At Synaptic Neuro Rehabilitation we have a unique client centric approach with custom programming based on symptoms. Many times these cross over different conditions and injuries. In the interest of shared experiences and getting to know one another at the clinic, we're starting a series based on these conditions. April was Parkinson's Awareness Month and in honour of this and of the partners in our community, the Parkinson's Association of Alberta - let's get to know more together.
Understanding Parkinson's Disease (PD)
Parkinson’s Disease (PD) is a progressive neurodegenerative disease that affects the dopaminergic neurons in our brain, most notably in the Substantia Nigra. This area of our brain is responsible for producing dopamine - an important chemical messenger involved in many of our body functions, including movement coordination.
There are a range of symptoms someone with PD may experience - motor symptoms will be the most notable/recognizable, but non-motor symptoms will often be experienced first. Non-motor symptoms are not easily recognized as symptoms of PD, and as a result, non-motor symptoms often go untreated.
Common motor symptoms include: | Non-motor symptoms could include: | Non-motor symptoms continued |
Slowness of movement Rigidity | Drooling | Hallucinations |
Tremor | Change in taste and smell | Sexual dysfunction |
Postural instability | Choking and swallowing difficulties | Orthostatic hypotension |
| Nausea and vomiting | Excessive daytime sleepiness |
| Constipation | Insomnia |
| Uncontrolled loss of stool | REM sleep behavior disorder |
| Bladder dysfunction | Restless leg syndrome |
| Unexplained changes in weight | Leg swelling |
| Dementia and cognitive impairment | Delusions and impulse control disorders |
| Double vision | Excessive sweating |
Depression is a prevalent and debilitating non-motor symptom of PD. Up to 50% of people with PD experience clinical depression symptoms at some stage in their disease progression. Clinical depression remains an under-diagnosed symptom of PD.
While most people start recognizing symptoms between age 50 to 60, some experience these symptoms at a much younger age. As symptoms begin to disrupt daily life, there are various treatment options that can help.
What Causes Parkinson's Disease & How is it Diagnosed?
For someone with PD, insufficient dopamine production disrupts their movement patterns. Despite researchers actively investigating this puzzle, suggesting that factors such as aging, environmental exposures, and genetic irregularities may initiate the bodily changes, no one knows exactly how PD starts.
For someone to be diagnosed with PD, a doctor will conduct a thorough medical history review and examination. No blood test or lab exam exists specifically for diagnosing PD so diagnosis relies solely on clinical observations and provided information. Imaging, such as an MRI or CT scan, may be ordered to rule out other possible causes for symptoms.
What Treatments are Available for PD?
There is currently no cure for PD, treatments available focus on managing symptoms and maximizing quality of life. There are 3 categories of treatment options:
Pharmacologic
Pharmacologic treatment options are dependent on an individual’s symptoms - there are currently no disease modifying drugs for PD, so medications would be prescribed to provide symptom relief.
Nonpharmacologic
Like pharmacologic options, nonpharmacologic treatment options are dependent on the symptoms affecting quality of life. These treatment options include:
Physiotherapy/Exercise Therapy
Exercise therapy can be very helpful for maintaining mobility and balance, as well as managing pain. Therapeutic exercise will be personalized to meet an individual’s needs and goals.
Occupational Therapy
Occupational therapy will address areas of self-care, work, and leisure activities. An occupational therapist can provide info on adaptive equipment, safety awareness, energy conservation, and mobility aids.
Speech- Language Pathology
A speech-language pathologist can help with issues related to speech, language, and swallowing.
Mental Health Support
Mental health support can benefit both the person living with PD, and their family/care partner. Changes in social life and family dynamics can be very difficult to adjust to, and having a professional to support everyone involved through these changes can make them easier to manage.
Cognitive Training
Engaging in challenging cognitive tasks/activities can work to manage cognitive decline. A “starting point” for cognitive training is currently undefined, but is generally person-specific.
Education
When equipped with the knowledge and skills related to living with PD, someone living with the disease would feel much more in control and better able to navigate daily life as independently as possible. Understanding of information provided allows someone with PD to better manage their own health.
Surgical
Surgical options may be considered when motor symptoms start to significantly interfere with activities of daily life. Surgical procedures someone with PD could potentially benefit from include deep brain stimulation and lesioning surgeries.Another common surgical procedure for those with PD is the implantation of a Duodopa pump, which is an alternative medication delivery system.
The Role of Family Support
Family and care partners play a very important role in supporting someone with PD. There are countless ways family support can provide for someone living with PD, including emotional support, helping with medications, and assisting with physical challenges - but often the role is seen as not only care-giving, but advocating for their loved one and their well-being. Family support and care partners make sure that decisions regarding treatment are made in line with their loved one’s life goals.
Resources for Those with PD & Those Who Care for Them
Much of the information provided in this post was based on info collected from Parkinson’s Canada and Parkinson’s Association of Alberta resources - below are the links to explore more!
Parkinson’s Canada
Parkinson’s Association of Alberta
CONTRIBUTED BY: Kyra Chmielewski - Rehabilitation Specialist
Comments