Parkinson disease
Parkinson’s disease (also known as Parkinson disease or PD) is a degenerative disorder of the central nervous system that often impairs the sufferer’s motor skills, speech, and other functions (Parkinson’s Disease, 2008).
Parkinson’s disease belongs to a group of conditions neurological in nature called movement disorders. It is characterized by muscle rigidity, tremor, a slowing of physical movement (bradykinesia) and, in extreme cases, a loss of physical movement (akinesia). The primary symptoms are the results of decreased stimulation of the motor cortex by the basal ganglia, normally caused by the insufficient formation and action of dopamine, which is produced in the dopaminergic neurons of the brain (Parkinson’s Disease, 2008).
PD is the most common cause of chronic progressive Parkinsonism which refers to the syndrome of tremor, rigidity, bradykinesia and postural instability. While many forms of Parkinsonism are “idiopathic”, “secondary” cases may result from toxicity most notably of drugs, head trauma, or other medical disorders. The disease is named after English physician James Parkinson, who made a detailed description of the disease in his essay: “An Essay on the Shaking Palsy” written in 1817 (Parkinson, 1817).
Treatment of PD can be treated temporarily with two drugs that will penetrate the blood brain barrier which are Levodopa and Carbidopa (Werner, 2007). However, the patient usually develops a resistance to these medications, and they have various side effects that can outweigh the need for drug therapy. Other drugs have been used to slow the metabolism of dopamine so whatever the body does manufacture will remain in the system longer.
Physical, speech, and occupational therapies are often deployed to maintain the health and general functioning levels of the patient for as long as possible. The old adage of use it or lose it is what physicians deploy as a means to prolong the functional use of motor control over the body.
Massage as a treatment to PD has also been used to prevent the stiffness and rigidity of voluntary muscles. Massage can be used with stretching and Range of motion exercises to increase flexibility and prolong the functional use of voluntary muscles. Patients that employ massage can also reduce anxiety and onset of depression due to the disease. The therapist should work in conjunction with the patients primary physician because the need for the need of some kinds of medication. The therapist should take extreme care because patients with PD do not have the range of motion that most other people do. Most therapists employ a mat and use the floor to work with these types of clients. The session should also be shortened so that the patient can receive the most benefit from the treatments.
According to a 2002 study conducted by the Touch Research Institute at the University of Miami, along with staff from the university’s neurology department and Duke University’s pharmacology department, Parkinson’s disease symptoms are reduced by massage therapy (Nicole Cutler, 2007).
In this study, the group of adults with Parkinson’s disease who received two massages a week for five weeks experienced improved daily functioning, increased quality of sleep and decreased stress-hormone levels. The massage consisted of 15 minutes in the prone position, focusing on the back, gluteal region, thoracic region, adductors, quads, hamstrings, calves and feet; and 15 minutes in the supine position, focusing on the thighs, lower legs, feet, hands, forearms, upper arms, neck, face and head (Nicole Cutler, 2007).
While several different massage modalities have been quantifiably researched in the context of Parkinsonism, including Trager, Alexander Technique and Swedish massage, all modalities report improvement in function, from the reduction of rigidity and improvement of sleep, to the reduction of tremor and increase of daily activity stamina (Nicole Cutler, 2007).
Studies from various resources state that the therapist should not be afraid of working with clients suffering from Parkinson’s disease. The pathology of this condition and the success reported with massage therapy make physical manipulation of the musculoskeletal system an ideal Parkinsonism management component. Since the disease is primarily a dysfunction of the nerves and massage affects the soft tissues, nerves, and ligaments of the body it is an ideal candidate for working along the physician to ease the pain and suffering of the patient. Being familiar with this disease and welcoming those affected can bring an enormous amount of satisfaction to any compassionate therapist.
The patient’s sense of wellbeing can also be achieved by use of lymphatic drainage, reflexology, PNF/MET/Stretching, shiatsu, Swedish, and trigger point therapy. Reflexology is indicated with special emphasis on head, endocrine system, and solar plexus points. Swedish is used to help reinforce a parasympathetic state which helps with uncontrolled muscular contraction, but it is also vital to work in conjunction or as part of a health care team. Deep Tissue Massage in conjunction with a health care team can help to improve patient’s awareness with slow and methodical pressure in the soft tissues of the muscles (Werner, 2007).
At this time a cure is not available for this disease; extensive research has been done lately with outcomes that only help the symptoms. Massage is just one of those ways to aid in the relief of the symptoms of the disease in my opinion simply calming the nervous system and assisting in stretches based on the articles and information that I have read on the topic would aid in minimizing the symptoms so that the patient can control and hold on to the range of motion that they presently have and prolong the symptoms from taking control and diminishing their quality of life.
June 13th, 2009 at 9:57 am
Super blog! I am {loving|enjoying} it!! We will come back again