Rehabilitation priorities for patients with Parkinson’s disease at all stages!

Parkinson’s disease is a neurodegenerative disorder. Due to the degeneration of dopaminergic neurons in the nigrostriatal structures of the patient’s brain, the patient is unable to produce enough dopamine, a neurotransmitter, resulting in the gradual development of a range of motor and non-motor symptoms. In the early stages of the disease, patients often present with symptoms such as resting tremor, motor bradykinesia, and muscle tonus; as the disease progresses, cognitive impairment, hallucinations, depression, and anxiety will develop. In addition, Parkinson’s disease can also cause a variety of problems such as loss of smell, swallowing disorders and sleep disorders. Epidemiological surveys show that there is one person with Parkinson’s disease for every 100 people over the age of 55 in China. Of the approximately 4.5 million people with Parkinson’s disease worldwide, nearly half are in China. The number of people with the disease is expected to rise to 5 million by 2030, making China the country with the largest number of Parkinson’s patients in the world. At the same time, the trend of younger Parkinson’s disease is becoming more pronounced, and there is no shortage of young adults under 40 years old in clinical treatment. Worryingly, about 48% of Parkinson’s disease patients do not realize they have the disease, and 60% of early stage patients do not receive timely treatment. As a slow-progressing chronic disease, rehabilitation plays an important role and includes a range of rehabilitation assessments and rehabilitative training. Early rehabilitation of patients can reduce the use of medications, reduce the incidence of complications, enhance daily activities, and improve psychological status. The rehabilitation assessment includes physical function, mobility, cognitive ability, swallowing ability, and psychological ability. Through the assessment, the patient’s existing functional impairment can be determined, and then treatment goals and measures can be formulated to meet the patient’s needs. The short-term goals of rehabilitation treatment are: 1) to improve joint mobility and prevent joint deformities; 2) to improve trunk movement, postural control, and coordination; 3) to enhance patient and caregiver safety awareness and prevent secondary injuries caused by patient falls. The long-term goal is to maintain or improve the ability of daily living and quality of life, and to achieve “from basic movement training to real improvement of functional impairment”. For people with Parkinson’s disease, there is still much work to be done to move from “able to move” to “able to use”. There is a method for rehabilitation. The main methods of rehabilitation are exercise therapy, physical therapy, life training, cognitive training, etc., to improve the function of daily activities (e.g., use of dressing aids, change of clothing), and environmental modifications (e.g., removal of walkway obstacles and hazards, use of elevated potty chairs). Parkinson’s disease exercise therapy has a set of easy-to-use training tools: 1, facial training in the mirror to do frown, force open and close the eyes, pout, purse the mouth, tongue and cheek puff and other expressions. 2, head and neck training head back for 5 seconds, both eyes look up at the ceiling, then head down, jaw as far as possible to touch the chest. Head to the left and look backward for about 5 seconds, then the same action to the right. 3, hand training finger grasp and release training, finger-to-finger training, finger counting training, hand fine motor training, such as picking up beans. 4.Lower limb training hip and knee flexion exercise, straight leg raise exercise, squat exercise, kick exercise. 5.Torso training Bridge exercise – patient lying down, legs bent, arms close to the bed to prevent sliding, held by the therapist or family members, slowly lift the hips, maintain a period of time and then slowly put down. 6.Turn over training The body is turned to the right side, the head is turned to the right side, the left hand rests on the right side, the left leg is placed on the right leg, and the body is turned over using the inertia of body rotation. Repeat in the opposite direction. 7, joint mobility training hands and knees under the support of the position, the center of gravity were forward, backward, to the left, to the right, so that the shoulders, elbows, hips and knees to get exercise. 8.Balance training Sitting, kneeling, standing under the weight of front and back, left and right, lateral movement, respectively. 9.Sit up training Sit up four steps – stretch your arms, bend over, pucker your buttocks, get up. 10.Gait training Start with the foot following the ground, then the palm of the foot, and finally the toes on the ground, stride as slowly as possible, and swing the arms back and forth as much as possible while walking. Swallowing therapy, diction and articulation training, and cognitive training are important aspects of rehabilitation for patients with mid- to late-stage Parkinson’s disease.