Neuro- Parkinsons Flashcards
What is Parkinson’s Disease?
A chronic, progressive, neurodegenerative disorder resulting from the degeneration of dopamine producing neurones in the substantia nigra of the basal ganglia.
What are the cardinal signs of Parkinson’s?
- Bradykinesia
- Rigidity
- Resting tremor
- Postural instability
What are common secondary clinical symptoms of Parkinson’s?
- Difficultly initiating and terminating movement
- Fatigue
- Freezing
- ‘Festinating’ gait pattern
- Sleep disorders
- Swallow dysfunction (dysphagia)
- Anxiety & depression
What is the role of the Basal Ganglia?
- Well-learned motor skills & movement sequences
- Preparation and planning
- Initiation and termination
- Sequencing and timing
- Regulating muscle tone and inhibition of antagonistic/unnecessary movements
What are the components of the Basal Ganglia?
1) Globus Pallidus (Internus& Externus)
2) Striatum (Caudate & Putamen)
3) Subthalamic Nuclei
4) Substantia Nigra (Pars compacta & Pars reticulata)
How does the Basal Ganglia influence movement?
It receives information from the cortex, sends information to the thalamus, which in turn sends information back to the cortex.
What are the two pathways within the Basal Ganglia?
- Direct Pathway
- Indirect Pathway
What is the function of the Direct Pathway?
Promotes movement – Go pathway.
What is the function of the Indirect Pathway?
Inhibits movement – Stop pathway.
True or False: Dopamine excites the direct pathway and inhibits the indirect pathway.
True.
What effect does a lack of dopamine have in Parkinson’s?
Less excitation of the direct pathway and less inhibition of the indirect pathway, resulting in less movement.
What are dopamine agonists?
Medications that mimic dopamine, e.g., Apomorphine, Pergolide.
What is Deep Brain Stimulation used for?
To decrease symptoms of dyskinesia resulting from prolonged dopaminergic treatments.
What is postural instability in Parkinson’s?
Flexed posture
Flexed hips and knees
Balance issues
What clinical staging tools are used for Parkinson’s?
- Modified Hoehn and Yahr Scale
Key physiotherapy principles in treating PD
- Cueing
- Dual tasking
- Balance Training
- Gait re-education
- Symptom specific exercise
What types of exercise have shown to improve function in Parkinson’s?
- Pilates
- Yoga
- Dance
- PD Warrior
Three types of dopamine medication
Dopamine copycats
Dopamine protectors
Dopamine replacements
Why use clinical staging tools?
Assists in the management of patients
