Parkinson's disease follow up

Question 1

CPG - resistance training

Answer 1

• strong evidence to address decreased strength and power
• can also improve non-motor symptoms, fall risk, function, quality of life
• consider resistance training with instability
• consider 1-2 times per week with long term implementation (life long)
• 80% of 1 RM to increase strength, 40% of 1 RM to increase power

Question 2

CPG-aerobic training

Answer 2

• strong evidence to improve aerobic capacity and endurnace
• also improves function, non-motor symptom, quality of life
• most studies included individuals with Hoehan and Yahr stages 1-3
• consider aerobic exercise (bike, walking, treadmill) 2-3 times per week, 30-40 minutes, moderate to high intensity (montior RPE/HR)

Question 3

CPG - flexibility

Answer 3

• moderate evidence for improving flexibility and axial mobility
• only one study of moderate quality included
• can be included as part of a program for all stages
• loss of flexibility noted to be significant symptom

Question 4

CPG - balance training

Answer 4

• strong evidence for improving postural control and balance confidence
• also improves non-motor symptoms, mobility, gait and quality of life
• with or without technology
• aquatics may help in early stages
• includes gait training with balance components
• studies included participants in hoehn and yahr

Question 5

CPG - task specific training

Answer 5

• strong evidence for improving
• functional tasks practiced
• types of task specific training: turning, dual task training, falls, mental imagery, UE function, multimodal training

Question 6

CPG - other interventions

Answer 6

• strong evidence to support
• community-based rehabilitation and exercise program
• external cuing
• integrated care

Question 7

Dopamine transporter scan

Answer 7

• Uses small amount of radioactive tracer to look at dopamine in brain
• visualized via single photon emoission CT
• if negative does not rule out PD early in disease
• if positive indicates problem with dopamine use
• does not differentiate PD from parkinsonian syndromes like PSP and MSA

Question 8

Syno-one skin biopsy test

Answer 8

• detects abnormal levels of alpha-synuclein
• cant differentiate between PD and other parkinsonian disorders
• get diagnosed earlier = earlier to get on preventative tx