Parkinson’s Disease

Parkinson’s disease, also known as tremor paralysis, is characterized by resting tremor, bradykinesia, muscle rigidity, and postural balance disorders. It is a common neurodegenerative disease in the middle-aged and the elderly. Its pathological features are the degeneration of dopaminergic neurons in the substantia nigra and the formation of Lewy bodies.

What’s the Symptoms of Parkinson’s Disease?

Static tremor

1. Myotonia

Due to the increase of muscle tension, it is “lead tube like rigidity” or “gear like rigidity”.

2. Abnormal balance and walking ability
Abnormal posture (festinating gait) — the head and trunk are bent; hands and feet are half bent. Patients would have difficulty start walking. Meanwhile, there are still other problems including reduced stride length, inability to stop at will, difficulty in turning, and slow movements.
Training Principles

Make full use of visual and audio feedback, let patients actively participate in treatment, avoid fatigue and resistance.

What’s the Training Method of [arkinson’s Disease Patients?

Joint ROM training
Passively or actively train the joints of the spine and limbs in all directions to prevent joints and surrounding tissue adhesion and contractures thus to maintain and improve the joint range of motion.

Muscle strength training
Patients with PD usually have proximal muscle fatigue in the early period, so that the focus of muscle strength training is on the proximal muscles such as the pectoral muscles, abdominal muscles, lower back muscles, and quadriceps muscles.

Balance coordination training
It is one of the important methods to prevent falls. It can train patients to stand with their feet separated by 25-30cm, and move the center of gravity forward, backward, left, and right; train single leg support balance; train patients’ trunk and pelvis rotating, train harmonious upper limbs swinging; train two feet standing, writing and drawing curves on the hanging writing boards.

Relaxation training
Shaking the chair or turning the chair can reduce stiffness and improve movement ability.

Posture training
Including posture correction and posture stabilization training. Correction training is mainly aimed at correcting patients’ trunk bending mode to keep their trunks upright.
a, correct neck posture
b, correct kyphosis

Walking training

Purpose
Mainly to correct the abnormal gait – the difficulty to start walking and turning around, low leg lift, and short stride. To improve walking speed, stability, coordination, aesthetics and practicality.

a, Good starting posture
When the patient stands, his/her eyes look forward and his body stands upright to maintain a good starting posture.

b, Training with big swings and steps
In the early stage, the heel touches the ground first, in the later period, the triceps of the lower leg correctly applies force to control the ankle joint. In the swing phase, the ankle joint dorsiflexion should be as much as possible, and the stride should be slow. Meanwhile, the upper limbs should swing greatly and coordinately. Correct the walking posture in time when someone can help.

c, Visual cues
When walking, if there are frozen feet, visual cues can promote the motion program.

d, Walking training under suspension
50%, 60%, 70% of the weight can be reduced though suspension, so as not to put too much pressure on lower limbs.

e, Obstacle-crossing training
To relieve frozen feet, take mark-time stepping training or place something in front that allows the patient to cross over.

f, Rhythmic start
Repeated and passive sensory input along the direction of movement can induce active movement. After that, complete movement actively and rhythmically, and finally, finish the same movement with resistance.