Monday Medical: Physical therapy for Parkinson’s disease
Editor’s Note: This is the second part in a two-part series on Parkinson’s disease. Part one outlined basics of the disease.
Parkinson’s disease affects movements, so it stands to reason that maintaining and improving movement can help combat the impact of this chronic disease.
“Physical therapy, occupational therapy, speech and language therapy all play an important role in the care and management of people with Parkinson’s,” said Patty Bobryk, a neurologic physical therapist at UCHealth SportsMed Clinic. “This is very much a team approach and a collaboration.”
Bobryk outlines what to know about physical therapy for Parkinson’s disease below.
Exercise smarter, not harder
Working with physical therapists can help people with Parkinson’s address common symptoms of the disease, including slowness, stiffness and imbalance.
“General strengthening is helpful, but we want to get the most bang for your buck and give the most benefits for function,” Bobryk said.
For instance, a physical therapist can help a patient strengthen muscles involved with lifting their legs to avoid the shuffling walk that can result from Parkinson’s.
Patients may work on large movements to help prevent the small, tight movements that people with Parkinson’s often develop, while exercises to strengthen the back, neck and core can help with postural alignment and support.
Bobryk recommends seeking rehabilitation treatment early on, even right after a diagnosis.
“One of the main things we want to do for long-term quality of life is to help prevent issues,” Bobryk said. “When someone’s living with a diagnosis, the changes can be really subtle. But when we see you every 3, 4 or 6 months, we can say, ‘This is a subtle change — let’s nip this in the bud before it becomes problematic.’”
Bobryk works with patients to craft programs to meet their goals, including maintaining activity levels.
Walking can become a challenge with Parkinson’s. The disease interrupts the flow of electrical impulses from the brain to the muscles, so people may find themselves freezing or unable to stop while walking.
“We want to give strategies to address those things and to maintain function,” Bobryk said. “Steamboat’s such an active town. A lot of people want to continue skiing and hiking, so we want to make sure we can keep them safe and participating, even if we have to modify their activities somewhat.”
One study of Parkinson’s patients found that increasing physical activity to two-and-a-half hours a week slowed the decline in quality of life.
“Physical activity is a key component in maintaining and improving function,” Bobryk said.
Activities such as cross-country skiing that use reciprocal movements can be especially helpful. Dance, which may involve large, sweeping movements, can help maintain good range of motion, while sports that involve quick movements, such as boxing and even movement-based video games, can help prevent slowing of motions.
“There’s the old saying, ‘Water that doesn’t move freezes,’” Bobryk said. “That’s kind of what happens in Parkinson’s. If you’re not moving, your movements can get really small and you get this poverty of movement.”
Gather your team
“When you’re diagnosed with anything, it can be really overwhelming,” Bobryk said. “One of the first things I always ask people to do is to gather their team. Gather your neurologist, make a connection with a rehab team, get support people together — family, friends, church, community, counseling — so that you’re not alone in this and you’ll have better outcomes.”
And keep in mind that each patient’s path may look different.
“There are no two patients I see who are exactly the same, and there’s no magic formula,” Bobryk said. “We’re addressing each person as an individual and each exercise program is tailor-made to their needs.”
Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at firstname.lastname@example.org.
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