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ClinEd 1 > MIDTERMS: Parkinson's Disease > Flashcards

MIDTERMS: Parkinson's Disease Flashcards

1
Q

Stiffness due to simultaneous contraction of opposing muscles, causing resistance to passive movement.

A

Rigidity

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2
Q

: Slowness of movement, difficulty initiating movements, and reduced arm swing and foot shuffling when walking.

A

Bradykinesia

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3
Q

Stooped posture, difficulty maintaining balance, and increased fall risk.
Postural Instability

A

Postural Instability

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4
Q

Resting “pill-rolling” tremors, typically starting in one hand, diminishing during voluntary movement and sleep, but progressing with the disease.

A

Tremors

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4
Q

Two sybgroups of Parkinson’s

A

Postural Instability Gait Disturbed (PIGD)
Tremor-Predominant (fewer issues with bradykinesia or postural instability).

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5
Q

What are the non-motor symptoms of Parkinson’s Disease?

A

Cognitive deficits: Dementia, bradyphrenia (slowed thinking).
Autonomic dysfunction: Excessive sweating, constipation.
Sleep disturbances: Insomnia, REM sleep disorder.

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5
Q

Pathophysiology of Parkinson’s Disease

A

Caused by the degeneration of dopaminergic neurons in the substantia nigra.
Results in reduced dopamine levels.
Lewy bodies are present in affected neurons.
Clinical symptoms only manifest after 30%-60% of neuron loss.

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6
Q

Motor Planning Issues in Parkinson’s Disease

A

Start hesitation
Freezing episodes
Poverty of movement
Impaired motor learning

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6
Q

Motor Function Impairments in Parkinson’s Disease

A

Masked face
Micrographia
Fatigue
Contractures & deformities
Impaired gait
Dysarthria
Dysphagia
Akathisia

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7
Q

Postural Issues in Parkinson’s Disease

A

Kyphotic posture
Increased risk of falls

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8
Q

Characteristics of Rigidity in Parkinson’s Disease

A

Increased resistance to passive motion regardless of speed
Felt in both agonist and antagonist muscles
Cogwheel and Leadpipe types of rigidity
Begins in shoulders/neck, progresses to face and extremities
Leads to contractures and postural deformities

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8
Q

Bradykinesia Features

A

Slowness of movement
Reduced speed, range, and amplitude of movements
Contributes to masked facial expression and micrographia
Decreased arm swing while walking

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9
Q

Cardinal Features of Parkinson’s Disease

A

Rigidity
Bradykinesia
Tremors
Postural Instability

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10
Q

Postural Instability in Parkinson’s Disease

A

Narrowing base of support
Rigidity and decreased trunk ROM
Stooped posture due to weakness of trunk extensor muscles

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10
Q

Hoehn & Yahr Classification of Disability in Parkinson’s Disease

(meaning of each stage 1-5)

A

Stage 1: Unilateral symptoms
Stage 2: Bilateral symptoms, no balance impairment
Stage 3: Balance impairment, still independent
Stage 4: Severe disability, can walk/stand unassisted
Stage 5: Wheelchair-bound or bedridden

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11
Q

What is the gold standard pharmacological treatment for Parkinson’s Disease (PD)?

A

Carbidopa/Levodopa.

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11
Q

Clinical Course of Parkinson’s Disease

A

Progressive with preclinical phase of 5-25 years
Mean duration of 10-20 years
Patients with PIGD subtype show more rapid progression

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11
Q

Unified Parkinson’s Disease Rating Scale (UPDRS)

(meaning of each part i-iv)

A

Part I: Non-motor experiences (e.g., mood, cognitive function)
Part II: Motor experiences (e.g., speech, eating)
Part III: Motor exam (e.g., rigidity, bradykinesia)
Part IV: Complications of therapy (e.g., dyskinesias)

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12
Q

What are some common medications used in the management of PD besides Carbidopa/Levodopa?

