PARKINSON'S DISEASE :

WORLD WIDE DATA :

ACCORDING TO - NATIONAL LIBRARY OF MEDICINE :

Near about 25.2 million people were projected to be living with Parkinson’s disease worldwide in 2050, representing near about 112% increase from 2021.

By 2050 Parkinson’s disease will have become a greater public health challenge for patients, their families, care givers, communities, and society.

ACCORDING TO - THE WORLD HEALTH ORGANIZATION :

The World Health Organization has estimated that Neurodegenerative diseases including Parkinson’s disease and Alzheimer’s disease will become the second leading cause of death worldwide by 2040.

ACCORDING TO THE ECONOMIC TIMES :

India faces a surge in Parkinson's disease cases, potentially becoming second globally. Young-onset Parkinson's is a growing concern in Southeast Asia.

With a prevalence rate of 15-43 per 100,000, India is experiencing a surge, with cases projected to increase significantly by 2030. A significant portion (40-45%) of Indian cases are early-onset with an average onset age of roughly 51 years.

WHAT IS PARKINSON'S DISEASE ?

IT IS A SLOW PROGRESSIVE NEURODEGENERATIVE DISORDER OF THE CENTRAL NERVOUS SYSTEM OF HUMAN BODY. IT AFFECTS MOTOR SYMPTOMS LIKE BRADYKINESIA ( SLOWNESS WHILE INITIATING ANY MOVEMENT) , TREMORS ( SHAKING OR TREMBLING OF HANDS / FINGERS) , RIGIDITY ( INFLEXIBILTY OR FEELING STIFFNESS IN JOINTS MOVEMENTS ) & POSTURAL INSTABILITY ( UNABLE TO MAINTAIN SITTING OR STANDING POSTURE OF BODY ) , IMBALANCE AND NON-MOTOR SYMPTOMS LIKE CONSTIPATION, SLEEP CYCLE DISTURBANCE, DEPRESSION , ANXIETY, VISUAL IMPAIRMENT, LOSS OF SMELL SENSATION, DIZZINESS, SPEECH DISORDERS AND MANY MORE.

HOW IT STARTED ?

HENCE IT IS NEURO-DEGENERATIVE DISORDER , DUE TO DEGENERATION OF BRAIN PARTS LIKE - SUBSTANTIA NIGRA, GLOBUS PALLIDUS, PUTAMEN ( WHICH PRODUCE DOPAMINE )

SO, WHEN OUR DOPAMINE ( A NEURO-TRANSMITOR , HELPS TO REWARD, PLEASE OUR BRAIN AND BODY PART MOVEMENTS) LEVEL GOES DOWN IT LEADS TO DECREASE CO-ORDINATION AND MOVEMENTS, ALSO AFFECTS MOODS.

BECAUSE OF DECREASE THE DOPAMINE LEVEL,DOPAMINE RECEPTORS IN BASAL GANGLIA ( A PART OF BRAIN) CIRCUIT NAMED STRIATUM LESS STIMULATED. THIS IS THE MAIN CAUSE OF RIGIDITY, BRADYKINESIA,TREMORS , DISORDER OF GAIT AND BALANCE .

CAUSES AND RISK FACTORS !

PARKINSON DISEASE HAS NOT A SINGLE CAUSE , THERE ARE MANY -

• IDIOPATHIC - UNKNOWN CAUSES.

• MULTI-INFARCT ATHEROSCLEROSIS - IT IS MULTIPLE SERIES OF STROKE WHICH CAUSES BRAIN DAMAGE.

• VIRAL INFECTION - Encephalitis lethargica is a disease characterized by high fever, headache, double vision, delayed physical and mental response, extreme tiredness (lethargy), and sometimes coma.

• CHEMICAL TOXICITY - MANGANESE, CARBON MONOOXIDE,CYANIDE TOXICITY CAN INDUCE PD

• DRUG-INDUCE - DRUGS LIKE PHENOTHIAZINES, RESERPINE,VALPROATE CAN INDUCE PD.

  WHAT ARE THE STAGES OF PD ?

  ACCORDING TO HOEHN AND YAHR SCALE OF PARKINSONISM THERE ARE 6 STAGES

• 0 : NO CLINICAL SIGNS ( NO TREMOR, NORMAL GAIT PATTERNS, NORMAL BALANCE , NO RIGIDITY ) .

• 1 : ONE SIDED INVOLVMENT . WE CAN SEE ONE SIDED PROBLEMS ARE INITIATED.

