Parkinson's Disease Rehabilitation

1. Rehabilitation in Parkinson’s
Disease
Dr. Mohabbat Ali
Coordinator, Advanced Rehabilitation
Services, AKUH

2. Parkinson’s Disease
Having Parkinson’s does not
mean you sit down and stop
being active

3. Parkinson’s Rehabilitation
Exercise will not alter the
progression of Parkinson’s but it is
essential for maintaining your
quality of life.
So: rehabilitation plays a key role
in the overall management plan

4. Researches
Studies clearly show that
people with Parkinson’s
who do exercise are better
in the long run than the
people with Parkinson’s
who do not exercise

5. Body alignment appropriate to quiet
standing and sitting
Standing alignment
Head balanced on level
shoulders
Upper body erect,
shoulders over hips
Hips in front of ankles
Feet a few cm (10 cm)
apart
Sitting alignment
Head balanced on level
shoulders
Upper body erect
Shoulders over hips
Feet and knees a few cm
apart
Parkinson's Rehabilitation Progran AKUH

6. Symptoms of PD
Motor sign.
Tremor (shaking usually starts on one side
of the body, often in the hand or finger)
Rigidity (stiffness where the limbs feel
like lead)
Akinesia (difficulty in initiating movement
and slowness of movement)
Problems with balance

7. Cont.…
Others sign:
 Imbalance
 Gait disturbances
 Swallowing-/ speech disorder
 Autonomic dysfunction
 Cognitive deficits (depression, dementia)
 Drug induced symptoms

8. Gait
 Gait is the medical term to describe human
locomotion, or the way that we walk.
Interestingly, every individual has a unique
gait pattern.

9. Gait Disorder
Difficulty initiating walk
Petit pas (small steps)
Festination
Freezing
Difficulty turning
Heel-toe gait

10. not correct

11. correct

12. Gait - Training

13. Instability in PD
 PD – patient fail to make the appropriate
anticipatory postural adjustments of the trunk
and the limb
 Displacement of the body center
 Minimized reflect ability to establish the
appropriate postural set

14. Instability
retropulsion

15. Instability Training

16. Instability Training

17. Instability Training

18. Dynamic - Balance Training
center

19. Dynamic - Balance Training
center

20. Exercises

21. Balancing

22. BALANCE EXERCISES

23. Preventing Falls
 DO NOT pivot your body over your feet when
turning. Instead try “U-turn” while walking
“U-turn” - Useful for more open
areas. Move your feet & body together
in an arc...

24. Clock-turn
“Clock-turn” Technique - Useful
in small areas & for when you
are stopped & must turn. Start
at 12PM & take 2 slow steps to
3PM, and so on

25. Avoid walking backwards
 Stepping sideways
“Side-step Arc” Technique -
Useful in
small spaces & as a way to avoid
stepping
backwards. Take slow side-steps
in an
arc...

27. poor sitting posture

28. Good sitting posture

29. Breathing exercises

30. Breathing Exercises

31. Stretching Exercises/ flexibility

32. Flexibility/Stretching

33. SEATED NECK AND CHEST STRETCH

34. SEATED ROTATION STRETCH

35. Back Stretch

36. NECK STRETCHING EXERCISES

37. Upper Back Stretching Exercises

38. SHOULDER STRETCHES
1

39. SHOULDER STRETCHES

40. STRETCHES FOR UPPER BACK

41. STRETCHES FOR UPPER BACK

42. STRETCHES FOR THE LOWER BACK

43. STRETCHES FOR THE LOWER LIMB

46. Occupational Therapy
Patient and caregiver education
goals of program
transfers, task simplification,
positioning, etc.
Home exercise program
Home and workplace modifications

47. Speech Therapy
 Swallowing evaluation
including modified barium
swallow
 Cognitive evaluation
 Articulatory speech training
for dysarthria
 Early therapy esp. effective
 Teaching compensatory
strategies for safer swallow

48. Techniques to Improve Speech
Increase loudness
Face the listener directly
Emphasize key words
Use short sentences
imagery
Range-of-motion exercises for muscle of
speech
Breathing exercises, breath control

49. For Parkies

50. For every one
“Lack of activity destroys the good condition of every
human being, while movement and methodical
physical exercise save it and preserve it”
Plato