Rehabilitation Interventions in Parkinson Disease

Moroz, Alex; Edgley, Steven R.; Lew, Henry L.; Chae, John; Lombard, Lisa A.; Reddy, Cara Camiolo; Robinson, Keith M.

doi:10.1016/j.pmrj.2009.01.018

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Volume 1, Issue 3, Supplement , Pages S42-S48, March 2009

Rehabilitation Interventions in Parkinson Disease

Alex Moroz, MD
- NYU School of Medicine, Rusk Institute of Rehabilitation Medicine, New York, NY^†
- Address correspondence to: A.M.
Steven R. Edgley, MD
- University of Utah, Salt Lake City, UT^‡
Henry L. Lew, MD, PhD
- Harvard Medical School, VA Boston Healthcare System, Physical Medicine and Rehabilitation Service, Boston, MA^§
John Chae, MD
- Case Western Reserve University, Department of Physical Medicine and Rehabilitation, MetroHealth Medical Center, Cleveland, OH^¶
Lisa A. Lombard, MD
- Santa Clara Valley Medical Center, San Jose, CA^∥
Cara Camiolo Reddy, MD
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, PA^#
Keith M. Robinson, MD
- Department of Physical and Rehabilitation, University of Pennsylvania Hospital, Philadelphia, PA^⁎⁎

Objective

This self-directed learning module provides an evidence-based update of exercise-based rehabilitation interventions to treat Parkinson disease (PD). It is part of the study guide on stroke and neurodegenerative disorders in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This focused review emphasizes treatment of locomotion deficits, upper limb motor control deficits, and hypokinetic dysarthria. New dopaminergic agents and deep brain stimulation are facilitating longer periods of functional stability for patients with PD. Adjunctive exercise-based treatments can therefore be applied over longer periods of time to optimize function before inevitable decline from this neurodegenerative disease. As function deteriorates in patients with PD, the role of caregivers becomes more critical, thus training caregivers is of paramount importance to help maintain a safe environment and limit caregiver anxiety and depression. The overall goal of this article is to enhance the learner’s existing practice techniques used to treat PD through exercise-based intervention methods.