Parkinson's disease is a degenerative brain disease that affected nearly 8,5 million people worldwide in 2019. Although this condition is currently incurable, various treatments and methods of neurological rehabilitation to best alleviate the daily lives of people affected by this disease. This is what we propose to explore together in the rest of this article.
What is Parkinson's disease?
Parkinson's disease is defined as a chronic neurological disease involving the destruction of dopamine-producing neurons. Its progression can vary from one patient to another.
Dopamine neurons play an important role in controlling movement. Therefore, when 50 to 70% of them are destroyed by the disease, the patient may suffer from certain motor disordersThese factors, among others, are what allow for the diagnosis of Parkinson's disease.
In France, nearly 25,000 new cases of Parkinson's disease are diagnosed each year. While doctors now understand the mechanisms of this disease, its origins remain unknown. Several hypotheses have already been put forward, however, the most convincing of which is based on a combination of environmental and genetic factors.
* Circular SG/DGOS/R4/DGS/MC3/DGCS/3A/CNSA no. 2015-281 of September 7, 2015 concerning the implementation of the 2014-2019 neurodegenerative diseases plan
What are the main symptoms of Parkinson's disease?
Parkinson's disease is diagnosed when at least two or three major symptoms of the disease are identified in a patient. These include, in particular:
- bradykinesia;
- specific muscle stiffness;
- trembling at rest.
Bradykinesia, or slowness of movement
Bradykinesia is defined as difficulty in initiating movement. Also known as slowness of movement, this symptom is often identified when a person is required to perform complex actions (coordinating multiple limbs, performing different movement sequences, etc.). A person with bradykinesia may experience fatigue, numbness, or a feeling of being unable to move properly. This can eventually lead to akinesia, or the absence of movement.
Rigidity, or stiffness of movements
Rigidity is defined as excessive tension in the body's muscles, which can lead to cramps, tendinopathies, and progressive joint stiffness, for example. This muscle stiffness can cause difficulty performing movements and is characterized by occurring at rest.
Generally, the stiffness affects the muscles around the spine of the patient with Parkinson's, but can also affect other muscles in the body, such as those in the hands and feet.
The trembling
One of the most indicative and well-known symptoms of Parkinson's disease is resting tremor. In other words, the affected limb will tend to move even when no movement is initiated. This symptom generally affects only one side of the body and may appear after several years of disease progression.
Generally, resting tremor first affects an upper limb (hand, wrist, finger). In rare cases, it can also affect a lower limb, such as the foot. This symptom tends to disappear during the patient's sleep and reappear upon waking. It can be treated, but remains greatly influenced by the patient's emotional state, as is also the case with other symptoms of Parkinson's disease.
What treatments are available for Parkinson's disease?
Parkinson's disease can be treated in various ways. Treatments must be determined by a neurologist and may change depending on the patient's clinical condition. It is important to note that while these different therapeutic options can improve the lives of patients with Parkinson's, they cannot stop the progression of the disease.
Drug treatments
Drug treatments for Parkinson's disease aim to compensate for a patient's lack of dopamine. They are generally presented in the form of tablets to be swallowed.
The surgical intervention
In certain complex cases or when drug treatments have yielded unsatisfactory results, surgery may be offered to the patient. This procedure involves deep brain stimulation through the implantation of electrodes in the brain. The decision to perform this surgery is not taken lightly and is only considered in cases of Parkinson's disease (and not parkinsonian syndrome) that have been present for at least five years.
Physiotherapy and rehabilitation for Parkinson's disease
Physical rehabilitation through physiotherapy is complementary to the primary treatment for Parkinson's disease. It helps maintain the patient's independence for as long as possible and preserve their physical abilities. This type of rehabilitation should be offered and implemented as soon as the diagnosis is made, with the aim of enabling the patient to best manage movement disorders and the impact this symptom can have on their daily life.
