxiety
- SleepDisorders:restless legs,insomnia
- AutonomicSymptoms: bladder andbowel,excessive sweating, sexual dysfunction
- Gastrointestinal:constipation
- Dribbling (difficulty managing their saliva)
- Sensory Disturbances: pain
- Fatigue
- Nutritional issues / weight loss
What are (2) medical managements of Parkinson’s disease?
- Levodopa (dopamine)
- Deep brain stimulation surgery
What are non-medical managements of Parkinson’s disease?
Team management is key
- Enable activity
- Enable participation
- Quality of life
- Symptom control
What can we offer as physios for patients with Parkinson’s disease?
- Self-management
- Prevent inactivity
- Prevent fear to move andfalling
- Improve physical capacity
- Reduce pain
- Delay onset activity limitations
- Functional ability: transfers, gait, manual activity
- Maintain vital functions
- Prevent pressure sores
- Prevent contractures
- Support carers
What are some things to consider during a Parkinson’s disease assessment?
- Drug history: timing of medication is vital
- Expectations and goals
- Carer support
- Falls
- Non-motor symptoms
What are some elements of objective assessment to complete for patients with Parkinson’s disease?
- Observation during functional activities: tremor, dyskinesia, bradykinesia, balance
- Range of movement and activity/power: trunk, LL and UL.
- When assessing tone feel for - Rigidity- axial rotation, LL, UL
- Sensation and proprioception
- Coordination
- Balance: perturbation,reactions, visual input
- Gait:freezing,dual tasking,outdoor/ uneven
- Functional: on/off floor,rolling, ly-sit,running, cycling, R&G,car transfers
- Confounding factors: processing speed, problem solving, pain, fatigue
- Respiratory function and pain management if appropriate
