Parkinson's

Question 1

What is Parkinson’s?

Answer 1

-Brain disorder associated with a loss of dopamine-producing nerve cells
-less dopamine in the brain means less control over movement and less mobility

Question 2

What is etiology of Parkinson’s?

Answer 2

-multifactorial
-both genetic and environmental factors
-age is the biggest risk factor
-median age of onset is 60years old

Question 3

What are the cardinal symptoms of Parkinson’s?

Answer 3

-tremor
-rigidity
-bradykinesia
-postural instability

Question 4

What are the non-motor symptoms of parkinson’s?

Answer 4

-anosmia
-REM
-sleep behavior disorder
-depression/anxiety
-fatigue
-pain
-confusion (sometimes dementia)

Question 5

What are the characteristics of early stage parkinson’s?

Answer 5

-asymmetry of symptoms (initially unilateral presentation
-axial rigidity may be present (affecting proximal musculature)
-subtle changes in coordination and balance
-gait changes
-alteration in perception of movement (motor-sensory disconnect)
-organizational and dual-tasking ability changes
-mild cognitive impairment

Question 6

What anatomy is affected?

Answer 6

-basal ganglia -> substantia nigra
*not producing enough dopamine
-basal ganglia circuitry
-involves basal ganglia and thalamus
-direct and indirect pathways

Question 7

Which pathway is most dominant in parkinson’s? (direct or indirect)

Answer 7

indirect pathway
*facilitates basal ganglia output = less movement
*facilitation of an inhibitory pathway = inhibition

Question 8

True or False: Parkinson’s starts proximally and asymmetrically.

Answer 8

True

Question 9

What are some interventions used for Parkinson’s?

Answer 9

-weight shifts
-visual target that is past the freezing point
-metronome
-group interventions: tai chi, dance, kick boxing, BIG for life
-LSVT big and loud
-neuroplasticity principles
-PWR (similar is LSVT)

Question 10

What neuroplasticity principles are most used with Parkinson’s interventions?

Answer 10

-Intensity
*keep it high
-Repetitions
*keep them high
*use it or lose it
*use it and improve it
-salience
*make it meaningful to their goals
-specificity
*try the things they are having trouble with

Question 11

What are the H&Y stages?

Answer 11

1.0 unilateral involvement only
1.5 unilateral and axial involvement
2.0 bilateral involvement without impairment of balance
2.5 mild bilateral disease with recovery on pull test
3.0 mild to moderate bilateral disease; some postural instability; physically independent
4.0 sever disability; still able to walk or stand unassisted
5.0 wheelchair bound or bedridden unless aided