Parkinson’s Therapy and LSVT Global:


What is Parkinson’s disease?

Parkinson’s is a neurodegenerative disease in which there is cell loss in a very specific region of the brain called the substantia nigra. The nerve cells, or neurons, in this region produce a specific type of neurotransmitter (a chemical messenger that allows neurons to communicate) called dopamine. The neurotransmitter dopamine helps to regulate movement. Therefore Parkinson’s disease is a type of movement disorder that can affect the ability to perform common, daily activities.

Approximately 60,000 Americans are diagnosed with Parkinson’s each year and currently there are one million people living with PD in the US. The most common of motor symptoms are tremors (a form of rhythmic shaking), stiffness or rigidity of the muscles, slowness of movement (called bradykinesia) and progressively smaller movements (called hypokinesia). There are also non-motor symptoms including sleep problems, constipation, anxiety, depression, and fatigue, among others. These symptoms vary and are progressive over the years. An individual living with Parkinson’s disease can have severe changes in gait, balance, speed, writing and speech.

What are the treatment options for Parkinson’s disease?

Although there is no cure, after diagnosis, treatment can help relieve symptoms.

Parkinson’s medications are the mainstay of treatment and are intended to increase dopamine levels in the brain, but other modalities are often used in combination. A proper medication regimen is highly individualized and adjusted over time based on symptoms and side effects. Levodopa, also known as L-DOPA, is the most commonly prescribed and effective drug in treating the symptoms.There are side effects that can occur with Levodopa including nausea, fatigue and orthostatic hypotension. In addition, as the disease progresses, involuntary movements (dyskinesias) can develop from Levodopa.

There are also surgical options for a subset of patients with Parkinson’s disease. Those with a robust response to Levodopa, no significant cognitive or psychiatric problems, and no significant problems with balance are good candidates for Deep Brain Stimulation. DBS involves implanting an electrode into a targeted area of the brain, usually the subthalamic nucleus (STN) or the globus pallidus interna (GPI). The electrodes are stimulated through a connection to a pacemaker-like device located under the skin in the chest.  The procedure can help patients with medication-resistant tremors. It can also help patients who have significant motor fluctuations in which medication response varies during the day and those with significant dyskinesias as a side effect of medication.

Most importantly, Physical therapy can improve your gait and direct you to the right exercise regimen. The American Parkinson’s disease association recognizes that Physical, occupational and speech therapy are critical to the treatment plan.

At Movement and Flow Physical Therapy we utilize a treatment protocol that has been developed specifically for Parkinson’s patients. Only therapists who are properly trained and certified are allowed to administer the treatment. Our therapist, Bianca Pereira PT, is fully certified and proficient in administering the protocol. LSVT BIG, is evidence based and has been proven by research to have a significant impact in patient’s functional mobility and long-term carryover after its completion. LSVT BIG is an effective, intense and one on one program that trains people with Parkinson’s disease and other movement related disorders to use their body more normally. The program trains the patients to use their bigger movements “automatically” in everyday living. It improves walking, balance and activities of daily living. It is based on the most effective evidence based strategies for learning and neuroplasticity (the brain’s ability to change). It helps people to recognize when their movements are “smaller or slower” and to “calibrate” their movements so they can apply what they have learned in the sessions to perform more comfortable, confident and effective movements outside the clinical setting and into their daily lives.