The deficiency of dopamine in Parkinson's disease (PD) leads to several problems. One key problem is the interruption of smooth, coordinated muscle function. This in turn can affect complex tasks such as speech, mobility, and coordinated use of the limbs. PD is a progressive neurodegenerative disorder, which can be treated with various medications and surgical procedures. However, since this condition is progressive, it invariably affects functional activities such as mobility and activities of daily living at some point.
There are two main factors that often impact functional activities in patients with PD. One is the direct result of the neurodegenerative process and its effect on coordination and other neurological functions. The other is the myriad of indirect effects related to neurological deficits and debilitation. Some of these secondary problems include problems such as decreased activity, deconditioning, depression, weight gain, joint pain and contractures, cognitive problems, drooling, constipation, and poor hygiene. These in turn lead to further disability and impairment. PD is more prevalent in older persons and, often, these patients have other comorbid conditions such as osteoarthritis, hypertension, diabetes, and cardiovascular disease. All of these comorbidities can worsen with deconditioning and further impact functional status.
The focus of rehabilitation interventions in patients with PD is to maintain and possibly improve function. Although physical therapy (PT) and occupational therapy (OT) may have little or no impact on the progression of PD, they can have a very significant effect on quality of life, functioning, and prevention of secondary problems.
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