Wednesday 29 November 2017

Parkinson’s Disease – What You need to know about it?

Parkinson's disease is one of the most common neurodegenerative disorders that is mostly seen in the elderly citizens, usually after the age of sixty. It is a movement disorder that is caused by the incremental deterioration of motor function and muscle control due to loss of dopamine-produced by malfunctioning brain cells. Typical symptoms include trembling of the limbs and head while resting, stiffness, slowness, tremors, shuffling gait and impaired balance. With further progression, patients with Parkinson’s disease may experience difficulty to even walk, talk or execute simple chores. Other symptoms may include depression, dementia and anxiety.


Parkinson's Disease (PD) Stages

PD is a progressive ailment with multiple stages, each of which is characterized by typical patterns.

Early PD – Mild Symptoms

Stage 1
  • Symptoms are mild and are usually mild and most likely affect only one side of the body  (unilateral involvement)
  • Symptoms include tremor of one hand, rigidity, clumsy leg,  facial expression affected on one side
Stage 2
  • Symptoms of PD are evident on both sides of the body (bilateral involvement) or at the midline
  • Symptoms  are   loss of facial expression on both sides, decreased blinking, speech abnormalities, rigidity of muscles in the trunk

Mid Stage PD-Moderate Symptoms
Stage 3
  • Symptoms of PD are characterized by loss of balance and slowness of movement
  • Typical symptoms- Balance is compromised, inability to make the rapid, automatic and involuntary adjustments, all other symptoms of PD (as in previous stages) may also be present

Advanced PD
Stage 4
  • Symptoms of PD are severely disabled
  • Patients are noticeably incapacitated, though they may still be able to walk and stand without assistance. However, they are unable to lead an independent lifestyle completely and require help.
Stage 5
  • Symptoms of PD are severe and are characterized by an inability to rise
  • Patients are likely to fall when standing or turning and may freeze or stumble when walking.
  • Hallucinations and delusions may also occur.

Treatment for PD
Treatment for PD varies from person to person depending upon their health condition and symptoms and may not involve a standardised procedure. It could include
  • Medications for increasing the dopamine by simulating receptors in the brain, anti-depressants, anti-tremor drugs and cognition enhancing medications
  • Surgical Therapy
  • Lifestyle Modifications including regular exercise regimes and getting adequate rest.

Exercises for PD
Exercise and physical activity are a crucial component in the treatment of PD. It helps to maintain balance, improves mobility and aids in performing daily living chores. It should incorporate
  • Stretching  exercises for increasing body flexibility
  • Aerobic activities
  • Exercises for strengthening and improving overall body resistance
  • This can be achieved by exercises like biking, running, yoga, dancing, Pilates, weight training and non-contact boxing. The type of exercise chosen depends on existing symptoms and physical limitations. For instance, in sedentary people, merely getting up and doing small movements is beneficial. More physically fit patients may attempt regular and vigorous activities. Exercises also reduce non-motor symptoms such as depression or constipation.

Parkinson Support Program (PSP)
PD includes a broad spectrum of symptoms, including movement- and non-movement-related problems. Hence patients with PD may wish to work with a variety of Health Care Providers (HCP) apart from the specialist who primarily treats the disease.  Parkinson Support Program essentially provides individualized support to both PD patients and their caregivers by educating them about the disease, providing personalised support, making meaningful suggestions for better interactions with concerned physicians about the symptoms and progression and even connecting them with  the correct movement disorder specialist who treats PD. PSP also aids in seeking the help of allied services  like physical therapists for helping  address painful muscle stiffness or a counselor who can provide strategies for coping with depression in PD patients. It is important to have an early professional intervention with   occupational or speech therapists for preventing or delaying future limitations in PD. Thus PSP helps patients manage their functionality and maintain a safe environment despite disease progression.

Conclusion
The progression of PD and the degree to which the body is impaired varies depending upon the health condition of each individual.  However, with proper intervention and treatment, most patients can lead a long, self-reliant and productive life for many years to come.

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