Parkinsons

Question 1

Parkinson’s Disease

Answer 1

Progressive disease of the nervous system marked by bradykinesia, resting tremor, rigidity and postural instability.
Associated with degeneration of basal ganglia of the brain.
Deficiency of the neuro transmitter dopamine.

Question 2

Clinical features

Answer 2

Bradykinesia 
Rigidity 
Postural instability 
Resting tremor 
Gait disturbance 
Difficulty initiating/stopping - movement/freezing 
Speech disturbances 
Fatigue 
Reduced cognition

Question 3

ACSM Guidelines

Answer 3

Stretch hold 30- 60 seconds
To the point of tightness
Repeat 2-4 times a day

Strengthening 8-12 reps
1-3 sets
2-3 times a week

Question 4

NICE and EU guidelines

European PD Guidelines

Answer 4

Recommend education and self management support training.

EU Guidelines - controlled trial competed showed benefits for highly intensive rehab course 3 hour a day sessions including cueing and complex motor sequence strategies.

Question 5

Outcome measures

Answer 5

Tragus to wall measures - kyphotic posture
Push and release test
6 min walk including Borg Rating Scale of perceived exertion.
Modified Parkinson’s activity scale (bed, chair, gait, bed mobility)
5x sit to stand
10 metre walk
Dynamic gait index and functional gait index - assess gait, balance and falls risk. MOBILITY & BALANCE
Rapid turns test - gait, mobility and freezing episodes. (guideline development group NICE Guidelines- recommends using to provoke freezing and know what to target with the intervention, dual tasks can be added to provoke freezing)
UPDRS- unified Parkinson’s disease rating scale (multipurpose and comprehensive assessment tool)

ICF Body function and structure / activity

Question 6

Scenario

Answer 6

Walking, shuffling, freezing.

Off phase
On phase

Auditory and sensory queuing

Mobilising around the kitchen, reaching.