Parkinson's disease
Parkinson's disease is a dysfunction of the basal ganglia caused by degeneration of the cells that produce dopamine in the substantia nigra.
What is Parkinson's disease?
It is a progressive neurodegenerative disease of the central nervous system that affects the parts of the brain involved in controlling and coordinating movement, muscle tone and posture.
Symptoms
- Motor symptoms: bradykinesia (slowing down of movements), tremor (greatest at rest), muscle stiffness, stooped posture, impaired balance and walking (starting, arm swinging, turning, episodes of freezing and festinating gait) and fatigue. Over time, there may be “on-off” episodes where symptoms appear before the next dose of medication is taken.
- Cognitive symptoms: lack of initiative or motivation, changes to memory and attention span.
- Emotional symptoms: depression, anxiety around physical effort, falls and getting around.
- Other symptoms: insomnia, constipation.
Who does it affect?
The prevalence of Parkinson’s in Catalonia is 229 in every 100,000 people.
Diagnosis
- The Hoehn and Yahr scale (HY): classification of Parkinson's disease into clinical phases according to severity.
- Unified Parkinson’s Disease Rating Scale (UPDRS): assesses mental state, behaviour, mood, daily activities, motor aspects and treatment complications.
- Parkinson’s Disease Questionnaire (PDQ-8): assesses quality of life of patients with Parkinson's disease.
- Mini-BESTest: assesses reactive and proactive postural control, sensory orientation, walking ability and the risk of falling.
- 6-Minute Walk Test (6MWT): assesses cardiovascular strength.
- Record of falls
- Record of physical activity
Typical treatment
This is focused on empowering patients and their carers to achieve behavioural changes within their own control and to motivate them to continue treatment long term. It centres on reducing medication and gaining quality of movement. The main goal is functional independence for the individual and general physical condition from the onset of the disease. It is all geared towards minimising secondary complications and the risk of falls.
Prevention
There are a growing number of studies emphasising that aerobic activity may have a neuro-protective effect. Likewise, during treatment, preventing inactivity, falling and fear of getting around or falling is stressed.