• 2 : BOTH SIDE OF BODY AFFECTED BUT STILL A PERSON CAN CONTROL HIS/HER BALANCE.

• 3 : BOTH SIDE AFFECTED , STARTING OF POSTURAL IMBALANCE ( CANNOT MAINTAIN BALANCE ) . PERSON MAY BE SUFFERED FALL DUE TO IMBALANCE. THIS PERSON LIVE AN INDEPENDENT LIFE-STYLE.

• 4 : BOTH SIDE BECAME MORE AFFECTED . THAT PERSON REQUIRED ANOTHER PERSON'S HELP TO DO SOMETHING.

• 5 : SEVERELY AFFACTED , FULLY DEVELOPED PARKINSON DISEASE , PATIENT RESTRICTED TO BED OR WHEELCHAIR.

WHY MAINTENANCE IS MORE IMPORTANT THAN PREVENTION ?

YOU HEARD ABOUT " PREVENTION IS BETTER THAN CURE ".

SO, WHY WE WROTE : " MAINTENANCE IS MORE IMPORTANT THAN PREVENTION" ?

LET'S DISCUSS :

AT PRESENT TIME THERE IS ' NO CURE ' OF PARKINSON DISEASE IT IS VERY UNFORTUNATE TO TELL ANYONE.

BUT SOMEHOW , THERE ARE SOME MEDICATIONS WHICH HELPS TO SLOWDOWN THE DISEASE PROGRESSION AND GIVE RELIEF TO MOTOR AND NON-MOTOR SYMPTOMS.

MEDICINES LIKE :

CARBIDOPA / LEVODOPA : IT IS THE GOLD STANDARD DRUG THERAPY FOR PARKINSON DISEASE.

DOPAMINE AGONISTS : THIS DRUGS ARE DESINGED TO ACT DIRECTLY ON DOPAMINE RECEPTOR TO STIMULATE.

SURGICAL OPTIONS :

ANOTHER WAY TO BATTEL AGAINST PD IS DBS ( DEEP BRAIN STIMULATION) . BUT IT IS A VERY CRUCIAL AND VERY EXPENSIVE SURGERY BARELY ONE MDDLE CLASS FAMILY CAN BEAR IT.

PHYSICAL THERAPY :

NOW IT COMES TO THE COMBINED APPROACH OF PHARMACOLOGICAL AND PHYSICAL THERAPY INTERVENTION . WHICH IS THE KEY MANAGEMENT OF THE PATIENT WITH PARKINSON DISEASE.

THERE ARE MANY EXERCISES WHICH IS USED TO TREAT PARKINSON'S SYMPTOMS .

EACH PATIENT HAS THERE OWN EXERCISE PROTOCOL ,SOME EXERCISE MAY BE SIMILAR, WHILE OTHERS MIGHT BE COMPLETELY DIFFERENT FROM THE REST, EVERY PARKINSON'S PATIENT'S BODY IS DIFFERENT, THEY EXPERIENCE DIFFERENT SYMPTOMS.

HOWEVER, BY DEDICATING SOME TIME TO SPECIFIC EXERCISES, YOU CAN EASILY AVOID ISSUES SUCH AS RIGIDITY , WEAKNESS, IMMOBILITY AND GAIT ABNORMALITIES.

SO, HERE ARE SOME EXERCISES THAT YOU CAN PRACTISE AT HOME TO OVERCOME YOUR LIMITATIONS : MAKE SURE WHILE YOU DO YOUR OUT OF BED EXERCISE ONE PERSON SHOULD ALWAYS STAND NEXT TO YOU.

• ACTIVE ANKLE PUMPS : WHILE LYING ON THE BED , PERFORM THE EXERCISES OF PULLING YOUR FEET TOWARDS YOUR FACE AND PUSHING THEM AWAY ; REPEAT THIS MOVEMENT 20 - 30 TIMES CONSECUTIVELY .

  

  IT INCREASES BLOOD CIRCULATION IN OUR LOWER PART OF OUR LEG.

• ACTIVE KNEE FOLDINGS : WHILE LYING ON THE BED , PERFORM THE EXERCISES OF SLIDING YOUR FEET TOWARD HIP ( KNEE FOLDING EXERCISE ) : DO THIS EXERCISE IN ALTERNATIVE MANNERS . ALSO DO IT FOR 20 TIMES 10*10 FOR EACH LEG.

