Parkinson Physical Therapy Case Study

Neurology is one of the most unexplored fields in medicine; however, more recently there has been a spike in the amount of research being done in this specialty. This is because people are becoming more interested in neuroscience, including myself. I attended a pre-medical vocational high school, which exposed me to a greater amount of knowledge pertaining to the basics of anatomy and physiology, along with hands-on opportunities in a medical setting. It was here where I realized that I wanted to pursue a career in medicine; however, due to the fact medical field is very broad, I had no set specialty. This changed when I was exposed to the cruel manifestations of Parkinson’s Disease. During, sophomore year of high school, my grandfather passed away due to complications of Parkinson’s Disease. The way that a neurodegenerative disease was able to overtake a person in the manner that it did was shocking, and while it brought me great grief initially, it later intrigued me. I took up an interest in neuroscience and began to do my own research which culminated in various projects and applications throughout the remainder of my time in high school. These experiences have culminated in my decision to work toward a Cell Biology and

Parkinson disease (PD) is one of the most common neurologic disorders. and it affects approximately 1% of individuals older than 60 years old. Parkinson’s disease is a condition that progresses slowly by treatment. In addition, loss of pigmented dopaminergic neurons of the substantianigra pars compacta and the presence of Lewy bodies and Lewyneurites are the two major neuropathologic findings in Parkinson disease (Hauser, 2016).

The World Health Organization projects that, by 2040, neurodegenerative diseases will become more common than cancer (Cashell, 2014). Parkinson’s Disease (PD) is widely listed as the second most common neurodegenerative disease (Wuong, 2012; Gillies et al., 2014; Cashell, 2014; Walker, Davidson, & Gray, 2012). This disease, usually characterized by a tremor, but featuring systemic effects, has been diagnosed in one to two percent of people over age 65 (Casey, 2013). Parkinson’s disease is incurable; the goal of the healthcare team is to help the patient to maintain function, independence and quality of life (Miertová et al., 2014; Magennis, Lynch, & Corry, 2014). In the discussion that follows, current understanding of the causes and treatment of PD will be summarized, along with examples of nursing interventions.

J.N., a 65-year-old Caucasian female with a history of anxiety and depression, presents for diagnostic testing at Saint Mary Medical Center in Hobart, Indiana to confirm or deny a diagnosis of Parkinson’s Disease, after presenting with recent onset of upper extremity tremor affecting both sides and facial masking. Patient history also includes bradykinesia, restlessness, fatigue, muscle weakness, and poor balance and coordination, all of which are common in a diagnosis of Parkinson’s Disease. J.N. was referred to the Neurology Department of Saint Mary Medical Center after a routine appointment with her Cardiologist, who noted the recent onset of additional signs and symptoms. J.N. is my mother and my inspiration for this assignment.

L.C. is a 78-year-old white man with a 4-year history of Parkinson’s disease (PD). He is a retired engineer, is married, and lives with his wife in a small farming community. He has 4 adult children who live close by. He is taking carbidopa-levodopa, pergolide, and amantadine. L.C. reports that overall he is doing “about the same” as he was at his last clinic visit 6 months ago. He reports that his tremor is about the same, his gait is perhaps a little more unsteady, and his fatigue is slightly more noticeable. L.C. is also concerned about increased drooling. The patient and his wife report that he is taking carbidopa-levodopa 25/100 mg (Sinemet), 1 tablet an hour before breakfast and 1 tablet 2

Parkinson’s disease is a “neurodegenerative disorder of the basal nuclei due to insufficient secretion of the neurotransmitter dopamine” (Marieb & Hoehn, 2013, p. G-17). The cause of Parkinson’s disease is unknown, but many factors play a role in the development of Parkinson’s disease. One factor that has been found in an individual who has Parkinson’s disease causes over activity of targeted dopamine-deprived basal nuclei. This over activity is caused by the breakdown of neurons that release dopamine in the substantia nigra (Marieb & Hoehn, 2013). Another factor that is present in a person who has Parkinson’s disease, is the presence of lewy bodies in the brain stem ("What is lbd?," 2014). Lewy bodies are unusual

At today’s visit she is accompanied by her husband and private aide. Her husband reports that she is doing much better. He states that her pain has improved and she has not taken her pain medication since last visit. He states that her anxiety had improved extremely with the recent change in her Xanax. He states that he has hired 24 help for the patient and since she has not fallen. She reports that she is feeling well. The caregiver reports that the patient continue to suffers from hypotension and hypertension with variation in blood pressure. The patient also continues to suffer from chronic tremors as a result of her Parkinson.

