Halfway through a home physiotherapy session, my patient suddenly said, “I am sorry, I always have a long face towards you.”
I quickly replied, “No worries about that, Mdm D. I know you don’t mean that. It’s just because of your condition.”
symptoms of parkinson's disease
Losing facial expression (also known as mask face) is a symptom of Parkinson’s Disease. Some of the other symptoms include:
Slowness movement, e.g. marching on the spot for 10 reps, which usually takes us less than 20 seconds, may take a minute for people with Parkinson’s Disease;
Rigidity, e.g. they cannot lower themselves onto the chair properly and lean back onto the chair in one piece;
Freezing gait, e.g. they may stop halfway through their walking and hesitate in small steps;
Resting tremor, i.e. involuntary shaking of hands or legs at rest.
Some patients with Parkinson’s Disease may also experience sleeping disorders, anxiety, depression, blood pressure abnormalities, etc., and this list is not exhaustive.
why does parkinson's disease occur?
Parkinson’s Disease occurs when there is a progressive degeneration at a particular part of the brain called the substantia nigra, resulting in a reduction in the production of a chemical called dopamine. Dopamine plays an important role in regulating our movement; therefore, a depletion of which would result in the symptoms described above.
physiotherapy treatment for parkinson's disease
Parkinson’s Disease is not curable. However, with proper medication, diet and exercise programs, patients with Parkinson’s Disease can still live with a decent quality of life.
Medication for Parkinson’s Disease, though not a cure, helps significantly keep the symptoms in check when taken appropriately. Some medicines will result in an “on-off” effect within a day, i.e. causing “on” times and the patient’s mobility is good; and “off” times and the patient is relatively immobile. Physiotherapists would check with the patient on their medication timing and schedule the physiotherapy accordingly to maximize the session’s effectiveness.
Research has shown that for patients with early-stage Parkinson’s Disease, long-term physiotherapy (6 months or longer) comprised of aerobic exercise and resistance training helps reduce the symptoms. We also train gait and balance so that the patient can ambulate safely as much as they can. At times when patients show signs of vestibular dysfunction, we will do vestibular rehabilitation as an adjunct to enhance gait steadiness as much as possible.
with exercises, my patient could sit on a chair without falling backward due to rigidity. and she took a great effort to pull up a smile at me. she was satisfied, and so did i.
Okada Y. et al. (2021). Effectiveness of Long-Term Physiotherapy in Parkinson’s Disease: A Systematic Review and Meta-Analysis. Journal of Parkinson’s Disease, 11, 1619–1630.
Gupta S et al. (2021). Non-motor symptoms in Parkinson’s disease: Opening new avenues in treatment. Current Research in Behavioral Sciences, 2, 100049
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