In PD, a low percentage over the age of ___ is afflicted, but as age increases the incidence of disease _________ until age 80.
- 55
- Increases
- Idiopathic
- Virus
- Toxins
- Medicines (Neuroleptics & Antidepressants)
- Metabolic Disorders
Possible causes of Parkinson’s Disease
What is the name of the cell that is for motor function and produces dopamine? Where is it located?
- Substantial Nigra
- Basil Ganglia (Resting Tremors)
Who does not respond to L-Dopa?
Parkinson’s Plus Syndromes
What cardinal signs must a PD pt have to be diagnosed?
- 3 out of 4 symptoms
- Tremor, Rigidity, Akinesia/Bradykinesia, and Postural Instability
(*if given L Dopa and responsive, pt has PD)
What type of symptoms are….
- Sensory issues usually from other diseases
- Speech (dysphagia, dysarthria)
- Cognitive (delusion, hallucination)
- Behavioral (*HD worse)
Nonmotor
What type of PD dysfunction involves
- Excessive sweating/seborrhea
- Hot and cold flashes
- GI Disorders
- Sleep Disorders
Autonomic ( due to BG damage near Thalumus)
What is the most common medicine used in PD (gold standard)? What can the side effects be after 5 years?
- Sinemet (carbidopa and levodopa)
(*low dose because can become ineffective) - Dyskinesia
What is the red flag that marks emerging disability?
Ambulation difficulty (gait balance disability, measured by PDQ-39)
What are the most important goals of PTA Interventions in PD?
- BIG movements
- Rotations
- PNF (Irradiation)
- Relaxation
- Flexibility
- Functional Training
- Balance, Gait, and Locomotor (canes)
How often should we exercise PD pt? What type of activity should be done? How long do they have to continue exercises post therapy?
- 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
- Cardiovascular fitness
- Strategy Training
- Secondary Sequelae
- Fall Risk
4 Key elements of PT
How do we improve velocity of walking with PD pt?
Increase tempo of music to enhance waking velocity 10 to 20%
(*may need to auditory cue bigger steps)
What are visual cues best used for? What is the amount of space between lines? What are the context specific problems?
- Spacial aspects of gait
- 2 to 2.5 feet (40% of height)
- Doorways & Thresholds
Having pt focus on taking a big step is what kind of cue?
Cognitive Cueing (Internal)
What benefit does relaxation have for a PD pt?
- Decreased Rigidity
- Increased Postural Stability
Best type of cueing for cadence/step length/ improved speed (velocity)?
Rhythmic Auditory Stimultion (RAS) (external)
