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This article will help you to understand this potentially disabling condition, and the benefits of physical therapy, exercise, and rehabilitation.

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Physical therapy is extremely important for the Parkinsons patient and usually follows an approach that uses active and passive exercise, gait training, practice in normal activities, and if needed, hot or cold treatments, water therapy, and electrical stimulation. Exercise is also essential for well-being; it is a common denominator in patients who are able to maintain productive years. To date, no specific approach has been proven to be better than others.

Exercise Programs. Exercise programs are used defined as passive or active.

• Passive exercise, mostly stretching and manipulation of muscles by a physical therapist, is aimed at preventing muscles from shortening. A passive exercise program that begins with slow and gentle exercises and becomes progressively more intense may improve mobility in patients with early and mid-stage Parkinsons disease.
• Active exercises are used to help range-of-motion, coordination, and speed. Patients should continually make efforts to practice movement, even simple ones, such as marching in place, making circular arm movements, and raising the legs up and down while sitting. Patients who enjoy sports or the use of exercise equipment should continue with these activities even if their skills diminish, assuming there are no other medical conditions that would prevent them.

Gait Training. Practicing new methods for standing, walking, and turning may help retain balance. The following tips may be helpful:

• Take large steps when walking forward, raising the toes at the forward step, and hitting the ground with the heel.
• Take small steps while turning.
• When walking or turning, have the legs 12 to 15 inches apart to provide a wide base.
• Do not wear rubber or crepe-soled shoes because they grip the floor and may cause the patient to fall forward.
• Using devices that keep a rhythmic beat, such a metronome (a simple device used by musicians to keep time), may be very effective, possibly more than music itself, in helping patients to walk faster and take longer steps. One study found that setting a metronome rhythm to about 10% faster than the patients fastest gait offers significant improvement over walking to no rhythm at all or to a rhythm that matches the gait.

Reducing Muscle Freezing. The patient should practice regular daily activities that simplify actions and reduce the incidence of muscle freezing. Most often, freezing occurs when a patient begins to move or is presented with an obstacle. Walkers do not appear to be helpful for freezing. The following may be helpful.

• Rock from side to side.
• If the legs feel frozen, lift the toes. This simple action may free spasm in some cases.
• Hum marching tunes. In fact, music has been shown to help people move and to get out of bed in the morning. Some report that wearing a Walkman and turning music on in situations associated with freezing, such as crossing a street, is helpful.
• Divide actions into separate events, which may prevent freezing that occurs from trying to coordinate too many physical operations at one time. For instance, when going through a doorway, approach the door, stop at the door, open it, stop, and then walk through the doorway.
• A cane equipped with a laser pointer may be helpful, at least temporarily.
• Simply being touched by another person can sometimes release the patient (although a Parkinsons patient should never be pulled or pushed).

If you have been diagnosed with Parkinson's Disease, you may be a candidate for conservative therapy at our office. Give us a call to find out today (888) 595-7282 .

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