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Understanding Parkinson’s Disease

Parkinson’s disease is the second most common degenerative brain disorder affecting adults, with Alzheimer disease being number one. Parkinson’s affects one in every 100 people over the age of 60 and men have a slightly higher risk than women. Nebraska leads the world in the prevalence of Parkinson’s disease per capita.

Parkinson’s disease is related to a loss of nerve cells in the brain that produces a chemical called dopamine. Dopamine and other chemicals in the brain are usually in balance and are important for the control of body movements, thought processes, decision making, moods, and other behaviors.

The exact causes of Parkinson’s are not known yet. Several factors including genetics, aging, and exposure to certain environmental toxins may contribute to the onset of the disease. It is a chronic degenerative disease, so people with Parkinson’s get worse over time; however, people do not generally die from it.

The severity and symptoms of Parkinson’s vary widely. Some people have the disease and experience a slower decline of movement and thinking over a longer period of time, while others may experience difficulty with mobility and thought processes as the disease progresses more rapidly.

The motor symptoms of Parkinson’s disease include:
• Bradykinesia - slowing down and loss of spontaneous and voluntary movement,
• Rigidity - unusual stiffness in a limb or other body part,
• Resting tremor - an uncontrollable movement that effects a limb when it is at rest and stops during voluntary movement,
• Postural instability - problems with standing or walking and impaired balance and coordination,
• Other physical symptoms may also be present.
The non-motor symptoms of Parkinson’s that are common and have a big impact on patients are:
• Cognitive impairment - decline in ability to multi-task and/or concentrate and potentially decline in intellectual functioning,
• Mood disorders - depression and anxiety,
• Problems sleeping - REM Sleep Disorder is where people act out their dreams,
• Low blood pressure with standing,
• Constipation,
• Speech and swallowing problems,
• Unexplained pains, drooling, and smell loss.

There is no objective test to make a definitive diagnosis of Parkinson’s disease. Instead, a doctor takes careful medical history and performs a thorough neurological examination, looking for motor symptoms. The doctor may also look at responsiveness to Parkinson’s medication as further evidence that Parkinson’s is the correct diagnosis. Unfortunately, since there is no definitive test for Parkinson’s disease, and because Parkinson’s symptoms are similar to those of other neurological conditions, the misdiagnosis rate remains significant.

There is no way to prevent Parkinson’s disease as of now. Studies have shown improved walking, balance, strength, flexibility, and fitness in people with Parkinson’s disease, who participate in a regular exercise program. A physical therapist can partner with Parkinson’s patients to manage their specific situation now and as their condition changes.

The LSVT BIG program is a great program to help Parkinson’s patients improve their mobility, speed, balance, and quality of life. It is an intensive four week program that addresses unique impaired movements for people with Parkinson’s disease. This type of program is necessary to optimize learning and carryover of better movements in everyday life.

Other great Parkinson’s program include dance classes, boxing, swimming, walking, yoga, and even Tai Chi. It’s important to work with a doctor to figure out what kind and level of exercise fits for each patient.
Although there is no cure for Parkinson’s yet, people with the disease are still able to lead a fulfilling and productive life for many years. Staying active and working with a team of professionals to proactively improve the quality of life is important. If you experience any symptoms or have any questions about Parkinson’s, do not be afraid to ask your doctor.

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