Neurorehabilitation in Parkinson's Disease

1. Ade Wijaya, MD – May 2019

2. Parkinson’s Disease
Motor Symptoms
Non-motor Symptoms
J. Nonnekes, A.H. Snijders, J.G. Nutt, G. Deuschl, N. Giladi, B.R. Bloem, Freezing of gait: a practical approach to management, Lancet Neurol. 14 (2015) 768e778.

3.  The 2nd commonest neurodegenerative disorder after Alzheimer’s disease (de Lau
and Breteler, 2006)
 “Multisystem” neurodegenerative disorder
 Risk factor: increasing age (de Rijk et al., 1995; Nussbaum and Ellis, 2003)
 Parkinson’s disease medication can only alleviate part of motor symptoms and has
no effects on non-motor symptoms
 Dose-limiting side effects
 Disabling symptoms  fall and decrease QOL
J. Nonnekes, A.H. Snijders, J.G. Nutt, G. Deuschl, N. Giladi, B.R. Bloem, Freezing of gait: a practical approach to management, Lancet Neurol. 14 (2015) 768e778.
Archibald N, Miller N, Rochester L. Neurorehabilitation in Parkinson disease. InHandbook of Clinical Neurology 2013 Jan 1 (Vol. 110, pp. 435-442). Elsevier.

4. Physiotherapy
Occupational therapy
Speech and language therapy
Archibald N, Miller N, Rochester L. Neurorehabilitation in Parkinson disease. InHandbook of Clinical Neurology 2013 Jan 1 (Vol. 110, pp. 435-442). Elsevier.

5. (Adapted from Nieuwboer et al., 2008.)

6.  ● Cueing strategies to improve gait
 ● Cognitive strategies to improve transfers
 ● Specific exercises to improve balance
 ● General exercise to improve physical capacity.
Archibald N, Miller N, Rochester L. Neurorehabilitation in Parkinson disease. InHandbook of Clinical Neurology 2013 Jan 1 (Vol. 110, pp. 435-442). Elsevier.

7. VISUAL REHABILITATION
CUEING WITH WEARABLES
GAMING
TELEMEDICINE
Ekker MS, Janssen S, Nonnekes J, Bloem BR, de Vries NM. Neurorehabilitation for Parkinson's disease: future perspectives for behavioural adaptation. Parkinsonism & related disorders. 2016 Jan
1;22:S73-7.

8. Ekker MS, Janssen S, Nonnekes J, Bloem BR, de Vries NM. Neurorehabilitation for Parkinson's disease: future perspectives for behavioural adaptation. Parkinsonism & related disorders. 2016 Jan
1;22:S73-7.

9.  PD symptoms can only be partly alleviated by medication  neurorehabilitation
 Neurorehabilitation in the context of PD is a complex and dynamic process
requiring the interaction of a broad range of specialities