Parkinson’s Disease &
Movement Disorders

Therapies can help patients reduce symptoms and stay active

Overview

Parkinson’s disease and other movement disorders can cause shaking, stiffness, and trouble moving various parts of the body. Patients may have difficulty walking, talking, swallowing, or doing simple tasks. A person’s thinking and mood can also be affected.

The impact of Parkinson’s and other movement disorders vary greatly from person to person. Some people become very disabled, while others experience only minor difficulties. In the case of Parkinson’s, the disease usually affects people over age 60, and symptoms tend to advance gradually.

Medication can reduce symptoms, and surgery can help certain patients. Moreover, rehabilitation can enhance patients’ abilities to function, remain active, and stay safe from falls and other accidents. Rehab therapists can also help patients and their families cope with both the practical and emotional impacts of the illness, and plan for future needs.

Causes

Types & Causes of Movement Disorders:

Movement disorders – also called motor disorders or motor system disorders – are a group of conditions with various causes. Some can be inherited, such as Parkinson’s disease. Others can be caused by another illness or injury, such as a stroke, brain injury, infection or toxin. In fact, any type of neurologic impairment is likely to cause a movement disorder. And certain medications can trigger one.

Types of movement disorders include:

  • Ataxia: loss of muscle coordination
  • Corticobasal degeneration (a progressive neurologic disorder)
  • Dystonia: twisting and repetitive movements caused by involuntary muscle contractions
  • Huntington’s disease
  • Lewy body dementia
  • Multiple systems atrophy (MSA)
  • Myoclonus: uncontrolled, irregular movements that result from another condition
  • Parkinson’s disease
  • Parkinson’s variants: conditions that are similar to Parkinson’s disease
  • Parkinsonism: conditions that appear similar to Parkinson’s disease because they affect the same part of the brain
  • Progressive Supranuclear palsy (PSP)
  • Tremor and essential tremor: involuntary shaking of one or more body parts
  • Vascular Parkinsonism: a condition caused by one or more small strokes

Symptoms

Early signs of a movement disorder can include smaller handwriting (micrographia) and reduced arm
swing when walking. Other symptoms can include:

  • Increased movement that is either deliberate or involuntary
  • Slowed movement
  • Shaking or tremors
  • Stiffness or rigidity of the limbs and trunk
  • Problems with balance or coordination
  • Speech changes, including softer volume, slowed or slurred speech, and monotone voice
  • Difficulty swallowing or chewing
  • Difficulty turning one’s head (don’t try to force a head turn)
  • Decreased facial expressions
  • Depression and other emotional changes
  • Urinary problems or constipation
  • Skin problems
  • Sleep disruptions

When to see a doctor

Seek medical help right away if the patient has:

  • Any change in mental status
  • Difficulty swallowing
  • More frequent falls
  • Sudden change in their symptoms

If you have any other cause for concern, contact a medical professional. This is not a complete list of issues requiring medical attention.

Evaluation

Parkinson’s and other movement disorders can be difficult to diagnose. A neurologist will usually
conduct a neurological examination and ask about the person’s medical history. Physicians may also
order brain scans or laboratory tests to rule out other conditions.

Other assessments will help determine the person’s rehabilitation needs. These can include:

  • Neuropsychological evaluation, a comprehensive, non-invasive test of a person’s mental abilities and mood, including attention and concentration, learning and memory, planning and abstract thinking, language and communication, motor and sensory functions, academic skills, and other intellectual abilities. The test is done through a questionnaire and typically takes four to six hours.
  • PT/OT/SL evaluations to determine the person’s needs for physical therapy, occupational therapy, and/or speech and language therapy.
  • Vocational rehabilitation evaluation to assess a person’s work-related abilities and deficits, and their needs for rehabilitation related to job skills.
  • Independent medical examination to determine the cause, extent and medical treatment of a work-related or other injury.
  • Functional capacity evaluation to determine a person’s ability to function in a range of circumstances, especially in employment situations, in an objective manner.
  • Driver evaluation to ensure the person demonstrates safety awareness and sound judgment while driving, and the skills needed to control a vehicle.

Treatment

Treatment for movement disorders can include medication, surgery, and/or rehabilitation. A newer therapy called deep brain stimulation – which uses electrodes implanted in the brain – can also reduce symptoms.

Rehabilitation can be especially effective in helping patients reduce symptoms and maximize their quality of life. Every situation is different, but a coordinated, team approach enables the best possible outcomes for both the patient and family. Services include:

  • Cognitive rehabilitation, featuring techniques that improve memory, attention, social behavior, planning and judgment. Clinicians help patients develop strategies to compensate for deficits and incorporate modifications and/or assistive technology to help the person live as independently as possible.
  • Residential rehabilitation, which provides supervised living in the community, with staffing based on the person’s needs. Services can include behavioral programming, social supports, nutritional care, and support and training in daily living skills such as personal care, household management, health and medical care, grocery shopping, money management and budgeting.
  • Therapeutic day programs, including individual and group programs that engage in a variety of daily living, vocational, social and recreational activities, designed to help people maintain skills and improve their quality of life. Programs can address communication, thinking abilities, behavioral issues, community participation, and need for supports or accommodations.
  • LSVT BIG & LOUD®, targeted therapies that address problems with movement and speech. The “BIG” program focuses on large limb motions to improve balance, strength, and speed of movements. It can be administered by a physical or occupational therapist who is certified in BIG therapy. The “LOUD” program aims to increase voice clarity and volume. It can be provided by a speech therapist who is certified in LOUD therapy. To learn more, click here.
  • Physical therapy, which increases mobility and improves muscle tone, balance, strength and endurance. Treatment includes enhancing the patient’s walking abilities and/or use of a wheelchair.
  • Occupational therapy, which improves skills needed to function successfully at home, work or school. Treatment focuses especially on enhancing the abilities of the arms, hands and fingers, so patients can feed, dress and bathe themselves, among other daily tasks.
  • Speech and language therapy, which improves communication skills and/or swallowing, while also strengthening thinking and memory.
  • Physiatry, a form of physical medicine that helps patients manage pain, weakness or disability, and enhances their independence and functioning.
  • Psychotherapy, which aids in adjustment to the condition, awareness of deficits, maintenance of relationships and social skills, and education regarding one’s neurological disorder.
  • Vestibular therapy, which improves balance and reduces dizziness through exercise.
  • Vocational rehabilitation, including enhancement of job skills and assessment for return to work. Therapists works with both patient and employer to support the patient’s employment, including onsite job training and job coaching.
  • Music therapy, which enhances coordination, communication skills, physical abilities, and mood through such activities as handling musical instruments, following rhythms, discussing and writing lyrics, and the like.
  • Pet therapy, which can stimulate movement and social interaction, and provide emotional support, through visits by certified therapy animals.
  • Neurology, which addresses any new or ongoing symptoms related to the brain or nervous system.
  • Nursing services, which address any medical conditions related to the movement disorder, and/or other health issues.Nurses provide medical management of these conditions, oversee medications, and work closely with the patient’s primary-care provider, neurologist or other specialists.
  • Support groups for patients and family members, which provide emotional support, practical ideas, motivation and inspiration that can help people thrive.