sábado, 4 de mayo de 2019

Neurophysiotherapy for Parkinson's Disease

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By Osman Shabir, M.Sc.Reviewed by Dr. Liji Thomas, MD

Neurophysiotherapy is a specialized branch of physiotherapy dedicated to improving function in states of physical impairment caused by neurological conditions.

The aim of neurophysiotherapy is to help rehabilitate patients with such reductions in function as is seen in brain-related diseases like Parkinson’s disease, by helping to re-form synaptic connections through the learning of new abilities and skills – a phenomenon called neuroplasticity.

How does Parkinson’s disease affect the body?

Parkinson’s disease is a progressive movement disorder with symptoms affecting the whole body. Key symptoms include:

Resting tremor, or shaking, both at rest and during movement
An overall slowing of movements (bradykinesia) which may result in a slow shuffling walk with smaller steps
A stooped posture with the trunk bending forwards producing a hunched appearance
Rigidity of muscles leading to muscle stiffness – these can affect the facial muscles, leading to decreased facial expression, as well as producing painful cramps
Balance problems increasing the tendency to fall and become injured
Lack of control over normal physiological functions, such as incontinence (lack of control over urination), constipation, sexual dysfunction, dysphagia (problems swallowing/feeding) and excessive saliva production
Softer, quicker or hesitant speech with monotonous expression, as well as increased difficulty in writing or fine motor movements of the hands and fingers

All of these symptoms affect physical ability and may progressively lead to disability. While medication and therapy may ameliorate some of the symptoms, careful management is required to ensure that the muscles remain functional and motor function is maintained, and to improve the overall quality of life.

Can neurophysiotherapy treat Parkinson’s disease symptoms?

Much clinical research has shown that goal-oriented physical activity/exercise can lead to significant improvement in the ability to walk, and in the dexterity of hands/fingers. Furthermore, with the correct combination of activities, the balance may also improve, as well as the speed of movement.

Exercise may also have neuroprotective or anti-degenerative effects on the brain. From animal studies is it evident that exercise improves the efficiency of dopamine utilization by actively modifying the substantia nigra (where the neurons associated with Parkinson’s are localized). Furthermore, exercise also increases glial-derived neurotrophic factor, which is a neuroprotective neurotrophic factor that helps strengthen dopaminergic neurons and prevent further degeneration.

Which type of exercise is most beneficial in Parkinson’s disease?

A common question relates to the kind activities or exercises that have been shown to be particularly beneficial for individuals with Parkinson’s disease?

Consistent exercise over the long-term (more than 6 months)
Greater intensity exercise for as long as possible (one hour 3-4 times a week) – particularly in early-stage or young-onset Parkinson’s disease
Join targeted programmes which are dedicated to neurophysiotherapy of Parkinson’s disease – where physiotherapists will tailor specific activities to the individual’s abilities - as well as enabling these patients to enjoy being part of a group

Exercise is beneficial for everyone, not just those with Parkinson’s disease. The more frequent and intense it is, within appropriate limits, the better the gain for overall health.

The same applies for individuals with Parkinson’s; researchers know now that exercise has neuroprotective effects on the brain as well as empowering rehabilitation and improving the motor issues associated with Parkinson’s disease. In combination with treatment and medication, neurophysiotherapy serves as a powerful strategy in improving motor function as well as slowing down neurodegeneration.