Final: Parkinson's Impairments Flashcards
What are the 4 cardinal motor symptoms associated with Parkinson’s?
- Tremor
- Rigidity
- Bradykinesia
- Postural instability
What is a tremor?
Involuntary oscillations resulting from contraction of opposing muscles
What are the 3 characteristics of early stage tremor?
- Distal hand or foot
- One side of the body
- Resting tremor
What are the 4 characteristics of late stage tremor?
- Increased severity
- Bilateral
- Action tremor
- Interferes with ADLs
What is rigidity?
Increased resistance to passive motion
Is rigidity velocity dependent?
No
What is cogwheel rigidity?
Jerky, ratchet-like resistance
What is lead pipe rigidity?
Sustained rigidity
How does rigidity progress over the course of the disease?
Proximal to distal and unilateral to bilateral. Increased severity
What are secondary complications associated with rigidity?
Contracture, postural deformity, fatigue, increased energy expenditure
What is braykinesia?
Insufficient recruitment of muscle force and under scale internally generated movements. Slowness of movement resulting in both increased reaction and movement time
What is hypokinesia?
Decreased movement, smaller amplitude, less movement, micrographia, decreased arm swing
What is akinesia?
Absence of movement, freezing, no arm swing
What are balance impairments associated with Parkinson’s?
Decreased limits of stability, slow anticipatory adjustments, poor reactive balance
What are posture impairments associated with Parkinson’s?
Decreased activation of antigravity muscles, flexed posture, COM located towards the forward limits of stability
What % of Parkinson’s pt’s have had a single fall in the past year?
70%
What % of Parkinson’s pt’s have had multiple falls in the past year?
50%
What are gait deviations associated with Parkinson’s?
Slow pace, increased variability and symmetry, poor postural control, decreased step size, reduced arm swing, reduced anticipatory postural alignment, turn en bloc
What is festination?
Unintentionally rapid short steps
What is freezing of gait?
Trembling or absent movement with the transient inability to take a step that is triggered by confrontation with competing stimuli
What types of pain are common with Parkinson’s?
Musculoskeletal, dystonic, neuropathic, radicular, central, akathisia, hypersensitivity more common in off state of medication
Is there primary sensory loss associated with Parkinson’s?
No
What sensory impairments are associated with Parkinson’s?
Pain, perception of kinesthesia and proprioception, visual perceptual deficits, oculomotor changes, olfactory dysfunction
What is a hallmark early clinical sign of Parkinson’s?
Decreased or loss of smell