Parkinson's: What is it and what is the role of physiotherapy


What is Parkinson

Parkinson's is a neurodegenerative disorder that affects the central nervous system, specifically the part of the brain that controls body movement. The disease is named after Dr. James Parkinson, an English surgeon who first described the symptoms of this disease in 1817.

Parkinson's disease is characterized by many symptoms, including shaking (tremors), muscle stiffness, slow body movements (bradykinesia), and balance problems. These symptoms usually develop gradually and slowly get worse over time. Although most cases of Parkinson's have no clear cause, some cases are linked to genetic and environmental factors. Characteristic features of Parkinson's disease include:

  1. Shaking (Tremor)
    • Typical symptoms of Parkinson's are tremors in the hands, fingers, arms, legs, or facial shaking or trembling at rest (resting tremor)
  1. Muscle stiffness
    • A feeling of muscle tension or stiffness that prevents body movement.
  1. Bradykinesia
    • Body movements are slow and feel stiff or restricted.
  1. Balance and coordination disorders
    • People with Parkinson's disease tend to fall easily or have difficulty walking smoothly.
  1. Posture disorders
    • Body posture becomes more prone or bent forward.

Causes of Parkinson's

The exact cause of Parkinson's disease is not completely understood, but it is thought to be related to a combination of genetic, environmental, and biochemical changes in the brain. The mechanisms involved in the development of Parkinson's disease include damage to certain neurons in the brain that produce the neurotransmitter dopamine. The following are several factors that are thought to contribute to the onset of Parkinson's disease:

  1. Damage to dopaminergic neurons

In the brains of Parkinson's patients, a group of neurons that produce dopamine, a neurotransmitter that plays an important role in regulating body movement, is damaged. This damage and death of dopaminergic neurons causes motor symptoms such as tremors, stiffness, and slow movement in those affected.

  1. Genetic factors

In a small number of Parkinson's cases, genetic factors may play an important role in the development of the disease. Several genetic mutations have been associated with an increased risk of Parkinson's disease. However, Parkinson's disease that is directly caused by genetic factors is generally rare and makes up only a small proportion of all Parkinson's cases.

  1. Environmental exposure

Certain environmental influences are associated with an increased risk of Parkinson's disease. Risk factors include, for example, chronic exposure to certain herbicides or pesticides. Additionally, air pollution and exposure to heavy metals such as manganese have been studied as potential risk factors for Parkinson's disease.

  1. Age factor

The risk of developing Parkinson's increases with age. The disease is more common in older people, but younger people may be less likely to be affected.

  1. Inflammation and Oxidative Stress

Some research suggests that inflammation and oxidative stress (an imbalance between reactive molecules in the body) may also play a role in damage to dopaminergic neurons and the development of Parkinson's disease.

The Process of Parkinson's

Parkinson's disease is a complex neurodegenerative process that causes damage and death of certain neurons in the brain, especially in areas responsible for controlling body movement. Parkinson's disease is characterized by decreased production of dopamine, a neurotransmitter that plays an important role in coordination and control of movement.

Following are the general processes in the development of Parkinson's disease:

  1. Damage to dopaminergic neurons

The Parkinson's process begins when a group of nerve cells in the brain called dopaminergic neurons become damaged. These neurons are located in a part of the brain called the substantia nigra, which is involved in dopamine production.

  1. Decreased dopamine

As a result of damage to dopaminergic neurons, dopamine production decreases. Dopamine plays an important role in transmitting signals between neurons and regulating body movements. When dopamine decreases, communication between neurons is disrupted, causing motor coordination problems.

  1. The appearance of motor symptoms

When the decrease in dopamine reaches a certain level, the motor symptoms of Parkinson's disease appear. These symptoms include tremors, muscle stiffness, bradykinesia (slow movement), and balance and coordination problems. These symptoms usually develop gradually and slowly get worse over time.

