1. Parkinson’s Disease
Jose S. Santiago M.D.

2. Parkinson’s Disease
Parkinson’s Disease- a chronic, progressive nervous system disease that causes problems in body movements

3. Parkinson’s Disease Cause:
1. Degeneration of nerve cells that produce dopamine, a neurotransmitter that affects motor movements.

4. Parkinson’s Disease Main Symptoms of Parkinson’s Disease:
1. Tremors- shaking or trembling of the hands, arms or legs
2. Muscle stiffness- severe limitation of movement
3. Bradykinesia- slow movement
4. Impaired balance- stooping and instability when standing

5. Parkinson’s Disease Treatment: 1. Drugs- Levodopa 2. Physical therapy
3. Occupational therapy
4. Speech therapy

6. Parkinson’s Disease
A 59 year-old patient with Parkinson’s disease comes to the physical therapy department for gait training and treatment of tremors.

7. Parkinson’s Disease T: Therapist P: Patient T: Hello. Good ______.
P: Good _______.
T: How ________?
P: I have ________ in my hand. I also have ____________________.

8. Parkinson’s Disease
T: Yes. You have _______ and your ____ has changed a lot. We will start today’s ______. Please ______ on the bed. I will do some _________ exercises to all your joints. Then we will do _______ and _____ training.
P: Yes sir.
T: If you feel any _____ when I do the ____, please tell me.

9. Parkinson’s Disease
T: Did you _____ the instructions at home which I told you for the ______?
P: Yes, I ___ some weight cuffs on my hands to stop the tremors.
T: That’s ____. Now we will ____ your posture. Please come _____ to the mirror. Please look straight. Make your body ____.
P: I can’t do more than this.

10. Parkinson’s Disease
T: That’s _____. Pull your stomach in. Please don’t bend your ____. Now we will ___ for some distance. Please listen to my instructions carefully. When you ___ walking, ____ your heels on the ground first and then the toes. Please _____ my legs. Then you can try to ___ it.
P: But I feel like falling down.

11. Parkinson’s Disease
T: You have a ______ on your hand. So you won’t fall down.
P: Okay sir. It is _____ to stop walking and to _____ around.
T: Yes I know. I have made some _____ on the floor. Follow them when you ____.

12. Parkinson’s Disease Occupational Therapy: P: Hello. Good _____.
T: Good _____. Please sit down on the ____ over there.
P: Yes sir.
T: Now I will ___ a weight cuff and you ___ to do this exercise.

13. Parkinson’s Disease P: How to do it?
T: I will ____ you. _____ this handle and _____ it in a _______ direction.
P: Like this?
T: Yes, right. Do it for __ minutes then we will ____ the next exercise.
P: Okay sir. Thank you.