  

  IT INCREASES KNEE FLEXIBILITY AND ACTIVATE MUSCLES OF LEG.

• ACTIVE STRAIGHT LEG RAISES : WHILE LYING ON THE BED PERFORM THE EXERCISES OF RAISING STRAIGHTEN LEG ABOUT 45 DEGREE , DO IT IN ALTERNATIVE MANNERS. DO IT FOR 20 TIMES 10*10 EACH LEG.

  

  IT HELPS TO STRENGTHEN YOUR HIP MUSCLES AND CORE MUSCLES. ALSO ACTIVATES HIP FLEXORS.

• ACTIVE HIP ABDUCTION - ADDUCTION : WHILE LYING ON THE BED PERFORM THE EXERCISES OF SLIDING LEGS AWAY FROM THE BODY AND TOWARDS THE BODY, DO IT SEPARATELY 10*10 EACH LEG.

  

  IT HELPS TO STRENGTHEN YOUR HIP MUSCLES AND ACTIVATES HIP ABDUCTORS & ADDUCTORS.

• PELVIC BRIDGING : WHILE LYING ON THE BED PERFORM THE EXERCISE OF BEND YOUR BOTH KNEES AND RAISE YOUR WAIST AND COUNT 5-10 , REPEAT THIS EXERCISE FOR 10 TIMES.

  

  THIS EXERCISE HELPS TO STRENGTHEN YOUR PELVIC FLOOR MUSCLES

• STATIC QUADRICEPS STRENGTHENING: WHILE LYING ON THE BED PERFORM THE EXERCISE OF PUTTING A PILLOW UNDER YOUR KNEE ,PRESS THE PILLOW WITH YOUR KNEE HOLD THIS POSITION FOR 5-10 COUNTS AND REPEAT IT FOR 10 TIMES.

  

  IT HELPS TO STRENGTHEN YOUR THIGH MUSCLES WHICH IS VERY CRUCIAL MUSCLE FORSTANDING, WALKING, STAIR CLIMBING.

• MARCH IN PLACE : WHILE STANDING ON THE FLOOR LIFT YOUR BOTH LEGS IN ALTERNATIVE MANNERS WITHOUT CHANGING THE POSITION. DO IT FOR 10*10 EACH LEG.

  

  THIS EXERCISE HELPS TO MAINTAIN YOUR WALK AND ALSO INCREASE GROUND CLEARANCE OF YOUR EVERY STEP.

• TANDEM STANDING : WHILE STANDING ON THE FLOOR PLACE YOUR FOOT ONE AFTER ANOTHER BY TOUCHING ONE'S TOE WITH ANOTHER'S HEEL AND COUNT MINIMUM 20 SEC (AS OER YOUR CAPABILITY) AND REPEAT IT FOR 10 SETS.

  

  IT HELPS TO MAINTAIN YOUR STATIC BALANCE .

• TANDEM WALKING : MAKE A STRAIGHT LINE ON THE FLOOR BY CHALK OR ANY COLORED PENCIL . WALK ON THAT LINE , LIKE CAT WALK.

  

  IT HELPS TO IMPROVE YOUR DYNAMIC BALANCE WHILE WALKING.

• SINGLE LEG STANDING : WHILE STANDING ON THE FLOOR HOLD A SOLID SUPPORT ( HANDRAIL/ WINDOW GRILL ) LIFT YOUR ONE LEG AND COUNT 5-10 AND PUT DOWN THE LEG, AND LIFT ANOTHER LEG IN ALTERNATIVE MANNER. REPEAT IT 10*10 TIMES EACH LEG .

  

  IT HELPS TO STRENGTHEN YOUR LEGS AND IMPROVE BALANCE .

• STAR EXCURSION BALANCE EXERCISE : WHILE STANDING ON THE FLOOR REACH MULTIPLE DIRECTION WITH ONE LEG WHILE ANOTHER LEG IS FIXED AT ONE POINT. DO IT FOR 5 TIMES IN EACH LEG.

  

  IT HELPS TO IMPROVE BALANCE AND CO-ORDINATION .

• SITTING TO STANDING PRACTICE : WHILE SITTING ON THE CHAIR CROSS YOUR ARMS ON YOUR CHEST ( OR HOLDING HAND SUPPORT) GET UP BY STRAIGHTENING YOUR KNEES.

  

  IT HELPS TO MAINTAIN BALANCE WHILE CHANGING POSTURE.