Parkinson’s disease (PD) is a condition that many people do not fully understand and are unable to identify. It is estimated that there are about one million individuals in the United States that live with Parkinson’s, and more than ten million individuals worldwide.
Parkinson’s is a movement disorder that affects an individual’s strength, flexibility, motor control, balance, coordination and gait. This is due to a loss of cells over time in a particular portion of the brain called the Substantia Nigra. This portion of the brain produces a chemical called dopamine which is responsible for the regulation of movement, but with loss of nerve cells, dopamine quantity is diminished. This underproduction of dopamine leads to many symptoms including: tremors, bradykinesias (slow movement), trunk and extremity stiffness, as well as deficits in balance and coordination. Additional symptoms that often are concurrent with PD are the following: sleep deprivation/disturbances, anxiety, depression and fatigue.
Parkinson’s is a progressive disease caused by genetic and environmental factors and currently does not have a cure, although there are many interventions that can help with managing these symptoms. Medication, deep brain stimulators and physical therapy are among the most popular and effective interventions for addressing the movement disorders associated with PD.
Physical therapy and exercise offer a conservative treatment option for managing these movement disorders. There have been many different modes of exercise shown to be beneficial with PD such as bicycling, walking, boxing, Tai Chi, yoga and dancing. Exercise has been proven to be neuroprotective in nature and helps slow down the progression of the disease and improve quality of movement. Traditionally, physical therapy focused on improving generalized deconditioning and strength with frequent augmented or external feedback provided during execution of functional tasks. It has been shown that within time internal cueing has a greater carry-over of task training. Our goal is to improve a patient ability for internal cueing in order to facilitate independence with all functional activities.
The LSVT BIG Program was designed specifically to address movement disorders in individuals with PD. The goal and primary focus of this program is increasing amplitude across motor systems. This is an intense and high effort program that will train and recalibrate the sensory system to provide proper internal cueing. It has been shown to improve balance and motor control leading to a reduced risk of falls and the ability for an individual to move “normally.” Each therapy session involves performing a set of daily activities including seated and standing exercises that focus on encouraging large movements of reaching, stepping, and turning. Physical therapists will provide assistance to challenge the balance system while ensuring maximal safety with each task.
If you or someone that you know suffers from Parkinson’s disease or any other balance dysfunctions, we would encourage you give Breakthru Physical Therapy and Fitness a call and speak with an LSVT BIG certified specialist. We will provide more information about the LSVT BIG program and set you up with a consultation.
-Dr. Jonathan Eaton PT, DPT, ACSM EP-C, LSVT BIG-Cert
Ebersbach, G., Ebersbach, A., Edler, D., Kaufhold, O., Kusch, M., Kupsch, A., &Wissel, J. (2010).Comparing exercise in Parkinson’s disease—the Berlin BIG Study. Movement disorders, 25(12), 1902-1908. Ebersbach, G., Ebersbach, A., Gandor, F., Wegner, B., Wissel, J., &Kupsch, A. (2014). Impact of Physical Exercise on Reaction Time in Patients With Parkinson’s Disease—Data From the Berlin BIG Study. Archives of physical medicine and rehabilitation, 95(5), 996-999. Winstein, C. J. (1991). Knowledge of results and motor learning–implications for physical therapy. Physical therapy, 71(2), 140-149.