PD Extra Flashcards
Parkinson’s definition
Progressive neurodegenerative disease, caused by lack of dopamine production in the substantia nigra neurones of the basal ganglia.
Cardinal signs
Bradykineasia
Resting tremor
Rigidity (cog wheel or lead pipe)
Patho of PD
Dopamine excites direct pathway and inhibits indirect pathway.
In PD you have lack of dopamine, so less excitation- leading to bradykineasia, and lack of inhibition so resting tremor.
Common PD meds
Madopar
Sinemet
Dopamine agonists (peroglide, ropinirole, apomorphine)
Anticholinergics
Dopamine alone cannot cross blood brain barrier
Höhn and yahr scale stages
Stage 1-5 1 is unilateral but no disability 2 bilateral but no impairment 3 bilateral, postural instability 4 severe disability 5 bedridden or wheelchair
How to treat postural changes
Strengthen exercises
Stretching for Rom- yoga
Functional exercises
PD warrior
Causes of fatigue
CNS- primary cause in MS, PD, CVA, TBI Endocrine dysfunction Neuromuscular Anaemia Medications
Secondary clinical signs of PD
Freezing when walking
Festinating gait pattern
Loss of facial expression and upwards gaze
Types of cueing
Kinaesthetic : holding someone’s arm for balance
Visual e.g lines on doorway
Auditory e.g metronome in time with steps
How cueing works
In PD the supplementary motor area is impaired, where usually the basal ganglia initiates SMA with internal cues.
External Cueing stimulates premotor area which initiates primary motor cortex( frontal lobe)
How to treat rigidity
Relaxation (Laura Mitchell technique working head to toe on guided contract relax), breathing exercises, mindfulness
Medication
Postural changes: encourage extension in spine. Lie prone and extend
How to treat falls
Balance work, muscle strength Confidence Practice transferring up from floor Personal alarm OT home assessment for prevention
