Therapies for Parkinson's Disease Patients

Parkinson’s disease can affect many aspects of daily living. Common symptoms include a shuffling walking pattern, poor posture, decreased balance and coordination, stiff muscles, tremors, confusion, and difficulty speaking and swallowing. Medications can provide some relief of these symptoms, however, Occupational, Physical and Speech therapy can also be beneficial in preserving these important qualities of life.

How Do Various Therapies Help with Parkinson's Disease?

Occupational Therapy

Occupational Therapists (OT) help patients do the things they want and need to do with increased safety and independence. OT focuses on self-care tasks, home management, fall prevention, and making home modifications. OTs can assist someone with Parkinson’s disease dress themselves independently with use of adaptive equipment or strategies to decrease tremors and improve coordination. OTs can educate on fall prevention and energy conservation techniques during self-care and home management tasks. OTs are also experts in home modifications to increase safety at home and to allow people to stay in their homes longer.

Physical Therapy

Physical therapists (PT) help patients by improving balance, strengthening muscles, improving coordination, walking, and endurance. PTs can also provide recommendations about the safest options for a mobility aide, such as a walker or cane. In patients with Parkinson’s, PT strengthens the muscles that are weak and stretches the muscles that are tight or ridged. This improves posture, the ability to walk , and the ability to get up and down from chairs. They also work on improving balance and coordination to prevent falls. Staying active and mobile can assist in delaying the disease process.

Speech Therapy

Speech Language Pathologists (SLP) are beneficial to patients with Parkinson’s disease to enhance communication, swallowing and cognition. In Parkinson’s disease, voice changes can negatively impact how loud and clear a person’s speech sounds. SLPs can provide strategies and exercises to help a person gain control over their voice and improve communication abilities.

Additionally, people with Parkinson’s can develop Dysphagia (difficulty swallowing). SLPs can evaluate swallowing safety and provide safe swallow strategies, diet modifications, and provide swallowing rehabilitation.

Lastly, Parkinson’s disease can impact cognitive abilities as the disease progresses. SLPs can teach strategies to compensate for changes in cognition and thinking.

Types of Therapy Programs

Occupational, Physical and Speech therapy services can be provided in a hospital, outpatient clinic, rehabilitation center, skilled nursing facility or within your home. There are also many comprehensive therapy programs such as LSVT BIG, LSVT LOUD and SPEAK OUT that are beneficial in combating symptoms of Parkinson’s disease and improving quality of life. These programs are provided by credentialed professions.

• SPEAK OUT is a speech therapy program designed specifically for people with Parkinson's Disease. It typically consists of 12 speech therapy sessions and daily home practice outlined in a comprehensive workbook. Tasks consist of speech, voice, and cognitive exercises to target many aspects of a person's communication at the same time. After completing SPEAK OUT, patients have the option to transition to "Loud Crowd," which is a maintenance program held once a week to promote going practice of skills learned in the initial 12 weeks. Loud Crowd is a great way to create friendships, maintain your skills, and improve your social connections and confidence in your communication skills.
• LSVT LOUD is another program that increases volume of speech, improves the intonation of speech and improves the ability to be understood. This program is 16 sessions, 4 consecutive days a week,  for 4 weeks. Each session is 1 hour and there is daily homework and carryover exercises that must be completed in addition to the therapy sessions.
• LSVT BIG focuses on "big" high amplitude movements completed with high effort and good quality. During a session, patients complete seven daily exercises that can be modified based on skill level, functional component tasks, walking, and a higher level functional task chosen by the patient that is broken down into smaller steps.  This program also consists of 16 sessions, 4 consecutive days a week, for 4 weeks. These session are one hour and daily homework and carryover exercise must be completed everyday.

Where to Find Help and Resources

Neurologists and primary care physicians can direct patients to programs in the area and provide appropriate referrals. There are also many support groups, caregiver groups, and ways to get involved to join the fight against Parkinson’s  disease. Parkinson’s Nebraska is an organization that can also provide guidance and assistance with finding programs and support throughout the community. Wherever you are a clinician, caregiver, patient or therapist, when we work together to fight Parkinson’s disease, great things can happen!