Lecture 21 Parkinson's disease

Question 1

Overview of Parkinson’s disease

Answer 1

significant effects on motor function
basal ganglia is affected
5 nuclei deep in brain
degeneration in cells, decrease in release of dopamine

Question 2

Hallmark symptoms of parkinsons diseasae

Answer 2

Rest tremor
stiffness (rigidity)
slowness (bradykinesia)
Postural instability and falls

Question 3

Postural instability and falls in PD are ____

time

Answer 3

typically associated with later stages of PD

Question 4

Falls occur in ____ of patients with PD

Answer 4

35-90

Question 5

PD patients are ____ to fall than age-matched controls

Answer 5

3 times more likely

Question 6

Likelihood of falls in those with PD ___

Answer 6

increases with duration of disease

Question 7

individuals with PD more likely to fall ____

causes

Answer 7

intrinsically, due to internal factors not external

Question 8

During the Functional Reach Test, individuals with PD see

Answer 8

decreased limits of stability

Question 9

individuals with PD have stability limits due to

Answer 9

stooped posture
increased rigidity
impaired anticipatory postural preparation

Question 10

During the retropulsion test, individuals with PD

Answer 10

see multiple, small shuffling, steps
often leads to imbalance

Question 11

What are the effects of PD on COP and COM

Answer 11

increased medio-lateral amplitude
increased frequency or velocity

Question 12

Instability _____ by medication and surgical treatments for PD

effectivness

Answer 12

UNAFFECTED
- provide little improvement
-possible to even have a negative effect

Question 13

APAs are ___ during step initiation in PD

Answer 13

altered
APA significantly smaller in amplitude
only present in self generated movements

Question 14

Providing an additonal sensory cue to individuals with PD can

Answer 14

increase the amplitude of their APA and trigger them to be faster

Question 15

APA are ____ during rise to toes in PD

Answer 15

altered
very small amplitude APA
slower movement of COM, go less far forward
still no improvement when on medication

Question 16

Effects of PD on Dynamic balance reactions

Answer 16

larger amplitude responses
Co-activation/stiffening (falling like a single log)
poor adaptability (postural inflexibility)

Question 17

PD effects on compensatory reactions

step

Answer 17

King et al 2008
* taking a lateral step
* Step length is drastically shorter in PD
* step duration is shorter than control, slow in velocity
* longer latency
* no improvements when on medication

Question 18

When can postural inflexibility be observed in individuals with PD?

Answer 18

similar patterns are generated even though switches in scenarios are evident
* between amplitudes
* between types of perturbation types (translations to rotations)
* between postures

Question 19

Anxiety affects up to _____ of patients with PD

Answer 19

60%

Question 20

Fear of falling reported by ____ of patients with PD

Answer 20

46%
lead to inactivity
occurance of falls

Question 21

effects of fear/anxiety on balance in PD

Answer 21

decreased amplitude, increased frequency of COP sway and backward shift or lean away from edge

Question 22

Dual task effects in PD

Answer 22

larger amplitude of sway
significant interference with balance control
great difference in PD fallers and Non fallers