Movement disorders in people with Parkinson disease: A model for physical therapy

被引:301
作者
Morris, ME [1 ]
机构
[1] La Trobe Univ, Bundoora, Vic 3083, Australia
来源
PHYSICAL THERAPY | 2000年 / 80卷 / 06期
关键词
movement science; neuromuscular disorders; Parkinson disease; physical therapy;
D O I
10.1093/ptj/80.6.578
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
People who are diagnosed with idiopathic Parkinson disease (PD) experience movement disorders that, if not managed, can lead to considerable disability. The premise of this perspective is that physical therapy for people with PD relies on clinicians having: (1) up-to-date knowledge of the pathogenesis of movement disorders, (2) the ability to recognize common movement disorders in people with PD, (3) the ability to implement a basic management plan according to a person's stage of disability, and (4) problem-solving skills that enable treatment plans to be tailored to individual needs. This article will present a model of physical therapy management for people with idiopathic PD based on contemporary knowledge of the pathogenesis of movement disorders in basal ganglia disease as well as a review of the evidence for physical therapy interventions. The model advocates a task-specific approach to training, with emphasis on treating people with PD-related movement disorders such as hypokinesia and postural instability within the contest of functional tasks of everyday living such as walking, turning over in bed, and manipulating objects. The effects of medication, cognitive impairment, the environment, and coexisting medical conditions are also taken into consideration. An argument is put forward that clinicians need to identify core elements: of physical therapy training that apply to all people with PD as well as elements specific to the needs of each individual. A case history is used to illustrate how physical therapy treatment is regularly reviewed and adjusted according to the changing constellation of movement disorders that present as the disease progresses.
引用
收藏
页码:578 / 597
页数:20
相关论文
共 82 条
[1]   FUNCTIONAL ARCHITECTURE OF BASAL GANGLIA CIRCUITS - NEURAL SUBSTRATES OF PARALLEL PROCESSING [J].
ALEXANDER, GE ;
CRUTCHER, MD .
TRENDS IN NEUROSCIENCES, 1990, 13 (07) :266-271
[2]  
[Anonymous], EUROPEAN J PHYS MED
[3]  
[Anonymous], MODELS INFORM PROCES
[4]  
[Anonymous], 1997, NEUROLOGY REPORT, DOI DOI 10.1097/01253086-199721040-00009
[5]  
Bagley S., 1991, Physiotherapy, V77, P415, DOI [DOI 10.1016/S0031-9406(10)62035-4, 10.1016/S0031-9406(10)62035-4]
[6]  
Ball J M, 1967, Am J Phys Med, V46, P1034
[7]  
Banks M A., 1989, Clin Rehabil, V3, P11, DOI [10.1177/026921558900300102, DOI 10.1177/026921558900300102]
[8]   Verbal instructional sets to normalise the temporal and spatial gait variables in Parkinson's disease [J].
Behrman, AL ;
Teitelbaum, P ;
Cauraugh, JH .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1998, 65 (04) :580-582
[9]   DISTURBANCE OF SEQUENTIAL MOVEMENTS IN PATIENTS WITH PARKINSONS-DISEASE [J].
BENECKE, R ;
ROTHWELL, JC ;
DICK, JPR ;
DAY, BL ;
MARSDEN, CD .
BRAIN, 1987, 110 :361-379
[10]   THE DRINKING ACTION OF PARKINSONS-DISEASE SUBJECTS [J].
BENNETT, KMB ;
MARCHETTI, M ;
IOVINE, R ;
CASTIELLO, U .
BRAIN, 1995, 118 :959-970