A

Dopamine agonists, COMT inhibitors, MAO-B inhibitors, anticholinergic agents, and Amantadine.

12
Q

When is the best time to perform physical therapy on a patient with PD taking dopamine replacement therapy?

A

During the optimal dosing cycle, when motor performance is at its peak.

13
Q

What is the primary focus of palliative care?

A

What is the primary focus of palliative care?

13
Q

Why should physical therapists be aware of the medications a PD patient is taking?

A

To monitor motor complications, assess optimal performance during peak medication dosage, and report any intolerances or motor fluctuations.

13
Q

What is the purpose of maintenance therapy in PD rehabilitation?

A

To maintain the patient’s current level of function, especially for those in the late stages of the disease.

13
Q

What diagnostic imaging is used to differentiate Parkinson’s Disease from essential tremor?

A

DaTscan, which measures dopamine transporter activity

13
Q

What does the Parkinson’s Disease Questionnaire (PDQ-39 or PDQ-8) measure?

A

Health-related quality of life across eight dimensions: mobility, ADL, emotional well-being, stigma, social support, cognition, communication, and bodily discomfort.

13
Q

What does the Parkinson’s Fatigue Scale (PFS-16) assess in PD patients?

A

The presence and impact of fatigue on daily life, focusing on physical and social aspects.

13
Q

What is the purpose of the Beck Depression Inventory (BDI) in PD?

A

To assess the severity of depression, including symptoms like hopelessness and physical symptoms like fatigue and loss of interest in daily activities.

14
Q

What are the core motor features required for a clinical diagnosis of PD?

A

Bradykinesia plus at least one of the following: resting tremor, rigidity, or postural instability.

14
Q

What is the purpose of the Hoehn-Yahr Classification Scale?

A

To chart the progression of PD using motor signs and functional status, from stage I (minimal disease) to stage V (severe deterioration).

14
Q

What cognitive domains does the Montreal Cognitive Assessment (MoCA) test in PD patients?

A

Memory, attention, language, visuospatial skills, and executive functioning.

14
Q

What recommendations are made for exercise in PD rehabilitation?

A

Short periods of non-fatiguing exercise, low repetitions, and increasing the activity’s difficulty as the patient improves.

15
Q

What does the Mini-BESTest evaluate in PD patients?

A

Balance control in conditions such as anticipatory adjustments, reactive postural control, sensory orientation, and dynamic gait.

15
Q

What type of exercises can help reduce muscle tension caused by rigidity in PD patients?

A

Relaxation exercises, such as gentle rocking and slow rhythmic rotational movements.

15
Q

What characterizes the early stage of rehabilitation for PD patients?

A

Patients are functional and independent with minimal impairments, and early intensive exercise may slow motor decline.

15
Q

: In the middle stage of PD rehabilitation, what happens to the patient’s independence?

A

Symptoms become more apparent, activity limitations emerge, and while patients may still be independent in gait and ADLs, their performance is slower and less efficient.

15
Q

What is a key focus during the late stage of PD rehabilitation?

A

The therapist needs to focus on preventive care to avoid secondary complications and provide compensatory training to maintain function.

15
Q

What is the focus of balance training for PD patients?

A

To improve center of mass (COM) and limits of stability (LOS), enhancing postural alignment and dynamic stability tasks.

15
Q

What is the goal of flexibility exercises in PD rehabilitation?

A

To improve range of motion (ROM) and physical function, using both static and dynamic stretching techniques.

16
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16
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16
Q

What are the goals of locomotor training in PD rehabilitation?

A

To reduce primary gait impairments and increase the patient’s ability to perform functional mobility activities safely.

16
Q

How can strengthening exercises benefit PD patients?

A

They improve muscle force, bradykinesia, functional mobility, balance, gait, fall risk, and quality of life.

17
Q

What types of activities are included in group and home exercises for PD patients?

A

Low impact aerobics, marching, recreational activities, and classes like yoga, Pilates, and Tai Chi.

17
Q
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17
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ClinEd 1 (14 decks)

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