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Parkinson's Disease

Parkinson's Disease is a neurological condition that affects a person's ability to move safely, balance, and coordinate their movements. Parkinson’s disease causes unintended or uncontrollable movements, such as shaking, stiffness, and difficulty with balance and coordination. Symptoms usually begin gradually and worsen over time. As the disease progresses, people may have difficulty walking and talking. They may also have mental and behavioural changes, sleep problems, depression, memory difficulties, and fatigue.

Parkinson’s Disease occurs when nerve cells in an area of the brain that controls movement called the Basal Ganglia die or become nonfunctional. Normally, cells in this region produce dopamine, and their loss results in decreased amounts of dopamine within the brain, causing the movement problems associated with the disease. It is still unknown why neurons in this region die, but one risk factor is age. Although most people with Parkinson’s Disease first develop the disease after age 60, as many as one in ten experience onset before the age of 50. Early-onset forms of Parkinson’s are often, but not always, inherited, and some forms have been linked to specific gene mutations.

Parkinson’s Disease also causes the loss of nerve endings that produce norepinephrine, the main chemical messenger of the sympathetic nervous system, which controls many functions of the body such as heart rate and blood pressure. Many brain cells of people with Parkinson’s Disease contain clumps of toxic protein, referred to as Lewy Bodies. Accumulation of Lewy Bodies in the brain can impair neural and cognitive function, and scientists are trying to better understand the normal and abnormal functions of neurotoxic proteins and their relationship to genetic mutations that impact Parkinson’s Disease and other neurological conditions like Alzheimer's Disease and Lewy Body Dementia.

Parkinson's Disease is a condition that affects many regions of the human body and which has impacts on many domains of human function. The most visible and stereotypical signs of Parkinson's Disease are tremors in the hands, legs, jaw and neck, muscular stiffness, slowed and imprecise movement, and impaired balance and coordination with an increased risk of falls. While management of Parkinson's Disease is an ongoing process that requires input from medical, specialist, and different Allied Health professions like Occupational Therapy, Speech Pathology, and Home Support, Physiotherapy is critical in the management of Parkinson's Disease as well.

Physiotherapy management of Parkinson's Disease addresses a person's present difficulties within the context of their diagnosis, while bearing in mind its potential future progression. That means that physiotherapy treatment for Parkinson’s Disease is rehabilitative as well as preventative - it addresses current concerns and risks while preparing the patient for what may come as the disease progresses. In the initial phases of management, physiotherapy focuses on addressing risks imposed by mobility difficulties. Manual therapy is useful for relieving muscle tension and pain, tremors are treated with strengthening, core work, hydrotherapy and purposeful movement. Balance and coordination are improved through exercise that strengthens the lower limbs and the core as well as their coordination through simple and complex movements. Falls risk is addressed and controlled by looking at a person's home environment and recommending modifications and assistive devices.

Parkinson's Disease progresses with time, and the nature of that progression is different for every person. Some will experience mild symptoms from the time of their diagnosis and experience no deterioration from that point. Others will experience worsening symptoms that require additional support. Still others will experience patterns of fluctuation. Given the highly individualised nature of a person's neurochemistry and the highly individualised nature of their environment, it is difficult to track or predict by trend the progression of the disease with any amount of information. Regardless of the progression or present nature of the situation, physiotherapy is able to help. 

Management of your discomfort depends on its causative factors, how it feels and changes during the day, what makes it better and worse, and the length of time you have been experiencing that pain. All of these factors will be addressed in your initial assessment, which is the first step toward managing and minimising any pain or discomfort. The treatment you receive will be tailored to address the specific cause of your discomfort, and will focus on minimising pain, maximising your ability to move pain-free, and developing a plan to minimise the risk of a flare-up in the future.

At Atlas Physio, we will provide you with education, structured management, and ongoing monitoring of your pain both in-clinic and out. Contact us to arrange an assessment, and to take the first step on a course of corrective care today.

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