Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword
- 1 A glossary of terms
- 2 Diagnosis of parkinsonism in the elderly
- 3 Parkinson's disease and parkinsonism in the elderly
- 4 Drug-induced parkinsonism in the elderly
- 5 Essential tremor in the elderly
- 6 Gait apraxia and multi-infarct states
- 7 The epidemiology of Parkinson's disease and parkinsonism in elderly subjects
- 8 Health and social needs of people with Parkinson's disease and the worldwide organization of their care
- 9 The drug treatment of Parkinson's disease in elderly people
- 10 Rehabilitation in Parkinson's disease and parkinsonism
- 11 Rehabilitation, nursing and elderly patients with Parkinson's disease
- 12 Rehabilitation, physiotherapy and elderly patients with Parkinson's disease
- 13 Rehabilitation, occupational therapy and elderly patients with Parkinson's disease
- 14 Rehabilitation, speech and language therapy and elderly patients with Parkinson's disease
- Index
12 - Rehabilitation, physiotherapy and elderly patients with Parkinson's disease
Published online by Cambridge University Press: 24 November 2009
- Frontmatter
- Contents
- List of contributors
- Foreword
- 1 A glossary of terms
- 2 Diagnosis of parkinsonism in the elderly
- 3 Parkinson's disease and parkinsonism in the elderly
- 4 Drug-induced parkinsonism in the elderly
- 5 Essential tremor in the elderly
- 6 Gait apraxia and multi-infarct states
- 7 The epidemiology of Parkinson's disease and parkinsonism in elderly subjects
- 8 Health and social needs of people with Parkinson's disease and the worldwide organization of their care
- 9 The drug treatment of Parkinson's disease in elderly people
- 10 Rehabilitation in Parkinson's disease and parkinsonism
- 11 Rehabilitation, nursing and elderly patients with Parkinson's disease
- 12 Rehabilitation, physiotherapy and elderly patients with Parkinson's disease
- 13 Rehabilitation, occupational therapy and elderly patients with Parkinson's disease
- 14 Rehabilitation, speech and language therapy and elderly patients with Parkinson's disease
- Index
Summary
Introduction
A primary motor disorder, such as Parkinson's disease (PD), appears to be an ideal target for physiotherapy intervention. Referral to physiotherapy is recommended in the early stages of the disease (Dobbs et al. 1992) and there is evidence of the clinical effectiveness of physiotherapy at this time (Comella et al. 1994). Unfortunately it is still more common for referral to be delayed until the disease is advanced (Oxtoby 1982), when the opportunity to initiate a preventative treatment strategy has passed.
Physiotherapy has a significant role to play in the short and long-term management of PD. Physiotherapy must be integrated with other therapies. This will maximize the benefits of therapy for the patient and carer by ensuring consistency of approach, reinforcement of treatment aims, and by developing appropriate compensatory strategies (Kauser and Powell 1996).
The pathophysiology of the motor disorder in PD
Due to a deficiency of dopamine in the basal ganglia motor control is impaired in PD. Patients experience this in terms of difficulties with initiating, maintaining, and changing from one sequence of voluntary movement to another. Excess abnormal involuntary movement, such as tremor, may also be present. Balance is often impaired in elderly patients with PD. Clinical examination defines these difficulties in terms of akinesia, bradykinesia, tremor, rigidity and impaired postural reflexes. Impaired integration of normal control may contribute to these problems and a sense of increased effort of movement may result (Lövgreen and Cody 1997).
- Type
- Chapter
- Information
- Parkinson's Disease and Parkinsonism in the Elderly , pp. 198 - 216Publisher: Cambridge University PressPrint publication year: 2000