Understanding Parkinson's disease: a comprehensive guide

Parkinson’s disease (PD) is a progressive neurological disorder that affects movement.

This condition primarily impacts the motor system, leading to symptoms like tremors, stiffness, and difficulty with balance and coordination.

Who is commonly involved?

Parkinson’s disease is most commonly diagnosed in people over the age of 60, although it can occur earlier.

Men are slightly more likely to develop PD than women.

The exact cause of Parkinson’s is unknown, but a combination of genetic and environmental factors is believed to play a role.

How is Parkinson’s disease diagnosed?

Diagnosing Parkinson’s disease can be challenging as there is no specific test for it.

Diagnosis is typically based on medical history, a review of symptoms, and a neurological and physical examination.

Doctors may use imaging tests like MRI or CT scans to rule out other conditions.

In some cases, a dopamine transporter (DAT) scan may be used to support the diagnosis.

How Parkinson’s disease affects the brain and body

Parkinson’s disease primarily affects a part of the brain called the substantia nigra, located in the midbrain.

The substantia nigra is responsible for producing dopamine, a neurotransmitter crucial for regulating movement and coordination.

In Parkinson’s disease, the neurons in this area degenerate and die, leading to a significant decrease in dopamine levels.

This reduction in dopamine disrupts the normal functioning of the basal ganglia, a group of structures linked to movement control, resulting in the characteristic motor symptoms of Parkinson’s.

The disease also affects other parts of the brain, including the frontal lobes, which are involved in cognitive functions, and the limbic system, which regulates emotions.

This widespread impact explains the variety of symptoms experienced by individuals with Parkinson’s.

One interesting aspect of Parkinson’s disease is how it affects familiar versus unfamiliar movement patterns.

Familiar movements, such as walking or brushing teeth, are often less impaired because they are more automatic and require less conscious effort.

These movements are typically controlled by well-established neural pathways that remain relatively intact in the early stages of the disease.

In contrast, unfamiliar movements or tasks that require more conscious planning, and coordination can be significantly more challenging for individuals with Parkinson’s.

This is because these tasks rely more heavily on the affected areas of the brain, leading to greater difficulty in execution.

Treatment options

While there is no cure for Parkinson’s Disease, various treatments can help manage symptoms.

These include:

• Medications: Drugs like Levodopa and dopamine agonists are commonly prescribed to manage symptoms.
• Physiotherapy: Physiotherapy plays a crucial role in managing Parkinson’s Disease. It helps improve mobility, balance, and flexibility. At Lifecare Frankston, we have multiple physiotherapists with a special interest in the treatment of Parkinson’s disease.
• Surgery: In advanced cases, surgical options like Deep Brain Stimulation (DBS) may be considered.
• Lifestyle changes: Regular exercise, a healthy diet, and occupational therapy can significantly improve quality of life.
• Sports medicine: Incorporating sports medicine principles can help in designing exercise programs that are safe and effective for Parkinson’s patients.

The role of physiotherapy in Parkinson’s disease

Physiotherapy is essential in managing Parkinson’s disease.

It helps patients maintain their independence and improve their quality of life.

At Lifecare Frankston, we can provide personalised care that addresses the unique challenges faced by Parkinson’s patients.

We use a variety of techniques, including exercises to improve strength and flexibility, balance training, and gait re-education.

Types of exercises:

• Aerobic exercise: Activities like walking, cycling, or swimming help improve cardiovascular health and overall endurance. It is recommended to engage in aerobic exercise at least 3 days a week for 30 minutes per session.
• Strength training: Exercises such as weightlifting or resistance band exercises help maintain muscle strength and prevent muscle atrophy. Strength training should be done 2-3 times a week.
• Balance and agility training: Exercises like tai chi, yoga, or specific balance exercises help improve stability and prevent falls. These should be incorporated 2-3 times a week.
• Stretching: Regular stretching helps maintain flexibility and reduce muscle stiffness. Stretching exercises should be done daily if possible.

What to expect from your physiotherapist:

• Initial assessment: Your physiotherapist will conduct a thorough assessment to understand your specific needs and challenges.
• Personalised exercise plan: Based on the assessment, a tailored exercise plan will be created to address your symptoms and improve your quality of life.
• Regular monitoring and adjustments: Your progress will be regularly monitored, and the exercise plan will be adjusted as needed to ensure optimal results.
• Education and support: We provide education on managing symptoms and support to help you stay motivated and consistent with your exercise routine.

Conclusion

Parkinson’s disease is a complex condition that requires a comprehensive approach to management.

With the right combination of medication, physiotherapy, and lifestyle changes, individuals with Parkinson’s can lead fulfilling lives.

If you or a loved one is dealing with Parkinson’s disease, our physiotherapists at Lifecare Frankston can provide and implement a tailored exercise program to maximise quality of life.

Lachlan McAlary is a physiotherapist at Lifecare Frankston, with a passion for helping people with neurological conditions live happy and fulfilling lives. He develops personalised rehabilitation programs that target an individuals’ specific needs and works to achieving their goals.

REFERENCES:

• Kalia, L. V., & Lang, A. E. (2015). Parkinson’s disease. The Lancet, 386(9996), 896-912. https://doi.org/10.1016/S0140-6736(14)61393-3 

• Postuma, R. B., Berg, D., Stern, M., Poewe, W., Olanow, C. W., Oertel, W., … & Litvan, I. (2015). MDS clinical diagnostic criteria for Parkinson’s disease. Movement Disorders, 30(12), 1591-1601. https://doi.org/10.1002/mds.26424 

• Schapira, A. H. V., Chaudhuri, K. R., & Jenner, P. (2017). Non-motor features of Parkinson disease. Nature Reviews Neuroscience, 18(7), 435-450. https://doi.org/10.1038/nrn.2017.62 

• Armstrong, M. J., & Okun, M. S. (2020). Diagnosis and treatment of Parkinson disease: A review. JAMA, 323(6), 548-560. https://doi.org/10.1001/jama.2019.22360 

• Bloem, B. R., Okun, M. S., & Klein, C. (2021). Parkinson’s disease. The Lancet, 397(10291), 2284-2303. https://doi.org/10.1016/S0140-6736(21)00218-X