What is Parkinson's Disease
Parkinson’s
disease is a disease that effects the motor neurons and progressively worsens
over time. Although there is no known cause or no cure for this disease, there
are alternatives that can help decrease the progression of the symptoms related
to this disease. The chemical that is involved with Parkinson’s is dopamine.
This chemical allows signals to be sent between the nerves and brain. As the
production of these cells diminish, the recognition of Parkinson’s begins to
appear. Parkinson's Disease tends to effect people later in life rather than earlier.
Signs and symptoms
With Parkinson’s comes many signs and symptoms. The symptoms
are put into two categories; primary and secondary. Primary symptoms are
considered to be from Parkinson’s its self, where the secondary symptoms are
caused from the primary symptoms. Here’s a list of primary and secondary
symptoms.
Primary
Resting Tremor
A resting tremor is known to be one of the first symptoms of this disease. It usually occurs in the hand but can move throughout the body to the feet, neck and head. A tremor is described to create shaking like motions to the effected body part. A person with this disease has no control over the movements as they appear even when at rest.
Bradykinesia
Bradykinesia is when there is a difficulty creating movement within the body. This disables the brain to be notified that a movement needs or wants to be made. A person that shows this specific symptom may have difficulty performing repetitive tasks such as buttoning a shirt, brushing their teeth, brushing their hair, etc. They also appear to shuffle when they walk.
Rigidity
Rigidity occurs due to the immobility of the individual. This causes the flexors to become tight and gives the person a stooped posture. This also decreases the range of motion within the individual which makes it difficult to move around. The muscles tense up and can cause discomfort and pain.
Secondary
Gait
Gait effects the arms and legs as it makes it difficult to bend them for walking. This causes the individual to freeze and hesitate about making a step forward. This is temporary when it does occur and usually stops with the more steps he or she takes. With this frozen foot symptom it increases the risk for falls.
Changes in speech, eating, handwriting
Parkinson’s disease effects the larynx muscles that controls ones vocal sounds when they speak, therefore effects the voice. It causes the voice to become monotone. This also causes the individual to have difficulty swallowing their food. The individual’s handwriting may also appear to be cramped and decreased in size. This is called micrographia.
Primary
Resting Tremor
A resting tremor is known to be one of the first symptoms of this disease. It usually occurs in the hand but can move throughout the body to the feet, neck and head. A tremor is described to create shaking like motions to the effected body part. A person with this disease has no control over the movements as they appear even when at rest.
Bradykinesia
Bradykinesia is when there is a difficulty creating movement within the body. This disables the brain to be notified that a movement needs or wants to be made. A person that shows this specific symptom may have difficulty performing repetitive tasks such as buttoning a shirt, brushing their teeth, brushing their hair, etc. They also appear to shuffle when they walk.
Rigidity
Rigidity occurs due to the immobility of the individual. This causes the flexors to become tight and gives the person a stooped posture. This also decreases the range of motion within the individual which makes it difficult to move around. The muscles tense up and can cause discomfort and pain.
Secondary
Gait
Gait effects the arms and legs as it makes it difficult to bend them for walking. This causes the individual to freeze and hesitate about making a step forward. This is temporary when it does occur and usually stops with the more steps he or she takes. With this frozen foot symptom it increases the risk for falls.
Changes in speech, eating, handwriting
Parkinson’s disease effects the larynx muscles that controls ones vocal sounds when they speak, therefore effects the voice. It causes the voice to become monotone. This also causes the individual to have difficulty swallowing their food. The individual’s handwriting may also appear to be cramped and decreased in size. This is called micrographia.
Treatment for Parkinson's Disease
Because there are no cure for this disease, the most
effective treatment option for Parkinson’s disease is drug therapy. The two
commonly prescribed drugs to treat this are carbidopa and levodopa. With both
of these drugs, there are a lot of different side effects. There are also
different considerations to massage with being on these medications.
Medications&Surgery
Carbipoda This drug increases the levels of levodopa within the brain which decreases parkinson’s symptoms. With this medication comes many different side effects which includes; nausea, diarrhea, pain within the abdomen, dry mouth, constipation and vomiting. It also puts the individual at risk for agitation, anxiety, dizziness, hallucinations, and excessive sweating. A client who is on this drug isn’t necessarily contraindicated due to being on this medication. The disease its self is contraindicated in some situations. Due to the drug producing more dopamine within the body, you have to take into consideration the effect of massage in a sense that it is said to increase the dopamine production within the body. As a therapist, you may need to assist the client on and off the table as they may have difficulty doing so. Bromocriptine Mesylate This drug is also used to improve the voluntary movement that occurs with Parkinson’s disease. Side effects of this drug includes; hypotension/hypertension, acute myocardial infarction, abdominal cramps, uncontrolled body movements and insomnia. More possible side effects include; headache, nervousness, blurred vison, depression, fatigue and dizziness. There are no contraindications for someone who is taking this medication, but the condition for what they are on it for could be contraindicated. The client may need to urinate during the massage, so assistance with helping them on and off the table would be necessary. Use more rapid strokes towards the end of the massage as it may help with alerting the client. Alternatives and there benefits Here are some alternatives that can benefit a Parkinson’s client; Massage therapy – muscle tension is decreased, relaxation is increased Acupuncture – reduces pain within areas of the body where needles are placed Tai chi – increases strength, balance and flexibility by slow movements Yoga – improves flexibility and overall balance Meditation – decreases stress and pain associated with this disease, improves your bodies overall health Music, pet therapy – increases relaxation, movement, flexibility. Also can improve speech which is effected by Parkinson’s |
Levodopa This drug is used to decrease the signs and symptoms of Parkinson’s disease. Side effects of Levodopa include; hypertension, cardiac irregularities, flushing, phlebitis, dry mouth, nausea, vomiting and constipation. Nervous system side effects include; muscle twitching, aggressive behaviour, seizures, tremors, bradykinetic episodes, mood changes, memory loss, depression and hallucinations. There are no contraindications of this drug, but client may need to be helped on and off the table. The client may also need to urinate during the session, and an abdominal massage may help to relieve gas and constipation. Diphenhydramine Hydrochloride This drug is used to treat many illnesses but most important one being Parkinson’s disease. The effect it has on Parkinson’s patients is that it helps to improve voluntary movements within the body. Side effects to this include; hypotension, anorexia, confusion, headaches, vertigo, urine frequency and hives. Massage considerations include; avoid deep tissue massage due to the sedative effects of the drug. Compressions, vibrations, and stretching may not be as effective as someone who is not on this medication. The client may need to urinate during the massage, so assist them getting on and off the table at all times. If any side effects are severe, massage should not proceed. Surgery The surgical procedure is mostly offered to patients with more progression of the disease and are not stable with their medications. It is called deep brain stimulation or DBS. This surgery involves the operator to open the brain and implant electrodes into the targeted area. There is then an electrode that is connected to the collarbone which allows signals to be sent to the brain. These impulses to the brain from the electrode may reduce the symptoms that are associated with Parkinson’s disease but doesn’t stop the disease from progressing. This surgery can reduce the progression of some of the symptoms that are associated with Parkinson’s that include; involuntary movements, tremors, rigidity and improve the slow movements. Recovery from this surgery varies from person to person, but generally takes several weeks to fully recover from this procedure. The quicker the recovery, the less discomfort occurs during the healing process. The doctor will require routine checkups to make sure the device is working to its maximum capacity and will ask you to perform range of motion tests within the affected area. They may also request an X-ray to ensure the system is in the proper place. |
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