Evidence Based Practice - Parkinson's Disease Flashcards
Why should large-amplitude, whole-body movements be performed?
Makes patients perform bigger, faster and more precise movements
Improves proprioception due to patients mentally focusing on the amplitude of the movement
Helps to restore normal movement patterns if performed intensively - by reversing hypokinesia
What areas of education should be highlighted in Parkinson’s Disease
Self-management strategies
Prevention of inactivity
Prevention/fear of falling
Disease-specific education
Why does education improve treatment outcomes?
Empowers patients to take a role in their care
Improves engagement and self-efficacy
What is the goal of exercise in early-stage Parkinson’s?
Improve stability
Improve activity levels
What is the goal of exercise in late-stage Parkinson’s?
Improve Transfers
Improve mobility
Improve postural control
What type of exercises should be implemented?
Endurance training
Resistance training
Balance training (e.g. tai chi, dancing)
Why does exercise improve treatment outcomes?
Maximises functional activity
Limits deconditioning
Reduces risk of secondary complications
What type of endurance training is required and why?
Intensive, complex and powerful endurance training - i.e. high repetitions of difficult movements
Important as has a neuroprotective effect if initiated soon after diagnosis
Why is balance re-training important?
Helps to prevent falls which will improve QoL and reduce risk of secondary complications
How many repetitions and why?
As high as possible (100s of reps) - as it improves the fluency of the motor skill via motor learning
Why should exercises be context/task-specific?
Improves engagement and therefore improves motor leaning
why are dual tasks important?
increased complexity of the task –> increased cognitive engagement –> improves motor learning
what is an example of dual-task in Parkinson’s?
walking and talking
how does mental imagery help with tasks?
Utilises the visual cortex to access the motor pathway - therefore reducing the reliance on basal ganglia
how is whole-part-whole effective for Parkinson’s disease?
Breaking the task down into individual segments requires cognitive problem-solving. The patient is then given a defined sequence to complete the task - under conscious control - reduces the automaticness of movements
what type of cues can be given?
visual (e.g. a strip on the floor)
auditory (e.g. metronome to step to)
tactile (e.g. rocking from side to side before taking a step)
How to cues help with movement in Parkinson’s disease?
Compensation for the lack of internal generation of movement - use of the premotor & parietal cortex and the cerebellum to generate movement
what is an attentional strategy?
asking the patient to actively focus on the task (e.g. think about taking a bigger step, or think about making a wider arc as you turn)
what is the benefit of attentional strategies?
Compensation - the movement is generated by the executive process - using the frontal and prefrontal pathways
Why is group exercise beneficial?
- Improves social interaction between patients who may be withdrawn due to their illness
- Allows patients to discuss and ask questions about their symptoms & management strategies with their peers
- Shows newly diagnosed patients the importance of exercise
what type of strength training should be employed?
Strength training against an external resistance (cycle ergometer, weight machines, therapeutic putty, elastic band, weight cuffs)
How should posture be improved?
Encourage upright standing by strengthening the back and hip extensors
why should posture be trained?
Stooped posture increases the risk of falls - by improving posture we can reduce the risk of falls