While attending the Parkinson’s Support Group, I observed and took note of many occurrences throughout the group. There were 18 caregivers/individuals with Parkinson’s in attendance, along with 3 students, the director, and the group leader (a counseling student intern). Each individual diagnosed with Parkinson’s, except for two, was accompanied by their spouse/caregiver. Members of this group sat around a rectangle table with the group leader at the front. The purpose of the group, on that particular day, was to discuss challenges that individuals with Parkinson’s and or caregivers face, activities and ways to cope, and some positive gains after the disability. The type of group that was ran was a support group, as compared to having guest speakers as usual. The Parkinson’s group was open to the

Parkinson Disease (PD) is a neurodegenerative disease symptomized by tremor, muscular rigidity, and slow imprecise movements. Typically, the disease affects middle-aged and elderly individuals. PD is associated with degeneration of the basal ganglia of the brain causing a deficiency of the neurotransmission of dopamine.

Parkinson's disease is a progressive degenerative disorder of the central nervous system that affects the motor system. It is marked by tremor at rest, muscular rigidity, postural instability, and slow, imprecise movement. The most obvious symptoms are movement related, which include; shaking, rigidity, slowness of movement, difficult with walking, balance, and gait. Other motor symptoms include: posture disturbances, such as a decrease in arm swing, a forward flexed posture, and the use of small steps when walking. Speech and swallowing disturbances are also common motor problems that can appear as well to a patient with Parkinson's disease. Young adults rarely experience Parkinson's disease because it is more common to affect

Parkinson’s Disease is a long-term progressive neurodegenerative disease consisting of motor system impairment, neuropsychiatric, and nonmotor features. The disease is characterized by the following key clinical features: bradykinesia, resting tremor, postural instability, and rigidity. These symptoms are due to the diminishing of dopamine in the nigrostriatal pathway and substantia nigra, which causes inhibition of the thalamus decreasing excitatory input to the motor cortex.1 Along with the key manifestations an individual with Parkinson’s Disease will experience problems associated with the disease or the antiparkinson medications. These co-occurring problems are hallucinations, dementia, daytime sleepiness, fatigue, depression, and pyschosis.2 Psychosis is a common problem in Parkinson’s Disease, and is characterized by paranoid delusions and hallucinations that are visual in nature.2 Risk factors for psychosis consists of advancing age, dementia, sleep disorders, and high doses of antiparkinson drugs.1

This will help the physical therapist create a mutual plan of action for the patient helping to balance autonomy and beneficence. This will help to ensure that the decisions made have balance to them while still being what is best for that patient. It also allows every case to be individualized to the patient.

Parkinson’s Disease is known as one of the most common progressive and chronic neurodegenerative disorders. It belongs to a group of conditions known as movement disorders. Parkinson disease is a component of hypokinetic disorder because it causes a decreased in bodily movement. It affects people who are usually over the age of 50. It can impair an individual motor as well as non-motor function. Some of the primary symptoms of Parkinson’s disease are characterized by tremors or trembling in hands, legs and arms. In early symptoms the tremor can be unilateral, appearing in one side of body but progression in the disease can cause it to spread to both sides; rigidity or a resistant to movement affects most people with Parkinson’s disease,

In the Evidence-Based Analysis of Physical Therapy in Parkinson’s Disease with Recommendations for Practice and Research by Samyra Keus, Bastiaan Bloem, Erik Hendricks, Alexandra Bredero-Cohen, and Marten Munneke, the authors discuss the relationship between physical therapy and Parkinson’s Disease and also practice recommendations for physical therapists to use to improve daily functions for individuals with Parkinson’s Disease. The core areas for physical therapy in Parkinson’s Disease are identified. The article explains that first the physical therapist should assess health problems and use history taking. These steps determine the core areas that should be focused on for treatment. Next, the therapist needs to learn the expectations of

Parkinson disease (PD) is a progressive neurodegenerative disorder characterized mainly by physical and psychological disabilities. This disorder was named after James Parkinson, an English physician who first described it as shaking palsy in 1817 (Goetz, Factr, and Weiner, 2002). Jean- Martin Charcot, who was a French neurologist, then progressed and further refined the description of the disease and identified other clinical features of PD (Goetz, Factr, and Weiner, 2002). PD involves the loss of cells that produce the neurotransmitter dopamine in a part of the brain stem called the substansia nigra, which results in several signs and symptoms (Byrd, Marks, and Starr, 2000). It is manifested clinically by tremor,