New Approaches in Rehabilitation of Parkinson Disease

Physical rehabilitation is effective in the treatment of people with Parkinson disease. The results are greater when treatment is started early. Incorporates complex, sequential movements with multiple sensory inputs creates responses that are environmentally appropriate, challenges balance, uses large-amplitude movements, and is effective. Animal research indicates that exercise may protect the dopaminergic neurons. Materials and Methods: First, the activities selected must engage the patient: the patient must find the activities interesting enough to do them regularly. Variety is important to facilitate shifts in movement as well as in thought. And movements must be big! (In fact, onetreatment technique even uses that word in its name.) Activities that are designed to improve balance are valuable even in the early stages of the disease. Programs that emphasize sensory-motor integration, agility, and motor learning demonstrate decreased progression of diseaseand improved motor function. Programs that involve the coordination of dual motor-cognitive tasks and complex sequences of movements and that force the participant to quickly change movements. Results: As the person progresses, practice of precise ADLs is advisable. Theseinclude rising from a chair, getting out of bed, turning in bed, adjusting covers, and being aware of posture. At the later stages of the disease, breathing exercises will need to be a more prominent aspect of treatment. Conclusions: Big movements still need to be stressed. At these later stages of the disease, use of assistive equipment may also need to be taught. What follows are ideas for treatment of more specific aspects of the disease. These are ideas and are not exhaustive. The words big, fun, and novel are good words to remember when planning treatment.