Parkinson's disease
Difficult, slowed movement and shaking, together with a characteristic stance and posture – these features are also known as rigidity, tremor and bradykinesia. Typical clinical manifestations can be seen in posture and gait: reduced and slowed visible movements, rigidity and tremor at rest. All these externally visible changes have their clinical correlate in changes in the brain, especially in the basal ganglia, namely the degeneration of dopaminergic neurons. Reduced facial expression and a lower blink rate are often noticed, as is a change in speech. Sometimes very small handwriting is noticed – so-called micrographia. Increased muscle tone results in rigid movement, sometimes as if we were turning a cogwheel. Changes in neuropsychological functioning are common, as is a noticeable impairment of the sense of smell, together with disturbances of the autonomic (vegetative) nervous system.
Changes appear in more and more domains – physical and psychological, in interaction with others and in functioning in everyday life. In evaluating the disease and monitoring its course, the doctor will follow a number of categories, such as: 1. slowness of movement, especially of the hands, including handwriting; 2. rigidity; 3. posture; 4. spontaneous arm movements when walking; 5. gait; 6. tremor; 7. facial expression; 8. seborrhoea, i.e. an oily face; 9. speech; 10. independence and functioning in activities of daily living.
The patient and those around them should also keep track of these features and monitor them, so that changes to medication and rehabilitation can be made in good time and the consequences and unfavourable course of the disease can be slowed or prevented. Exercise has a special role: alongside the medicines you take as recommended by your neurologist, the physiatrist will prescribe exercise and explain and show you how to exercise and how to do regular physical activities such as various sports, walking and hiking when the stage of the disease allows. The aim is to preserve mobility, adapt it to daily activities, dose it well and coordinate it with your medication to prevent falls and fractures, which are common in Parkinson's disease. The physiatrist will also refer you to a speech and language therapist for speech therapy if needed and, if necessary, to a psychiatrist. Cooperation between the specialist physiatrist and the specialist neurologist is important. Physical modalities and work with a physiotherapist and a kinesiologist will significantly improve your physical abilities; therapeutic ultrasound and other modalities play the same role, but what is key is monitoring your condition, adjusting your medication and well-dosed exercise therapy. Faktor Zdravlje Polyclinic has top specialists in physical medicine and rehabilitation who keep up with the latest developments in neurorehabilitation, while our trained therapists and kinesiologists will support you while you exercise.
