Flashcards in PD - Nature of Impairment and Clinical Implications of Research Findings Deck (11):
What is PD and what does it affect?
PD = neurodegenerative disease affecting many parts of the CNS including the basal ganglia; pt's lose the ability to perform automated tasks without directing attention to them
Primary motor impairments in PD?
T = Tremor
R = rigidity
A = akinesia (brady/hypo) - worse with movement+dual tasking
P = postural instability
Morris et al (1994) - examined bradykinesia and hypokinesia during gait in people with PD. What did that find?
Normal walking at preferred speed: reduced velocity (bradykinesia) and reduced stride length (hypokinesia); cadence is increased but the OVERALL effect is still reduced velocity
Fast walking: PD mainly increases cadence not stride length in order to walk faster
Walking with auditory cue (metronome): they can match cadence to auditory cue but this alone doesn't do anything for stride length or velocity
Morris et al (1994) - TAKE HOME MESSAGE
Speed is reduced mainly d/t a reduction in STRIDE LENGTH and compensated for by an increase in CADENCE
So you see short steps, slow walk, increased cadence
Akinesia (freezing) - when do you get it?
- initiating standing, walking, rolling over
- dual tasks
- end of medication
MORE LIKELY in narrow doorways or in busy environments
Define freezing of gait
- feeling that feet are glued to the floor when walking through narrow spaces, making a turn, initiating walking, crowded spaces
- can be accompanied by trembling of the legs + small shuffling steps
Secondary motor impairments in PD?
Dystonia (thought to be related to L-dopa use) - painful and abnormal mm contractions resulting in abnormal postures
MM weakness + reduced power
Name some activities that are limited by impairments of PD
Reaching, holding, and manipulating objects
What does the UPDRS test and what are teh components?
1. Action tremor
2. Finger taps
3. Hand grips
4. Hand pron/sup
5. Heel taps
6. Postural instability test
7. Rising fromchair
8. Rigidity of neck
9. Compensatory stepping correction (trust test)
What are some tools to assess for ACTIVITY LIMITATIONS in PD (and MS and MND)
9 hole peg test