Parkinson's Disease

What is Parkinson’s disease?

Parkinson’s disease primarily affects the nervous system which in turn impairs body movements.  It damages neurons in a specific area of the brain called substantianigra. The symptoms are the result of the gradual degeneration of nerve cells in the area of the midbrain that controls body movements. 

How common is Parkinson’s Disease?

Parkinson’s disease is one of the most common neurodegenerative conditions in the world.  It is commonly found among the elderly population, especially between the ages of 50 and 65, though it can also occur in younger adults. Men are more prone to Parkinson’s than woman.

What are the signs and symptoms of Parkinson’s disease?

Tremor:  This uncontrolled shaking usually begins in a limb, often your hand or fingers, although it can happen in the jaw or feet.  You often notice your thumb and forefingers rubbing together, especially at rest and when you are feeling stressed.  This kind of tremor is called pill-rolling tremor.

Bradykinesia (Slowed movement):  With time, Parkinson’s disease impairs your movements.  You may find doing even simple tasks difficult and time-consuming.  Your steps may become shorter when you walk.  Getting in and out of a chair, walking and rolling over in bed may be difficult.  You may drag your feet during walking.  There will be slowness in overall movements.  Even talking becomes difficult.  All this happens because of slowing down of brain’s signal to specific body parts.  Due to bradykinesia, your face can be expressionless – mask-like look.

Changes in walking:  Arms not swinging while you walk is a common symptom of Parkinson’s disease.  It may not be easy for you to walk around corners.  You may feel your feet are stuck to the floor. 

Rigid muscles:  Muscles can become stiffer in any part of the body.  Stiffer muscles restrict your range of motion.There will also be abnormal tone or stiffness in the trunk and extremities

Impaired posture and balance:You may have a stooped posture and may have balance problems as a result of Parkinson’s disease.

Loss of automatic movements:  Your ability to do involuntary movements such as blinking, smiling or swinging your arms may take a beating.

Speech changes:  Your ability to speak effortlessly also comes down; as a result you may speak softly, quickly, slur or hesitate before talking.  There won’t be usual inflections in your speech, just a monotone.

Writing changes:  Writing becomes a problem and you struggle to write.  Your writing may appear small.

What are the Stages of Parkinson’s Disease?

There are five different stages of Parkinson’s disease starting from the mildest stage to the most severe stage.

Stage 1

During this stage mild symptoms will start to appear which will not interfere with the daily activities. Mild tremors and slight changes in movement, posture etc appears on one side of the body. In some cases, stage 1 will not show any symptoms.

Stage 2 

Both sides of the body may be affected by slightly worsened tremors and movement issues. Patients will still be able to do his activities himself however it will become difficult and will take longer time.

Stage 3

This is the mid-stage of Parkinson’s Disease. Loss of balance and slowness in movement is prominently seen in this stage. With difficulty in balance, falls are common. Patients can still lead an independent life however activities like dressing and eating will become difficult.

Stage 4

At this stage, it becomes extremely difficult for the patient to live an independent life. Activities of daily living like dressing, eating, bathing etc become severely inhibited and cannot be performed without assistance. Patient may be able to walk independently but in most cases will need a walker or the movement will be extremely slow.

Stage 5

Stage 5 is considered as the most advanced stage of Parkinson’s Disease. In this stage, patients often require a wheelchair because walking and standing alone will become nearly impossible. Some patients will get bed-ridden. Severe impairment in motor skills will be noticed and patient will be dependent for almost all of his activities of daily life. He will need round the clock assistance. At this stage, patient may experience hallucinations and delusions as well.

Does the disease progress?

 The onset of symptoms is gradual in nature, slowly over years, sometimes starting with a hardly noticeable tremor in just one hand.  Parkinson’s comes with two main aspects of symptoms.  One affects you explicitly like tremors and rigid muscles.  The other aspect of symptoms are non-motor type such as emotional changes, depression, loss of smell, dementia etc.Progression of symptoms happens differently in different people due to diversity of the disease and worsens as your condition progresses over time.

What does the Plexusparkinson’s recovery program offer?

Plexus offers a multitude of therapies that focus on reducing the symptoms, reducing the dosage of parkinsonian drugs and regaining the lost functions. The lost functions include balance, flexibility, poor speed of movements, hand writing problems like micrographia and inability to perform daily activities. The therapies include but are not limited to-


Regular Physiotherapy helps people with Parkinson’s disease improve their mobility by reducing stiffness in muscles. It improves posture, balance and gait. Physiotherapy includes Strength and endurance training, flexibility, gait and balance training.

Occupational Therapy

The main aim of occupational therapy is to help people perform their day to day activities like eating, bathing, cleaning etc. independently to the maximum extent possible. Occupational Therapists work closely with people with Parkinsonism ensuring that their life is made easy at home, work and in General community. Handwriting training is an important aspect of Occupational therapy practice in patients with Parkinson’s disease.

Speech Therapy

Along with movement, Parkinson’s disease affects muscles in the face, mouth and throat which are used for speaking. This will cause problems in speaking, swallowing, and in voice. Speech Therapists who are trained in all forms of communication including non-verbal communication, help people with Parkinsonism by teaching them different techniques of communication. They also offer tips to solve problems associated with eating and drinking.

What kind of changes do the patients notice after completion of this program?

After the completion of the program patients experience significant reduction in their rigidity and movements become much more smooth and easy to perform. The daily struggles in their routine reduce and there is gradual reduction in the dosage of the parkinsonian drugs.

A doctor with Parkinson’s disease

Parkinson’s disease is one of the most common and most disabling chronic illnesses that affects a person holistically. Right from facial expressions to a shuffling gait, it affects the patient from top to toe. What can be worse for a doctor who has spent about forty years treating and curing patients with multiple illnesses than to suffer from a crippling disease like Parkinson’s? Dr N came to us with a full blown Parkinson’s plus syndrome. He had great difficulty in walking, multiple freezing episodes, history of falls, fixed gaze, poor hand writing and incomprehensible speech. Parkinson’s had affected his life and his role as a doctor. Due to poor speech output and illegible handwriting which was stricken by micrographia, his patients were having a tough time seeking for his consultation and advice. A thorough google search brought him to Plexus. Under this program he was subjected to a combination of treatment modalities. The physical therapists focused on regaining his confidence in walking by improving his balance and reducing the freezing episodes. The occupational therapists focused on improving his participation and performance in his daily life tasks and most importantly his handwriting. Being a doctor, handwriting was a major tool of his work life and regaining that was a challenging task. Towards the end of the stipulated time frame, he was able to walk with great ease, climb stairs, his facial expressions and social participation improved, his handwriting became legible and he was able to write his prescriptions. Also his overall participation in daily activities improved and the influence of the disease on his life role as a doctor reduced. Moreover, the dosage of his medications reduced by it’s one-third.


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