Parkinson's Disease

Plain-language definition

Neurodegenerative disease with tremor, rigidity and slowness of movement. Essential physiotherapy to maintain independence.

Signs and points requiring attention

• Resting tremor: involuntary rhythmic movements, typically of the hands ('pill-rolling tremor'), which decrease during voluntary movements. This cardinal symptom is often the first sign noticed by patients and their families.
• Muscle rigidity and bradykinesia: increased resistance to passive movements ('cogwheel rigidity') and slowness in initiating and executing movements. These symptoms considerably impact daily activities like dressing or eating.
• Characteristic gait disorders: freezing (sudden blocking of gait), festination (small hurried steps), shuffling gait with reduced arm swing. These disorders significantly increase fall risk.
• Postural balance disorders: instability in standing position, slowed or absent balance reactions. This symptom often appears later but constitutes a major factor in loss of independence and falls.

• Frequent or unexplained falls requiring reevaluation of the rehabilitation program and possibly medication adjustment. Report every fall to your physiotherapist and neurologist.
• Prolonged freezing episodes preventing walking or leaving a room. This symptom may require specific compensatory strategies and sometimes therapeutic adjustment by the neurologist.
• Confusion, hallucinations or behavioral disorders: these symptoms may be related to medication or disease progression. Consult the neurologist promptly for treatment adaptation.

Assessment and care

• Large amplitude movement exercises to combat micrographia and hypokinesia. Work on trunk rotations, arm movements and body extension to counter the typical flexed posture.
• Gait rehabilitation with visual cues (floor lines, obstacles) and auditory cues (metronome, rhythmic music) to overcome freezing and improve step length. Treadmill training if appropriate.
• Global muscle strengthening and static and dynamic balance work. Postural reaction exercises, dual-task work (cognitive + motor) reproducing daily life situations.
• LSVT BIG program or equivalent protocol: intensive and specific method aimed at recalibrating movements through exaggerated amplitude exercises. Scientifically proven effectiveness for improving motor function in Parkinson's patients.

This information does not replace diagnosis or medical consultation.