Impairement of functional ability in patients with Parkinson’s disease, a qualitative study

Mabel Manoj Mathew, Suresh J.


Mabel Manoj Mathew, Suresh J. – Impairement of functional ability in patients with Parkinson’s disease, a qualitative study. Fizjoterapia Polska 2022; 22(5); 48-54

DOI: https://doi.org/10.56984/8ZG20Ak5q

Abstract

Background. Population studies on the incidence of Parkinson’s are important to scientists’ understanding of the history of the disease, its progression, and the risk factors associated with it. Information about the incidence in different age groups and genders can help healthcare experts design strategies to meet patients’ needs. Objective. To understand the subjective functional Impairment in patients with Parkinson’s disease. Methodology. It is a qualitative study with a sample size of 10, including Parkinson’s disease patients between the age group of 40 to 70 years. The interviews of the patients were conducted either through phone calls or zoom calls depending on their convenience. Results. The most mentioned complaints by the patients included in the study are, tremor, masked face, a fixed expression, difficulty in talking, slowness of movement, unsteadiness while walking, fear of fall, short-stepped gait, forward bent or stooped posture, and freezing episodes. Patients require only minimal assistance from caregivers or family members to do their daily activities (n = 4) and are majorly dependent on others for their day-to-day requirements (n = 3), completely dependent, and bedridden (n = 1). Conclusion: According to the data collected from the patients, it can be concluded that patients with Parkinson’s disease develop difficulties in their functional activities and end up with activity limitations as the disease progresses and the symptoms worsen.

Keywords:
Parkinson’s disease, quality of life, motor symptoms, activity limitations, functional ability

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Evaluation of rehabilitation of patients suffering from parkinsonism

Aniela Zawistowska, Wirginia Cytowicz-Karpiłowska, Bohdan Karpiłowski

Aniela Zawistowska, Wirginia Cytowicz-Karpiłowska, Bohdan Karpiłowski – Evaluation of rehabilitation of patients suffering from parkinsonism. Fizjoterapia Polska 2006; 6(2); 133-137

Abstract

Background. The purpose of the observation and analysis was to evaluate the effects of rehabilitation treatment of patients suffering from Parkinsonism treated in Olsztyńskie Stowarzyszenie Chorych na Parkinsona. According to the Hoehn-Yahr scale those were the patients in the 3rd stage of the disease. Material and methods. 32 patients were studied: 13 women and 19 men in the age of 47-81. The rehabilitation programme of the author comprised manual exercise, such as object gripping, moving objects in space, tackling objects, and refining day-to-day activities and writing. Other types of exercise was also applied: breathing exercise, stretching, relaxing exercise, coordination exercise, balance exercise, face expression exercise and gait correction exercise. The gait correction programme started with adopting the standing position, correcting it, and then balancing from one foot to the other, marching in different directions, and overcoming the obstacles. They underwent the non-pharmacological rehabilitation treatment for 6 months. Before the programme was started and after it was concluded we evaluated such symptoms as: tremor, motor slow down, gait, manual abilities and handwriting. Results. The observation of the above symptoms before and after the rehabilitation treatment shows the symptoms alleviation. In all of the cases the difference is statistically significant. Conclusions. After the six-months period of rehabilitation there is a significant difference in gait, less symptoms of motor slow down, improvement in manual abilities, less tremor and improvement in handwriting. All those achievements have more or less influence on fighting the anxiety and depression.

Key words:
Parkinsonism, rehabilitation method, effects
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Diagnostics of Balance and Gait Disorders in Patients with Parkinson’s Disease

Maria Kłoda, Grażyna Brzuszkiewicz-Kuźmicka, Edyta Smolis-Bąk, Izabela Korabiewska, Monika Lewandowska, Dariusz Białoszewski

M. Kłoda, G. Brzuszkiewicz-Kuźmicka, E. Smolis-Bąk, I. Korabiewska, M. Lewandowska, D. Białoszewski – Diagnostics of Balance and Gait Disorders in Patients with Parkinson’s Disease. FP 2017; 17(2); 122-131

Abstract

Parkinson’s disease is a chronic, progressing affliction of the human central nervous system. It is one of degenerative diseases and affects mainly the extrapyramidal system, and in particular the substantia nigra of the midbrain.  Along with the axial symptoms of Parkinson’s disease, the other most important ones would include abnormalities of posture and gait. The improper posture has an impact on future problems with locomotion and self-service functions.
Prior to introducing any physiotherapy, there should be carried out a number of tests, which will allow both, quantitative and qualitative assessment the patient’s gait and his or her posture. These tests include among others: gait analysis performed on a treadmill of the ”Zebris” FDM-TDM type, which uses the WinFDM-T data base system, Vicon 460 system for the three-dimensional assessment of gait, Timed Up & Go, 10 MWT or Tinetti tests.
Demographic data indicate the increasing incidence of the Parkinson’s disease, which seems to be due to the gradual lengthening of a human life span. This makes it very important to properly rehabilitate and care for the patients.
As the disease progresses, patients begin to experience discomfort during their daily activities, and in locomotion, and thus their quality of life is being reduced. Here comes the great importance of implemented physiotherapy treatments, which are supposed to maintain, for as long as possible, the patients’ mobility at the level sufficient to enable their independent functioning. Introduced early enough physiotherapy procedures significantly improve gait parameters in patients with the Parkinson’s disease, thus delaying progression of the disease.

Key words:
diagnostics, Parkinson’s disease, balance disorders, gait disorders

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The Pathogenesis of Parkinson’s Disease Related Balance Disorders. The Balance Disorders Evaluation Methods. Review Article

Maria Kłoda, Renata Kowalska-Taczanowska, Grażyna Brzuszkiewicz-Kuźmicka, Andrzej Friedman

M. Kłoda, R. Kowalska-Taczanowska, G. Brzuszkiewicz-Kuźmicka, A. Friedman – The Pathogenesis of Parkinson’s Disease Related Balance Disorders. The Balance Disorders Evaluation Methods. Review Article. FP 2016;16(1);82-87

Abstract
Basis of the Parkinson’s disease are the chronic neurodegenerative changes, manifesting themselves in the asymmetric bradykinesia, the muscular rigidity and the resting tremor (the so-called triad of symptoms). Along with the advancement of the disease, there occur symptoms within the autonomic nervous system, speech and swallowing disorders, dementia, cognitive function disorders. The neurodegenerative process caused by the dopamine deficiency in the brain, leads to the gradual loss of movements coordination, which is worsening along with the development of the disease. Slowness of movements, characteristic for the patients with Parkinson’s disease, is in turn the leading cause of the locomotion disability. This symptom, together with the coexisting postural instability, are qualified as the main causes of the balance disorders accompanying the disease in question.  The implementation of the proper procedures for diagnosis of the balance disorders, in this group of patients, actually helps to reduce the number of falls.Currently the most popular tool for evaluating the posture stability disorders are the clinical tests of balance. Very popular for the evaluation of the balance disorders are the simple motor ability tests, allowing to assess a given motor skill in the quantitative and the half-quantitative manner. The actual usefulness of the balance assessment on the stabilometric platforms has been proved in the numerous clinical studies. The efficacy of the described method has been demonstrated in the research of the probability of falls due to Parkinson’s disease. Meaningful are also the reports of the superiority of the posturography over the other methods for the balance assessment. Unfortunately, the application of the posturography tests in balance analyses, in patients with Parkinson’s disease, is still being limited to the selected centers. This is mainly due to the relatively high cost of the purchase of the posturography platform.

Key words:
Parkinson’s disease, posturography tests, balance assessment

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