Flashcards in Parkinsons Deck (22)
What is parkinsons?
Chronic and progressive movement disorder that makes the patient unable to control movement normally
What happens in parkinsons
Malfunction and death of cells in substantia nigra (dopamine producing cells)
What's the causes parinsons?
Unknown in most cases
What's the prevalence of parkinsons?
Primary- 78% (don't know how it happened)
Secondary- 8% (drugs, trauma, infection, toxins)
What's the typical parkinsons pt
Adult - 65-75 y/o
Male > Female
Dyskinesia (bradykinesia / hypokinesia), Small involuntary
Dystonia- (Difficulty initiating movement) involuntary muscle cramps
What is an essential tremor?
Tremor with no other signs of PD
What are some assessment tools for PD?
Hoehn & Yahr Scale
What are the Hoehn and Yahr's stages of PD
Stage 0 - no signs
Stage 1 - unilateral disease
Stage 1.5 - Unilateral plus axial movement
Stage 2 - Bilateral disease, w/o balance impairment
Stage 3 - Mild to moderate bilateral disease, postural instability; capacity of living indep. still
Stage 4 - Still able to walk or stand unassisted but unstable
Stage 5 - Wheelchair bound or bedridden w/o assist
What are some treatment approaches for PD?
Surgical - Deel Brain stim, Ablation, Transplantation
Pharmacological - Symptomatic, Neuroprotective
Nonpharmacologic - Education, Nutrition, Exercise
What is the goal of meds in treating PD?
Restore lost dopamine function
-adds synthetic dopamine
Stimulate dopamine receptors
stimulate release of remaining dopamine
inhibit enzyme that breaks dopamine down
What is L-dopa?
Synthetic version of dopamine
What does deep brain stimulation do?
Electrically stimulates the area around the electrode thus activating or inhibiting brain tissue depending on parameters
What does DBS help with?
Speech (can also hurt)
Balance (can also hurt)
What are complications to DBS?
Doesn't cure PD
Inter-operative (hemorrhage, infection)
Perioperative (weakness, fatigue, confustion, mood changes)
Hardware-related (Erosion, lead fracture)
What are some key areas of intervention with PD?
-Fall prevention, self-care, community included
What are some outcomes for therapy in pt c PD?
Minimize/ delay functional limitations leading to disability
pt understanding of disease
pt caregiver integration of appropriate intervention strategies
Where do you want to stretch and strengthen the pt
Stretch the front (neck flexors, pecs, biceps, flexors
Strengthen the back (axial retractors, extensors,
What are some exercises not recommended?
What are some areas of functional impairment?
Turning in bed
sit to stand
gait (festination (shuffling gait), akinesia, freezing)
What is festinating gait?
Short step length
Lack of DF on heelstrike
absent counter rotation of trunk
loss of reciprocal arm swing
What are some things you can do to help with gait training?