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PT 742 Common Medical Conditions > Parkinsons > Flashcards

Flashcards in Parkinsons Deck (22)
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1

What is parkinsons?

Neurodegeneration
Chronic and progressive movement disorder that makes the patient unable to control movement normally

2

What happens in parkinsons

Malfunction and death of cells in substantia nigra (dopamine producing cells)

3

What's the causes parinsons?

Unknown in most cases
gene mutations
environment
genes

4

What's the prevalence of parkinsons?

Primary- 78% (don't know how it happened)
Secondary- 8% (drugs, trauma, infection, toxins)

5

What's the typical parkinsons pt

Adult - 65-75 y/o
Male > Female
Tremor
Dyskinesia (bradykinesia / hypokinesia), Small involuntary
Rigidity
Dystonia- (Difficulty initiating movement) involuntary muscle cramps
Postural instability

6

What is an essential tremor?

Tremor with no other signs of PD

7

What are some assessment tools for PD?

Hoehn & Yahr Scale

8

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

9

What are some treatment approaches for PD?

Surgical - Deel Brain stim, Ablation, Transplantation
Pharmacological - Symptomatic, Neuroprotective
Nonpharmacologic - Education, Nutrition, Exercise

10

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

11

What is L-dopa?

Synthetic version of dopamine

12

What does deep brain stimulation do?

Electrically stimulates the area around the electrode thus activating or inhibiting brain tissue depending on parameters

13

What does DBS help with?

Tremors
Stiffness
Freezing
Speech (can also hurt)
Balance (can also hurt)

14

What are complications to DBS?

Doesn't cure PD
Inter-operative (hemorrhage, infection)
Perioperative (weakness, fatigue, confustion, mood changes)
Hardware-related (Erosion, lead fracture)

15

What are some key areas of intervention with PD?

Therapeutic exercise
-aerobic conditioning
-Strengthening
-Posture
-ROM
-Balance
Functional Training
-Fall prevention, self-care, community included

16

What are some outcomes for therapy in pt c PD?

Minimize/ delay functional limitations leading to disability
Secondary prevention
pt understanding of disease
pt caregiver integration of appropriate intervention strategies

17

Where do you want to stretch and strengthen the pt

Stretch the front (neck flexors, pecs, biceps, flexors
Strengthen the back (axial retractors, extensors,

18

What are some exercises not recommended?

Biceps
ABD
Pecs
SLR

19

What are some areas of functional impairment?

Turning in bed
sit to stand
falling
gait (festination (shuffling gait), akinesia, freezing)

20

What is festinating gait?

Short step length
Lack of DF on heelstrike
absent counter rotation of trunk
loss of reciprocal arm swing

21

What are some things you can do to help with gait training?

Treadmill training
Auditory cues
Visual cues
Verbal Cues

22

What are some un-freezing strategies?

Try stepping over cracks on sidewalk
Try mimic others walking
Carry walking stick and place in front of you as target
Relax, rock back on heels and try again
Tap the leg you want to move forward