PT for Individuals with PD Flashcards
history and systems review
- Date of symptom onset
- Date of diagnosis
- Stage, if known
- Medications
- Motor signs
– Dyskinesias? Dystonia? - Non-motor signs
- ADL and fine motor skill
- Breathing, chew/swallowing, voice projection, cognition
- Medications and timing of these
- On/Off periods present?
- Fall history
- Orthopedic history
- Cardiac history
Significance of falls in PD:
falls increase the risk of hospitalization
increase the risk of NH admission
decrease survival rates
falls are a major cause of disability and reduce QOL
pts with PD are 3.2x more likely to sustain a fracture than those without PD
-femoral fracture (27% within10 years of dx) –> road to pneumonia and mortality
dyskinesias
involuntary random movements
-wiggling, twitching
dystonia
contorted posture, often with a twisting component
-spasms, cramps, posture
-can be painful
motor fluctuations: variable response to medications
wearing out, wearing off, roller coaster effect, on-off, uneven medication effects
OFF PERIOD
-Words that patients often recognize include “low time”, “bad time”, “shaking time”, “slow time”, “time
when my medications don’t work.”
ON PERIOD
Words that patients often recognize
include “good time”, “walking time”, “time when my medications work.
Body structure and function examination items for PD
flexibility
-FAR- functional axial rotation
posture - fixed vs reversible
strength
-MMT, functional testing
rigidity
spasticity
Explain the difference between rigidity and spasticity
SPASTICITY
-velocity dependent
-occurs disproportionately on one side of the joint
-occurs more in one direction than other
-typically occurs with cortical and corticospinal damage
-clasp knife phenomenon
-cannot reduce just with cortical strategies
RIGIDITY
-not as velocity-dependent
-occurs on both sides of the joint
-often with BG damage
-can sometimes be reduced by cortical strategies (consciously override this)
INTERVENTIONS- WHERE TO LOOK FOR STUDYING
NM II STUDY GUIDE
aerobic exercise
balance and gait training
resistance training
task-specific training and
external cuing
CATEGORIES OF UPDRS
- Non-Motor Aspects of Daily Living
(Mentation, behavior, mood) 2. Motor Aspects of Daily Living
(ADLs) 3. Motor examination 4. Motor Complications
(Complications of medications)
Total 176 points
* Motor subscale 108 points
1-5 stages of HOEHN AND YAHR
review on SG
What types of examination items and outcome measures are used for those with PD?
look at SG
4 COMPONENTS OF CPG FOR INTERVENTION FOR PD
aerobic exercise
balance and gait training
resistance training
task-specific training and
external cuing
