Parkinson’s and MS Rehabilitation

Parkinson's Disease

It is estimated that 6.3 million people have Parkinson's disease worldwide, affecting all races and cultures. This progressive neurological movement disorder can affect balance, strength, coordination and functional mobility and place individuals at increased risk for having a fall.

As Parkinson's disease progresses, it becomes increasingly disabling, making daily activities like bathing or dressing difficult or impossible.

Common symptoms experienced by individuals diagnoses with Parkinson's Disease include:

• Tremor - A tremor is an involuntary, rhythmic shaking of an arm, leg, head or the entire body. A tremor may start out in only one part of the body with an occasional "twitching" of a finger, and gradually progress to the whole arm. Not everyone with Parkinson's Disease will experience a tremor.
• Rigidity - Rigidity is a stiffness or decreased flexibility in an arm, leg, or multiple joints. This symptom often begins in the legs and/or neck. Most individuals with Parkinson's Disease will have some form of rigidity. As rigidity progresses, some individuals may experience pain associated with this symptom.
• Bradykinesia - Bradykinesia is defined as a slowness of movement. Individuals with bradykinesia have difficulty initiating movement or lack the ability to keep moving at a specific pace once they get started. Individuals with bradykinesia may develop a shuffling-type walking pattern which places them at risk for falls from tripping over items in their path. They may eventually progress to akinesia (no movement).
• Postural Instability - (impaired balance and coordination). Individuals with postural instability often demonstrate a "stooped" standing posture with head and shoulder tipped and rounded. They may have a tendency to lean forward or backward. This change in posture places them at increased risk for falls

Research has shown that safe, regular exercise for individuals with Parkinson's Disease can address posture, gait pattern (trunk rotation and arm swing), strength and balance reactions to decrease risk of falling and to promote increased independence throughout all stages of the disease.

While physical therapy cannot "cure" Parkinson's Disease, our physical therapists will work with you to develop strategies to help you and your family manage the effects of this disease and improve your function in order to maximize your independence. Every patient is different. Our physical therapists will design an individualized exercise program to meet your needs.

The following video by The American Physical Therapy Association can help you learn more about how physical therapy intervention may help Parkinson's Disease.

For more information about Parkinson's Disease, please visit Wilmington Parkinson & Lewybody Diseases Support Group - an education, advocacy, referral and support organization for Parkinson's Disease. parkinsonassociation.org

Additional Information About Parkinson's Disease available at:

• European Parkinson's Disease Association: www.epda.eu.com/en/
• Parkinson Primer from National Parkinson's Foundation: www.parkinson.org

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The following video by The American Physical Therapy Association can help you learn more about how physical therapy intervention may help Parkinson's Disease.

For more information about Parkinson's Disease, please visit Wilmington Parkinson & Lewybody Diseases Support Group - an education, advocacy, referral and support organization for Parkinson's Disease.

Parkinson's Wellness Recovery: PWR!Moves™ Exercise Class

Bodies in Balance provides hour long exercise classes that is specifically targeted to individuals living with Parkinson's disease. This class follows the PWR! Program whose mission statement is "to develop and implement worldwide access to cutting edge Parkinson disease-specific neuroplasticity-principled exercise programs that hold promise to slow disease progression, improve symptoms, restore function, and increase longevity and quality of life."

Classes led by physical therapists who have completed PWR! Parkinson's certification. We provide this class with belief (backed by evidence based research) that exercise is medicine for individuals living with Parkinson's disease and has the potential to slow your Parkinson's progression. Classes address many areas of improving fitness: strength, balance, coordination, flexibility, and cardiovascular functioning. Movements in class aid in facilitating neural protection, guiding brain health, and repair. Participants of the PWR!Moves course can expect to move, sweat, laugh, and move their bodies!

Requirements for entry include: A physical therapy assessment to screen for safety, physical limitations, and health risks. Participants then attend approximately 1-3 additional physical therapy sessions to learn the basic PWR! Program moves so that they may jump right into classes ready to go. We offer both Level 1 and Level 2 for varied abilities.

MS Rehabilitation

There are approximately 400,000 individuals living in the United States who have been diagnosed with Multiple Sclerosis (MS) and over 2.5 million worldwide. Most people are diagnosed with MS between age 15-50.

Multiple Sclerosis is a progress disease of the central nervous system. MS is an autoimmune disease that causes the body's immune system to attack myelin (the protective coating to the nerves). Once the myelin of a nerve is damaged it becomes more difficult to transmit nerve impulses (messages carrying sensory and/or motor input). The areas that are damages are referred to as "lesions" or "plaques".

Common symptoms of MS include fatigue, numbness, visual disturbances, bladder problems, mobility issues and others.

The most common types of Multiple Sclerosis are:

• Relapsing-Remitting MS: The most common form characterized by clearly defined attacks of worsening neurologic function followed by partial or complete recovery periods. The attacks are referred to as relapses, flare-ups or exacerbations. Approximately 85 percent of people with MS are initially diagnosed with relapsing-remitting MS.
• Secondary-Progressive MS: Most people who are initially diagnosed with RRMS will eventually transition to SPMS, which means that the disease will begin to progress more steadily and progressively and may not experience true relapse time frames.
• Primary-Progressive MS: The Primary-Progressive form of MS is characterized by a steadily worsening of neurologic function from the beginning. The rate of progression may vary over time with occasional plateaus and temporary improvements; however, there are no distinct relapse or remission phases. About 10 percent of people with MS are diagnosed with PPMS.
• Progressive-Relapsing MS: The least common of these forms of MS is characterized by a steady progression of the disease from the beginning with occasional exacerbation along the way. People with this form of MS may or may not experience recovery following these attacks; the disease continues to progress without remissions.

Research has shown that individuals (especially those with mild to moderate disability) are likely to benefit from skilled intervention including aerobic activity, balance, and strengthening exercises.

Our physical therapists will evaluate your balance, coordination, strength, range of motion, tone/spasticity and functional mobility (your ability to walk and perform other tasks throughout the day) and are trained in techniques to address deficits in any of these domains and will design an individualized exercise program to meet your needs.

• nationalmssociety.org