Parkinsons disease problem list

Question 1

Impaired Mobility and Gait

Answer 1

*Evidence: Shuffling, festinating gait; minimal arm swing; freezing when turning or walking through doorways; history of minor falls.
*Cause: Bradykinesia, rigidity, and postural instability due to basal ganglia dysfunction and dopamine depletion.
*Impact: Increased fall risk, reduced confidence and independence in mobility.

Question 2

Postural Instability and Poor Balance

Answer 2

*Evidence: Hesitation when navigating obstacles; forward-leaning posture; needs support for sit-to-stand; falls.
*Cause: Impaired motor control and diminished postural reflexes from basal ganglia degeneration.
*Impact: Reduced safety in ADLs, dependence on caregiver, risk of injury.

Question 3

Postural Deformities

Answer 3

*Evidence: Thoracic kyphosis, neck protraction, forward head posture.
*Cause: Muscle rigidity and long-term altered movement patterns.
*Impact: Breathing and swallowing difficulties, worsened balance, pain/discomfort.

Question 4

Tremor and Reduced Fine Motor Control

Answer 4

*Evidence: Resting tremor in right hand; difficulty using cutlery.
*Cause: Disruption in basal ganglia motor loop and reduced dopaminergic control.
*Impact: Challenges with self-feeding, dressing, handwriting, and other ADLs.

Question 5

Difficulty with Transfers (e.g., Sit-to-Stand)

Answer 5

*Evidence: Requires wife’s assistance to stand.
*Cause: Bradykinesia, reduced lower limb strength, and impaired motor planning.
*Impact: Decreased independence, caregiver strain, fall risk.

Question 6

Cognitive Load / Dual Tasking Difficulty

Answer 6

*Evidence: Risk of freezing and falls when navigating complex tasks or environments.
*Cause: Cognitive-motor interference common in PD.
*Impact: Risk of accidents, confusion during ADLs, reduced task performance.