  1. Changes in brain structure

In addition to damage to dopaminergic cells, changes in brain structure occur which are also associated with Parkinson's disease. Proteins, called Lewy bodies, accumulate in nerve cells. Lewy bodies consist of protein aggregates that can disrupt the normal function of neurons and signaling in the brain.

The Role of Physiotherapy in Parkinson's Cases

Physiotherapy plays an important role in the treatment of Parkinson's disease. Appropriate physiotherapy can help improve the quality of life for people with Parkinson's disease by reducing motor symptoms, improving balance, mobility and physical ability, and reducing the risk of falls. Here are some aspects of the role of physical therapy in Parkinson's disease:

  1. Movement and Flexibility Training

Physiotherapy can provide an exercise program specifically designed to improve flexibility and mobility in people with Parkinson's disease. This exercise aims to strengthen muscles that may be stiff and increase range of motion.

  1. Movement and balance therapy

People with Parkinson's disease often experience problems with walking and balance. A physical therapist can help with special exercises to improve walking and balance.

  1. Strength Training and Physical Rehabilitation

Physiotherapy also includes strength training and physical conditioning to improve muscle strength and endurance. This can help improve the ability of Parkinson's disease sufferers to carry out daily activities more easily.

  1. Functional Activity Therapy

Physiotherapy can engage people with Parkinson's disease in functional exercises that are similar to daily activities. This helps strengthen the skills needed to perform daily activities more smoothly.

  1. Education and Understanding

In addition to physical exercise, physiotherapists also play a role in educating and understanding Parkinson's disease sufferers and their families in managing symptoms, practicing compensatory techniques, and preventing falls.

Also read: Ini Cara Terhindar Dari Stroke

Reference : 

  1. Belvisi D, Pellicciari R, Fabbrini A, Costanzo M, Pietracupa S, De Lucia M, Modugno N, Magrinelli F, Dallocchio C, Ercoli T, Terravecchia C, Nicoletti A, Solla P, Fabbrini G, Tinazzi M, Berardelli A, Defazio G. Risk factors of Parkinson disease: Simultaneous assessment, interactions, and etiologic subtypes. Neurology. 2020 Nov 3;95(18):e2500-e2508. doi: 10.1212/WNL.0000000000010813. Epub 2020 Sep 17. PMID: 32943485; PMCID: PMC7682833.
  2. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Parkinson’s disease: Overview. 2009 Mar 10 [Updated 2019 Jul 4]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK293713/
  3. Kouli A, Torsney KM, Kuan WL. Parkinson’s Disease: Etiology, Neuropathology, and Pathogenesis. In: Stoker TB, Greenland JC, editors. Parkinson’s Disease: Pathogenesis and Clinical Aspects [Internet]. Brisbane (AU): Codon Publications; 2018 Dec 21. Chapter 1. Available from: https://www.ncbi.nlm.nih.gov/books/NBK536722/ doi: 10.15586/codonpublications.parkinsonsdisease.2018.ch
  4. Osborne JA, Botkin R, Colon-Semenza C, DeAngelis TR, Gallardo OG, Kosakowski H, Martello J, Pradhan S, Rafferty M, Readinger JL, Whitt AL, Ellis TD. Physical Therapist Management of Parkinson Disease: A Clinical Practice Guideline From the American Physical Therapy Association. Phys Ther. 2022 Apr 1;102(4):pzab302. doi: 10.1093/ptj/pzab302. Erratum in: Phys Ther. 2022 Aug 1;102(8): PMID: 34963139; PMCID: PMC9046970.
  5. Radder DLM, Lígia Silva de Lima A, Domingos J, et al. Physiotherapy in Parkinson’s Disease: A Meta-Analysis of Present Treatment Modalities. Neurorehabilitation and Neural Repair. 2020;34(10):871-880. doi:10.1177/1545968320952799
  6. Zafar S, Yaddanapudi SS. Parkinson Disease. [Updated 2022 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470193/


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