Final: Parkinson's Intervention Flashcards
The POC is variable based on what four factors?
- Pt complaints and goals
- Assessment findings
- Prognosis
- Stage of disease
What does the current evidence support in terms of early intervention?
Combination of physical therapy and pharmacology management to maximize function, minimize secondary complications, provide education and support, slow progression of disability and disease
What are the effects of aerobic exercise in pt’s with PD according to the research?
Changes in excitation, gray matter volume, and neurotrophic factors. Lack clear biomarker for disease progression
What are benefits of endurance training for PD patients?
Improved VO2 max, gait speed, mood, motor function, QOL, cognition
What are the benefits of regular exercise in PD patients?
Better QOL, mobility, physical function, cognition, less disease progression at 1 yr follow-up
What aerobic exercise is appropriate for PD patients according to the CPG?
Mod-high intensity gait training
What motor learning strategies are useful for PD?
Part and blocked practice. Minimize distraction and use dual task to improve performance. Progress to random practice
What external cues are useful when treating PD?
Visual, auditory, pulsed. Rhythmical, consistent, not rushed. Encourages conscious motor pathway activation. Performance will deteriorate if cues are removed.
Why should PT’s use external cues with PD according to the CPG?
- Reduce motor disease severity
- Reduce freezing of gait
- Improve gait outcomes
How can auditory cues be effective?
Improved cadence, stride length, gait velocity
How can visual cues be effective?
Improved stride length
Why do individuals with PD freeze?
Often occurs during dual tasks, increased difficulty or in response to environmental demands
What are the parameters for training using RAS prior to FOG?
3x per week for 6 weeks Progressively increase challenge of course
What does RAS stand for?
Rhythmic auditory stimulation
What should you consider with amplitude training?
Cues for big movement and repetitive, high intensity amplitude training
What are the parameters for strength training for PD?
30-60 minutes, 2x per week. Performed during the on period following medication
Why should PD patient implement resistance training according to the CPG?
- Decrease motor disease severity
- Increase muscle strength and power
- Improve non-motor symptoms, functional outcomes and QOL
Should you target flexors of extensors more?
Extensors
Should you perform isometric training with PD patietns?
No because of rigidity
Does the CPG support flexibility training?
Expert opinion suggests it, but there is low quality evidence
What are methods to temporarily relax rigidity?
Gentle rocking, rhythmic rotation, segmental rotation, NDT and PNF techniques, breath work
Why should balance training be incorported into PD interventions according to the CPG?
- Decreased postural control impairments
- Improve balance, gait, mobility
- Increase balance confidence
- Improve QOL
Why should pt’s with PD perform gait training according to the CPG?
Decrease motor disease severity, improve stride length, gait speed, mobility, and balance
What are the goals of functional gait training?
Increase step length, increase gait speed, encourage reciprocal arm swing, improve upright alignment, vary task and environmental demands, use of compensatory strategies
What is one consideration to be mindful when fitting an assistive device for PD?
Height of the device should not promote flexion
What are pulmonary related interventions for PD?
Diaphragmatic breathing, air shift techniques, strengthening of accessory muscles, manual techniques, ROM, postural exercises
Why should PT’s recommend community based exercise for people with PD according to the CPG?
Reduce motor disease severity, improve non-motor symptoms, improve functional outcomes, improve QOL
What are types of community based exercises for PD, and what are the recommended parameters?
Yoga, tai chi, pilates, boxing, dance. 2x per week for 45-60 minutes. At least 12 weeks duration