Indeed, physiotherapy helps reduce muscle stiffness, slowness of movement, tremors, and blockages. It improves movement quality, functional independence, and the overall physical condition of individuals with Parkinson's disease. Exercises are tailored to the patient's needs and may incorporate techniques to overcome blockages, such as auditory, tactile, or visual cues. The physiotherapist's intervention is particularly important from the time of diagnosis and throughout the progression of the disease to maintain the patient's physical abilities and prevent potential complications.
| Good to know: physiotherapy sessions are prescribed by a doctor and reimbursed at 100% by social security under the ALD 16 Parkinson scheme. |
Speech therapy rehabilitation
Speech therapy is essential for preventing and correcting any speech difficulties a patient might experience. The same applies to writing difficulties or swallowing problems, for example. The earlier speech therapy begins in the treatment of Parkinson's disease, the more effective it can be for a patient.
This treatment helps maintain or regain voluntary control over impaired functions, such as speech, facial expression, and swallowing. In this regard, intensive methods, such as LSVT Loud, have proven particularly effective. The speech-language pathologist conducts an initial assessment to evaluate the difficulties, then adapts the exercises according to the individual's needs and the progression of the condition. Treatment may include intensive sessions, limited in duration and repeated regularly.
Speech therapists can also assess and treat cognitive impairments associated with Parkinson's disease, including executive dysfunction, attention deficits, and memory problems. These services are also prescribed by a doctor and fully covered by social security.
The importance of psychomotor therapy in the rehabilitation of Parkinson's disease
Psychomotor therapy studies all the body's motor behaviors in relation to brain activity. It focuses on how the body moves and functions, as well as its ability to perform certain movements.
Psychomotor therapy aims to preserve autonomy and maintain bodily abilities such as movement and posture. It allows the patient to reconnect with their body, rediscover, and retain their capabilities. The exercises offered take into account the patient's desires and preferences, working on various functions.
In Parkinson's disease, ideomotor slowing, characterized by a weakening of physical and mental functions, complicates information processing. The psychomotor therapist then intervenes to stimulate mental flexibility by giving various instructions.
Psychomotor exercises aim to retrain the patient's ability to concentrate, perform tasks simultaneously, improve short- and long-term visual and verbal memory, and work on orientation, balance, and coordination. While psychomotor therapy is not always the first recommended intervention for Parkinson's disease, it becomes essential in more advanced stages. It is particularly well-suited when movement becomes difficult and hypertonia is present, promoting muscle relaxation.
Psychomotor therapy can precede physiotherapy sessions to improve mobility. It is carried out by a psychomotor therapist and is performed on medical prescription from the neurologist or the attending physician.
The importance of rehabilitation in the treatment of Parkinson's disease
As we saw earlier, rehabilitation is an essential element in the treatment of Parkinson's disease. Whether it involves speech therapy, physiotherapy, or psychomotor therapy, it offers additional comfort to the patient, alongside their medication.
Physiotherapy is recommended by the French National Authority for Health (HAS) as a complement to the initial treatment prescribed by the neurologist. It helps slow the progression of motor and postural problems, particularly through various motor exercises. These exercises are determined by the healthcare professional (physiotherapist) based on the patient's overall condition and the stage of the disease.
The Allyane method in the context of rehabilitation related to Parkinson's
Motor rehabilitation helps combat akinesia and certain coordination disorders through various exercises based on movement (range of motion, speed, etc.) and on themes specific to Parkinson's disease (balance, posture, breathing, locomotion, etc.). In this context, the Allyane method can be particularly beneficial in optimizing patient outcomes.
The Allyane neuromotor reprogramming method is based on work combining mental imagery with proprioceptive identification of the gesture, defined by multisensory stimulation (via low frequency sounds emitted by a patented medical device).
The use of this neuromotor reprogramming method in the management of Parkinson's disease can thus allow the patient to better understand a movement, to lift certain motor inhibitions and to regain a certain fluidity in their movements.
Would you like to learn more about the Allyane method and its benefits in treating Parkinson's disease? Don't hesitate to contact us!