Parkinsons Disease 2017

Question 1

In PD, a low percentage over the age of ___ is afflicted, but as age increases the incidence of disease _________ until age 80.

Answer 1

• 55- Increases

Question 2

• Idiopathic- Virus- Toxins- Medicines (Neuroleptics & Antidepressants)- Metabolic Disorders

Answer 2

Possible causes of Parkinson’s Disease

Question 3

What is the name of the cell that is for motor function and produces dopamine? Where is it located?

Answer 3

• Substantial Nigra - Basil Ganglia (Resting Tremors)

Question 4

Who does not respond to L-Dopa?

Answer 4

Parkinson’s Plus Syndromes

Question 5

What cardinal signs must a PD pt have to be diagnosed?

Answer 5

• 3 out of 4 symptoms- Tremor, Rigidity, Akinesia/Bradykinesia, and Postural Instability (*if given L Dopa and responsive, pt has PD)

Question 6

What type of symptoms are….- Sensory issues usually from other diseases- Speech (dysphagia, dysarthria)- Cognitive (delusion, hallucination)- Behavioral (*HD worse)

Answer 6

Nonmotor

Question 7

What type of PD dysfunction involves - Excessive sweating/seborrhea - Hot and cold flashes - GI Disorders- Sleep Disorders

Answer 7

Autonomic ( due to BG damage near Thalumus)

Question 8

What is the most common medicine used in PD (gold standard)? What can the side effects be after 5 years?

Answer 8

• Sinemet (carbidopa and levodopa)(*low dose because can become ineffective) - Dyskinesia

Question 9

What is the red flag that marks emerging disability?

Answer 9

Ambulation difficulty (gait balance disability, measured by PDQ-39)

Question 10

What are the most important goals of PTA Interventions in PD?

Answer 10

• BIG movements- Rotations- PNF (Irradiation)- Relaxation- Flexibility- Functional Training- Balance, Gait, and Locomotor (canes)

Question 11

How often should we exercise PD pt? What type of activity should be done? How long do they have to continue exercises post therapy?

Answer 11

• LSVT BIG; 1 hour; 4 days a week (4 weeks); Borg 8/10- Aerobic (50-85% HR) (220 - Age x .50 to .85)- Life long

Question 12

• Cardiovascular fitness- Strategy Training- Secondary Sequelae- Fall Risk

Answer 12

4 Key elements of PT

Question 13

How do we improve velocity of walking with PD pt?

Answer 13

Increase tempo of music to enhance waking velocity 10 to 20% (*may need to auditory cue bigger steps)

Question 14

What are visual cues best used for? What is the amount of space between lines? What are the context specific problems?

Answer 14

• Spacial aspects of gait- 2 to 2.5 feet (40% of height)- Doorways & Thresholds

Question 15

Having pt focus on taking a big step is what kind of cue?

Answer 15

Cognitive Cueing (Internal)

Question 16

What benefit does relaxation have for a PD pt?

Answer 16

• Decreased Rigidity- Increased Postural Stability

Question 17

Best type of cueing for cadence/step length/ improved speed (velocity)?

Answer 17

Rhythmic Auditory Stimultion (RAS) (external)