The role of Physiotherapy in Parkinson’s disease

Physiotherapy has a key role in patients with Parkinson’s disease. The overall goal is to preserve functional independence as long as possible, resulting in a better quality of life.

Physiotherapy tries to achieve the patient’s maximum physical capacity with appropriate training. We achieve this with an early application of a preventive exercise program. To personalize treatment, we perform a physiotherapeutic assessment to identify treatment priorities and monitor treatment progression.

This allows us to focus the physiotherapeutic intervention on the main motor problems and handicaps of the affected individuals. With the treatment we seek to change habits and the use of motor strategies based on the principles of psychomotor learning to alleviate motor deficits. A large part of the success of the treatment consists in achieving the involvement of the patient and his or her caregiver in the treatment, improving motivation and remaining very active.

Motor problems in Parkinson’s patients

– Bradykinesia is the slowness in initiating and executing movement.

– Hypokinesia. is the scarcity of movement.

– Postural disorders: it is known as simian posture, and is characterized by having the knees and hips slightly flexed, shoulders and head bent forward, leading to an anteriorization of the center of gravity.

– Gait disorders, which highlights the loss of arm movements when walking (brachiation); longitudinal decrease of the step, shuffling and slow course. The progressive loss of heel-toe, which is the correct way of stepping on the ground when taking a step. The phenomenon of “Festination”, which is the progressive increase in speed and decrease in stride length, with problems when braking the gait. Freezing during gait (freezing).

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– Rest tremor (4 to 6 Hz), defined as any involuntary rhythmic movement of a limb or body part. – Stiffness (cogwheel sign). This is the increased resistance to relatively slow passive movements, constant throughout and is not speed-dependent.

– Loss of postural reflexes.

– Postural instability.

– Micrographia. Tendency to write small

– Fine motor impairment.

Most common treatments or exercises

We must take into account that the treatment must be adapted to the needs of each individual. In general lines, we could orientate a treatment with the objectives of:

– Toning the musculature, mainly the antigravity.

– Elongate the musculature with a tendency to shorten or shorten.

– Teaching selective mobilization of the pelvic girdle.

– To teach the dissociation of the head-trunk and the shoulder girdle and pelvic girdle.

– Improve coordination of the upper and lower extremities.

– Improve posture.

– Improve static and dynamic balance.

– To teach movement strategies that will improve displacements and transfers.

– Improve fine motor skills.

Whether at home or in the office, it is recommended to perform physical exercise daily with a duration of 30 to 45 minutes. The goal is to stay active, no task should be performed to the limits of fatigue, it should be noted that you have worked but you can continue with your day to day. On the other hand, it is advisable to walk about 30 minutes a day. Parkinson’s sufferers should look for activities that motivate them, be it aquagym, pilates, dancing, going for a walk with friends… to maintain their independence as long as possible.