Lecture 21 Parkinson's disease Flashcards
Overview of Parkinson’s disease
significant effects on motor function
basal ganglia is affected
5 nuclei deep in brain
degeneration in cells, decrease in release of dopamine
Hallmark symptoms of parkinsons diseasae
Rest tremor
stiffness (rigidity)
slowness (bradykinesia)
Postural instability and falls
Postural instability and falls in PD are ____
time
typically associated with later stages of PD
Falls occur in ____ of patients with PD
35-90
PD patients are ____ to fall than age-matched controls
3 times more likely
Likelihood of falls in those with PD ___
increases with duration of disease
individuals with PD more likely to fall ____
causes
intrinsically, due to internal factors not external
During the Functional Reach Test, individuals with PD see
decreased limits of stability
individuals with PD have stability limits due to
stooped posture
increased rigidity
impaired anticipatory postural preparation
During the retropulsion test, individuals with PD
see multiple, small shuffling, steps
often leads to imbalance
What are the effects of PD on COP and COM
increased medio-lateral amplitude
increased frequency or velocity
Instability _____ by medication and surgical treatments for PD
effectivness
UNAFFECTED
- provide little improvement
-possible to even have a negative effect
APAs are ___ during step initiation in PD
altered
APA significantly smaller in amplitude
only present in self generated movements
Providing an additonal sensory cue to individuals with PD can
increase the amplitude of their APA and trigger them to be faster
APA are ____ during rise to toes in PD
altered
very small amplitude APA
slower movement of COM, go less far forward
still no improvement when on medication
Effects of PD on Dynamic balance reactions
larger amplitude responses
Co-activation/stiffening (falling like a single log)
poor adaptability (postural inflexibility)
PD effects on compensatory reactions
step
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
When can postural inflexibility be observed in individuals with PD?
similar patterns are generated even though switches in scenarios are evident
* between amplitudes
* between types of perturbation types (translations to rotations)
* between postures
Anxiety affects up to _____ of patients with PD
60%
Fear of falling reported by ____ of patients with PD
46%
lead to inactivity
occurance of falls
effects of fear/anxiety on balance in PD
decreased amplitude, increased frequency of COP sway and backward shift or lean away from edge
Dual task effects in PD
larger amplitude of sway
significant interference with balance control
great difference in PD fallers and Non fallers
