Parkinson`s disease

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WEEK 4 ASSIGNMENT

Part I

Etiology

Parkinson’s disease is a progressive disorder that negative impactson body movements. It starts with unnoticeable tremors in the limbs,but the symptoms worsen with time. Both environmental factors, suchas head injuries and exposure to chemicals used in insecticides, andgenetic predisposition are associated with the condition. However,doctors maintain that there is no specific cause of Parkinson’sdisease that is known (Olszewska, 2016).

Epidemiology

Parkinson’s disease is one of the most common neurodegenerativeconditions in the modern world. It affects at least a million peoplein the United States and over seven million people worldwide everyyear. Prevalence is higher among the elderly (above 60 years), males,and people of African and Asian heritages (Kalia &amp Lang, 2015,Olszewska, 2016).

Pathophysiology

The condition is as a result of declining role of neurotransmitters,mainly dopamine. This is influenced by both genetic and environmentalfactors. The loss of dopamine is as a consequence of the death ofcells in the midbrain. Nonetheless, the definitive cause remains amystery (Olszewska, 2016).

Clinical history

Several historical documents have reported symptoms of conditionssimilar to Parkinson’s disease. However, it was not until the early19th century when James Parkinson described it. In the last twocenturies, there have been numerous developments in the understandingof the illness and management interventions (Olszewska, 2016).

Signs &amp symptoms

The signs and symptoms vary from one patient to another. They includetremor in the limbs (especially hands and fingers), reduced abilityto move, increased muscle rigidity, stooped posture, lack ofunconscious movements, changes in speech, and neuropsychiatricproblems (Olszewska, 2016).

Medical treatment

Because it is chronic, Parkinson’s disease cannot be cured.Nonetheless, interventions such as management of symptoms andtherapies (physical and occupational) can be used to improve thepatient’s life. Levodopa is the leading prescribed drug for thecondition, but can be combined with other medications (Olszewska,2016).

Prognosis

Parkinson’s disease is a progressive condition. Motor symptoms areunnoticed at the onset, but the severity worsens and becomesaggressive if there are no interventions. If untreated, the patientwill lose ambulation and become bedridden within ten years. Theprogression of disability can be reduced significantly throughmedication and therapies (Olszewska, 2016).

Part II

According to Adhikari (2012), Parkinson’s disease is associatedwith several impairments that have clinical significance. They alsohave direct impacts on the occupational performance of the patient.In addition to the physical disabilities, due to the rigidity ofmuscles, there is a broad range of mental impairment mainlyproblem-solving skills and deductive reasoning. This has beenattributed to the effects of the underlying causes on cognitivedomains in the brain and its linkage to dementia. However, severalfactors affect the progress of the disease and, thus, the level ofimpairment. Adhikari (2012) established that while the age of thepatient has no significant impact on disability, the level ofeducation and stage of the disease are critical factors, especiallyin cognitive abilities decline.

Lawrence et al. (2014) established that Parkinson’s disease hasadverse effects on the quality of life of the patient. This isbecause of inadequate ability to complete basic activities of dailyliving. As a result, the patients are likely to experience otherchallenges, which includes depression and health related problems.Nonetheless, the most significant impact of the condition onoccupational performance is its effects on dual-tasks. The inabilityto perform tasks simultaneously is the most important indicator ofParkinson’s disease impairment. This can have an enormous impact onthe ability of individuals to comfortably and efficiently completesimple jobs (Fuller, et al., 2013). According to Fernandes et al.(2015), dual-task condition or working with one eye closed has hugeeffects on balance among Parkinson’s disease patients.

Part III

Occupational therapies are essential for patients suffering fromParkinson’s disease. They have a direct impact on the progress ofimpairment and thus enhance activities of daily life. Occupationaltherapists are concerned with how the disease affects the functionalabilities of the patient. For example, how limbs function, balance,gait, and speech impacts on performance. Evidence suggests that thereare clinically significant benefits derived from the therapies. Whencombined with medical interventions, they can significantly reducethe progress to disability, and, thus, performance in variousoccupations (Jansa &amp Aragon, 2015).

The most important occupational therapies that must be prioritizedamong Parkinson’s disease patients are motor training. They areaimed at enhancing walking, muscular strength and balance, whichimprove the ability to perform functional tasks (Allen et al., 2012).Gait training can be used to deal with stooped posture, especiallywhen walking. Secondly, the therapist should consider using ‘movementstrategy training’ (MST), which enables the patient to deal withmovement impairment associated with the condition. For example, astructured practice can be used to teach the patient to usealternative strategies to initiate functional moves (Morris et al.,2012). Thirdly, therapies that enhance resistance strength are alsobeneficial. They improve the capability of the patient to producepower by using multiple muscles. This promotes their walking andbalance, and, therefore, performance in activities of daily life andother tasks (Morris et al., 2012).

Conclusion

Parkinson disease is a neurodegenerative disease which affects bodymovement, resulting in disability. Although the symptoms are mild andunnoticeable at the beginning, they become aggressive if there are nointerventions. It affects physical and mental abilities of thepatient, which impacts on occupational performance. Treatmentstrategies that include occupational therapies can significantlyreduce the progress to disability.

References

Adhikari, S, et al. (2012). Effects of age, stage of disease, andeducational level on cognitive dysfunction in non-demented idiopathicParkinsonism: A preliminary report. Industrial Psychiatry Journal21(1): 32–38.

Allen N. E., et al. (2012). Exercise and motor training in peoplewith Parkinson’s disease: A systematic review of participantcharacteristics, intervention delivery, retention rates, adherence,and adverse events in clinical trials. Parkinson’s Disease,Vol. 2012, Article ID 854328.

Fernandes, A. et al. (2015). Balance in single-and dual-task in. Conference Paper. 1st Doctoral Congress inEngineering (DCE), Porto, Portugal.

Fuller, R. et al. (2013). Dual task performance in Parkinson`sdisease: A sensitive predictor of impairment and disability.Parkinsonism &amp Related Disorders, 19(3) 325-328.

Jansa, J. &amp Aragon, A. (2015).Living with Parkinson’s and theEmerging Role of Occupational Therapy. Parkinson’s Disease,Vol. 2015, Article ID 19630.

Kalia, L. &amp Lang, A. (2015). . The Lancet,386(9996), 896–912.

Lawrence, B. et al. (2014). Activities of Daily Living, Depression,and Quality of Life in Parkinson’s Disease. PLoS ONE 9(7):e102294.

Morris M. E., et al. (2012). Protocol for a home-based integratedphysical therapy program to reduce falls and improve mobility inpeople with Parkinson’s disease. BMC Neurology 12:54. DOI:10.1186/1471-2377-12-54.

Olszewska, D. et al. (2016). . In Neurodegerativedisorders: a clinical guide, by Hardiman, O. &amp Doherty, C.(2016), Cham: Springer, 85-115.