Lecture Notes

Difficulty Controlling Movement

Dyskinesias

• Tremor at Rest: Severe shaking even when not moving.
  • Example: Michael J. Fox, an actor diagnosed with Parkinson's, kept hands in pockets to manage tremors on TV.
  • Tremors can make basic activities (e.g., drinking coffee, writing) difficult and cause self-consciousness.

Postural Instability

• Increased risk for falls.
• Special care: clear walkways, use assistive devices.
• Combination of symptoms: Tremors, rigidity, slow movements make reacting to changes difficult.

Collaborative Care for Dyskinesias

• Physical Therapist: Vital for assessing and planning individualized exercise programs to improve balance, strength, and maintain functional ability.
• Occupational and Speech Therapists: Assist with safety evaluations and environmental risk assessments for falls.

Adaptive Tools and Techniques

• Devices like a spoon that neutralizes tremors by pulsating.
• Information on the latest tools for enhancing the quality of life.

Minimizing Falls Risk

• Patients are at high risk due to rigidity, slow movements, and postural instability.
• Home Environment Adjustments:
  • Remove loose throw rugs or tape them down.
  • Ensure adequate lighting.
  • Clear paths by rearranging furniture, removing clutter (e.g., extension cords, shoes).

Assistive Devices

• Grab Bars: By toilets to assist getting up.
• Raised Toilet Seats: Reduce effort required to sit and stand.
• Shower Chairs: Aid in taking showers; especially important if shower is within a bathtub.
• Supportive Shoes: Important for stability.
• Rolling Walkers: Recommended for safety; modern ones have brakes, seats, and baskets.
• Encourage Independence: Help patients see the benefits of tools like walkers for minimizing falls.

Emotional and Practical Support

• Allow extra time for daily routines and activities.
• Adaptive Tools for Daily Living: Various tools available for eating, dressing, and other daily activities.
• Example: Travel mugs with lids to prevent spills.
• Occupational Therapists: Help find adaptive tools for basic life functions.

Conclusion

• Collaborate with therapists (physical, occupational, speech) for patient care.
• Aim to help patients live as normal and independent lives as possible.