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Parkinson’s Disease : Occupational Therapy

Help Educate your Client on PD

  •  Generally normal life expectancy – slowly progressive – but the rate varies between persons and that is why ongoing therapy is recommended for motor and cognitive symptoms associated with PD

 

  • Degeneration caused by clusters of ‘Lewy Body Proteins’ with the brain cells, primarily impacting the basal ganglia (gray matter that contributes to complex movements). The substantia Niagara becomes depigmented which impacts dopamine production. This is why individuals with this diagnosis will take dopaminergic medication like levodopa.
      • The basal ganglia is associated with the function of sensitivity to rewarding outcomes. Bradykinesia largely presents due to the implicit desire to chose the path of least resistance. When you don’t have function in the part of your brain that can see the trade-off between reward and effort, you have no innate desire to move quickly—which results in absence of high-speed movements. You need the external cue/command. [1]

Stages [2]

Stage one: Symptoms affect only one side of the body.

Stage two: Symptoms begin affecting both sides of the body, but balance is still intact.

Stage three: Symptoms are mild to moderate and balance is impaired, but the person can still function independently.

Stage four: Symptoms cause severe disability, but clients can still walk or stand without assistance.

Stage five: Symptoms cause the client to become wheelchair-bound or bedridden, unless assisted.

9 Dimensions of Wellness - Buffalo Occupational Therapy

Symptoms and Clinical Presentation of PD

Symptoms and Clinical Presentation

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Evaluations and Progress Notes for Parkinson’s Disease

(S) Subjective

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(O) Objective

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(A) Assessment

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(P) Plan

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General Treatment Ideas for Parkinson’s Disease

Person

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Environment

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Occupation

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Research Approach Ideas

Research Approach Ideas

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References

References
  • Summa, S., et al., Adaptive Training with full-body movements to reduce bradykinesia in persons with Parkinson’s disease: a pilot study. Journal of NeuroEngineering and rehabilitation, 2015. 12.
  • Mahle, A.J. and A.L. Ward, Adult Physical Conditions: Intervention Strategies for Occupational Therapy Assistants. 2019, Philadelphia, PA: F.A.Davis. 1057.
  • David, F.J., et al., Progressive resistance exercise restores some properties of the triphasic EMG pattern and improves bradykinesia: the PRET-PD randomized clinical trial. Journal of neurophysiology, 2016. 116(5): p. 2298-2311.
  • Rodger, M.W.M. and C.M. Craig, Beyond the Metronome: Auditory Events and Music May Afford More than Just Interval Durations as Gait Cues in Parkinson’s Disease. Frontiers in neuroscience, 2016. 10: p. 272-272.
  • Rodriguez-Blazquez, C., et al., The MDS-UPDRS Part II (motor experiences of daily living) resulted useful for assessment of disability in Parkinson’s disease. Parkinsonism & related disorders, 2013. 19(10): p. 889-893.
  • Dibble, L.E., et al., High intensity eccentric resistance training decreases bradykinesia and improves quality of life in persons with Parkinson’s disease: A preliminary study. Parkinsonism & related disorders, 2009. 15(10): p. 752-757.
  • Huang, C.-Y., et al., Improving Dual-Task Control With a Posture-Second Strategy in Early-Stage Parkinson Disease. Archives of physical medicine and rehabilitation, 2018. 99(8): p. 1540-1546.e2.
  • Tollár, J., et al., A High-Intensity Multicomponent Agility Intervention Improves Parkinson Patients’ Clinical and Motor Symptoms. Archives of physical medicine and rehabilitation, 2018. 99(12): p. 2478-2484.e1.
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