Parkinsons Disease

Question 1

Indirect Pathway

Answer 1

Usually:
M1 –> excites BG –> disinhibits the THA –> inhibits the movements

PD:
M1 –> excites BG –> SubNig sends D2 receptor –> inhibits the Thal –> increases movement.

Question 2

Direct Pathway

Answer 2

Usually:
M1 –> excites BG –> BG disinhibits the THA –> allows movement initiation
–> can have sub nigra to send D! receptor to BG to increase the movement and provide for action potential to initiate movement

PD:
- removal of Sub Nigra which doesn’t allow movement to occur when it was not strong enough

Question 3

Primary Motor Impairments of PD

Answer 3

Akinesia –> absence of movement due to difficulty in initiating or maintaining movement
Bradykinesia
Hypokinesia
Decrease postural stability
Rigidity
freezing of gait (festination)
Tremor
Secondary –> dyskinesia, dystonia

Question 4

Factors that determine if the risk of falls

Answer 4

Previous in the past 12/12
Previous freezing of gait 3/12
>3.6s to walk 4m

Question 5

Physiotherapy Management for PD

Answer 5

Cueing and attentional strategies
Falls Prevention
LSVT-BIG (recalibrating the movements –> they are big full body movements, high intensity and high effort)