Parkinson’s: symptoms, treatment, and the key role of physical therapy in improving quality of life
What is Parkinson’s?
Parkinson’s disease (PD) is a neurodegenerative disorder related to the loss of dopaminergic innervation in the substantia nigra (basal ganglia).
It is known that there are other altered circuits, structures, and neurotransmitters that may explain the broad spectrum of symptoms of the disease.
The prevalence of Parkinson’s has doubled in the last 25 years, with global estimates in 2019 showing more than 8.5 million people affected (WHO, 2022).
The precipitating cause is unknown, although it is probably multifactorial, with biological, genetic, environmental, and aging factors possibly involved.
Motor symptoms: Resting tremor, bradykinesia, rigidity, postural instability.
Non-motor symptoms: Neuropsychiatric disorders, autonomic disorders, sensory disorders, sleep disorders.
Objectives of physical therapy in Parkinson’s disease.
To improve the person’s quality of life, trying to slow the progression of the disease and minimizing the impact of the natural progression of symptoms
in their work, social, and family environments.
How do we do it?
Work on the quality of movements and coordination.
Work on elasticity, strength, and muscle tone.
Posture re-education.
Training in straightening and
balance reactions.
Maximizing functional capacity and independence in ADLs.
Gait training.
In more detail, we work as follows:
1. Initial assessment
Clinical interview: Collects information on motor symptoms (tremor, rigidity, bradykinesia) and non-motor symptoms (sleep disorders, fatigue, pain, depression).
Functional assessment: Uses scales such as the UPDRS (Unified Parkinson’s Disease Rating Scale), Tinetti test, and Timed Up and Go (TUG).
Gait and balance analysis: Observe freezing, festination, and risk of falls.
Respiratory assessment: Assess lung capacity and chest mobility.
2. Design of therapeutic objectives
Improve mobility and independence in daily activities.
Re-educate gait and posture.
Strengthen muscles and improve flexibility.
Train balance and prevent falls.
Optimize respiratory function.
Reduce stiffness and bradykinesia.
Teach relaxation and self-control techniques.
3. Physiotherapy intervention
a. Therapeutic exercise
Joint mobility: Active and passive exercises to maintain range of motion.
Muscle strengthening: Focused on lower extremities and trunk.
Gait training: Use of visual and auditory cues to improve cadence and stride length.
Balance: Exercises on unstable surfaces and changes of direction.
https://www.parkinson.org/library/espanol/fact-sheets/recomendaciones-ejercicio
b. Complementary therapies
Relaxation techniques: Diaphragmatic breathing and autogenic training.
Sensory stimulation: Use of textures and vibrations to improve proprioception.
c. Education and counseling
Teach strategies to overcome motor blocks.
Advise on home adaptations to improve safety.
Instruct family members and caregivers in assistance and mobilization techniques.
https://unamglobal.unam.mx/global_tv/concluyen-el-proyecto-cerebro-humano/
4. Follow-up and reassessment
Schedule regular sessions to assess progress and adjust the treatment plan.
Use the same assessment scales to measure the effectiveness of treatment.
🏠 What about exercising at home?
Essential! A professionally guided and adapted exercise routine can make all the difference. Walking to music, climbing stairs, doing gentle yoga or stretching… it all helps.
🔑 Consistency > Intensity
❤️ Living with Parkinson’s, but also with movement
Parkinson’s can slow you down in many ways, but it doesn’t have to stop your life. With a multidisciplinary approach—where physical therapy plays a key role—it is possible to:
✔ Maintain your independence
✔ Reduce the impact of symptoms
✔ Reconnect with your body and your abilities