Parkinson disease is cured by activity that is medicine. Not metaphorically or loosely – in a clinically specific, research-based sense. The body of evidence that regular, structured physical activity slows the functional decline that accompanies Parkinson’s disease, preserves the quality of movement on which the daily independence of the patient depends, and maintains the neuroplasticity that allows the Parkinson’s brain to continue to adapt and compensate.
However, not every physical activity is equally effective in delivering these benefits. and even physical therapy of patients with Parkinson’s disease is not necessarily organized around the particular neurological mechanisms that make movement training of this population different than rehabilitation of any other patient. Parkinson’s disease therapists who have devoted their training and clinical practice to neurological rehabilitation produce resultsthat general physical therapy can never replicate – because they understand the specific neurological processes that are underlying the movement dysfunction and apply the specific therapeutic modalities that address those processes rather than generic exercise prescriptions applied to a neurological presentation.
At iMotion Physical Therapy, Parkinson’s disease patients receive specific therapist care for their condition, providing them opportunities to access the standard of specialist care that their condition requires.
What Makes Parkinson’s Physical Therapy Specialized
Parkinson’s disease is a progressive neurological disorder that is characterized by the loss of dopamine-producing neurons in the substantia nigra, the part of the brain that regulates the production and smooth execution of voluntary movement. Due to a drop in dopamine, the motor system loses the automaticity, amplitude-appropriate, well-timed movement quality on which healthy movement relies.
The resultant pattern of movement is neurologically specific: decreased amplitude of movement (smaller steps, reduced arm swing, softer voice), bradykinesia (slowing of movement and difficulty initiating movement), rigidity (muscular stiffness and resistance to passive movement), and postural instability (impaired automatic adjustment of balance that increases the risk of falls).
The real specialization of therapists of the Parkinson’s disease condition lies in the fact that these conditions do not respond to the same rehabilitation strategies that musculoskeletal conditions need. The neurological amplitude recalibration caused by Parkinson’s disease is not addressed in the standard strengthening and stretching programs. Generic balance training does not focus on the particular postural instability processes of the Parkinsonian brain. Practical physical therapy of Parkinsonism must take methods and strategies specifically designed and tested with this form of the neuromuscular disorder – the most rigorously researched of which is the PWR! (Parkinson Wellness Recovery) program and LSVT Big protocol.
How Specialized Therapists Keep Parkinson’s Patients Active
To treat symptoms is not the simple clinical goal of specialized therapists in the treatment of Parkinson’s disease. It is to preserve the level of functional activity that quality of life requires, to slow the progression of disability and build the physical and neurological capacity that will enable patients to continue doing what is important to them – walking independently, engaging in daily activities, socializing and retaining the sense of physical competence that is so closely associated with psychological well-being.
The treatment approach that should be used to achieve this is one based on a number of interrelated principles.
High-amplitude movement training
is a direct counter to the neurological bias towards movement compression induced by Parkinson’s disease. The Parkinson brain systematically accommodates smaller and smaller movement ranges as normal, increasingly constraining the movement output that daily functioning demands. Parkinson’s disease is treated by special therapists who teach patients to consciously generate deliberately large-amplitude movements across all classes of motor action stepping, reaching, turning and transitioning between positions using either the PWR! movement paradigm or the LSVT BIG protocol to generate the high-repetition, high-effort practice that recalibrates the movement amplitude sense of the brain.
The progressive balance and gait training
approach addresses the specific postural instability and gait disturbance characteristics of the Parkinson’s disease systematic challenge progression that develops the actual reserve capacity. These include dual-task training, i.e., performing a cognitive task in parallel with a balance or gait challenge because the automaticity of healthy balance has been best restored through practice under those situations that require divided attention. One of the most disruptive and fall-risk-generating aspects of Parkinson’s disease is specifically targeted by cueing strategies, which include auditory rhythm, visual lines and attentional cues to which patients are exposed to help them initiate and continue with movement when the freezing mechanism interrupts the walking process.
Individualized exercise programs
are designed so that the rehabilitation program will be based on the current disease state, functional limitations, physical condition and personal activity goals of the specific patient. The clinical competence to identify and adjust the program to suit the patient with a relatively early-stage Parkinson’s disease has different training goals than the patient with more advanced motor symptoms – and the clinical skill to distinguish and adjust the program accordingly is what distinguishes specialist Parkinson’s rehabilitation and standardized protocols.
Physical Therapy Fremont: iMotion’s Dedicated Parkinson’s Clinic
The Mowry Avenue clinic at 555 Mowry Avenue is a special neuro- and Parkinson’s rehabilitation center at Physical Therapy Fremont at iMotion. PWR! certified therapists in Parkinson disease provide customized rehabilitation programs that combine the evidence-based PWR! movement training with manual therapy to address the rigidity and mobility limitations that complicate neurological movement limitations; balance and gait training calibrated to the current functional level of the patient; and caregiver education that extends the impact of the programs into the home environment of the individual patient.
The Fremont Parkinson program starts with a thorough initial assessment that measures quality of gait, performance of balance, amplitude of movement, dual-task capacity, and the particular functional activities that are of the greatest importance to the daily life and personal goals of each patient. The treatment is constructed on the basis of this evaluation and is adjusted on a regular basis as the needs and abilities of the patient alter.
Los Gatos Sports Therapy and Parkinson’s Rehabilitation
Although the term Los Gatos sports therapy is normally used to refer to the rehabilitation of athletic injuries, the Los Angeles clinic of the imotion sports and orthopedic rehabilitation clinic offers physical therapy for Parkinson’s disease, in addition to its sports and orthopedic rehabilitation services, which extend to the local communities of Los Gatos and Monte Sereno, as well as the surrounding Bay communities, who need specialized neurological care.
Conclusion
To patients and families researching Parkinson’s physical therapy in places such as the greater Southern California region and communities such as Murrieta, CA, knowing what specialist Parkinson’s physical therapy entails and what the evidence-based standards of PWR! and LSVT BIG programs provide are valuable clinical knowledge regardless of where rehabilitation eventually occurs.
The special Parkinson’s program of iMotion Physical Therapy in Fremont, along with the rehabilitation capabilities of Parkinson’s disease at San Jose and Los Gatos, is the standard of specialist care – with PWR! certified therapists of Parkinson’s disease whose daily clinical focus is on the movement challenges and rehabilitation goals of this specific group of patients.
Active living is possible with Parkinson’s disease. It is possible due to specialized therapy.