Physiotherapy procedures in persons with Parkinson's disease

Abstract

Parkinsonova bolest smatra se jednom od kroničnih bolesti središnjeg živčanog sustava koja zauzima vodeće mjesto. U svijetu, kao i kod nas događa se sve češća pojava novooboljelih slučajeva Parkinsonove bolesti. Različite su kliničke manifestacije bolesti kao i tijek i progresivnost bolesti. Iako je oboljenje od Parkinsonove bolesti karakteristično za osobe starije životne dobi, sve češće ljudi obolijevaju od nje, porastom incidencije i prevalencije bolesti, pojava novooboljelih u mlađoj životnoj dobi smatra se pod utjecajem genetske predispozicije. Kod Parkinsonove bolesti ima nekoliko glavnih simptoma koji se javljaju i napreduju, a to su: tremor, bradikinezija, rigor i posturalna nestabilnost. Kod svakog pacijenta simptomi različito napreduju i različiti je tijek progresivnosti bolesti, može dovesti do potpunog invaliditeta, a kod nekih osoba su samo blago vidljivi simptomi. Parkinsonova bolest javlja se kod svih etničkih skupina, rasa, većinom se javlja kod muške populacije, ali javlja se i kod ženske populacije u manjim postocima. Parkinsonova bolest ima više skupina po kojoj se manifestiraju određeni simptomi i tijek, a to su tremor dominantni tip, akinetički tip i mješoviti tip. Parkinsonova bolest utječe na središnji živčani sustav. Dijagnosticiranje još uvijek nije potvrđeno, a postoje i slične dijagnoze Parkinsonove bolesti zbog toga je izrazito bitno na pravilan način izraditi fizioterapijsku procjenu kako bi se postavila točna dijagnoza. Lijek za Parkinsonovu bolest još ne postoji, a medikamentoznom terapijom se utječe na smanjenje i regulaciju simptoma. Prije izrade plana terapije bitno je napraviti fizioterapijsku procjenu pacijenta i određene testove, kako bi se rehabilitacijom izradili kratkoročni i dugoročni ciljevi i odredili potrebni fizioterapijski postupci i terapijske vježbe. Glavni cilj je olakšati pacijentu svakodnevni život i svakodnevne aktivnost, vratiti koordinaciju, balans, ravnotežu, posturalnu stabilnost i poboljšati kvalitetu života pojedinca.Parkinson´s disease is considered one of the chronic diseases of the central nervous system, holding a leading position. Both globally and in our county, the occurrence of newly diagnosed cases of Parkinson´s disease is becoming increasingly common. The clinical manifestations of the disease, as well as it´s course and progression, vary. Although Parkinson´s disease typically affects older individuals, it is increasingly being diagnosed at a younger age. The rise in incidence and prevalence of the disease, along with the appearance of the new cases among younger individuales, is thought to be influenced by genetic predisposition. Parkinson´s disease includes several main symptoms that appear and progress over time. Those symptoms include tremor, bradykinesia, rigidy and postural instabilitiy. In each patient, the symptoms manifest and progress differently. The course of the disease can lead to complete disability, while in some cases only mild symptoms are present. Parkinson´s disease occurs in all ethnic groups and is more prevalent among the male population, but it is also increasingly seen in women, with a small percentage occurring in the younger population. Parkinson´s disease has two main types, the akinetic-rigid type and the tremor-dominant type. It primarily affects the central nervous system. Diagnosis is still not definitively confirmed, and due to the existence of similar diagnoses, it is extremely important to properly conduct a physiotherapeutic assessment in order to establish an accurate diagnosis. There is currently no cure for Parkinson´s disease, but through medication and therapy it is possible to reduce and manage the symptoms. Before creating a therapy plan, it is essential to perform a physiotherapeutic evaluation of the patient and specific tests, in order to set short-term and long-term goals and determine the necessary physiotherapeutic procedures and kinesiotherapeutic exercises. The main goal is to ease the patient´s daily life, restore coordination, balance, and stability and improve strength. For this reason, the most commonly used exercises are those aimed at improving strength, coordination, balance, breathing exercises, and relaxation. Among physiotherapy procedures, electrotherapy and massage are often used for relaxation and have a beneficial effect on symptoms