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1. CASE PRESENTATION OF
PARKINSON DISEASE
By Bharat Sharma

2. DEMOGRAPHIC DATA :
• Name : GOPAL SHARMA
• Age : 60 YRS
• Gender : MALE
• Occupation : FARMER

3. Chief complain :
Patient complain difficulty in balance
and tremors in left hand

4. History :
 History of present illness : 3 months ago he experienced in a minor fall and
landed on an outstretched right hand and leading to wrist pain
. He is balance issues since 1 year left hand tremors and difficulty in hand
writing
 Past Medical history :- He is suffered from depression
. Right wrist injury
 Drug History :- Dopamine, Antidepressant
 Personal History :- Non Smoker
. :- Alcohol no

5. On observation
 Gait :- Shuffling gait
 Posture : Moderate kyphosis
. :- Forward head posture
 Left hand tremors present
 Deformity :- absent
 Orientation :- Depressed
 Tone :- Normal

6. On examination :
 Rom :- Upper limb (AROM) > Limited bilateral shoulder flexion and Abduction both left or right
 Trunk :- Bilateral Rotation
 Lower limb :- Bilateral hip extension , Dorsiflexion (Non weight bearing) Left or right
All other Rom normal
PROM :- Upper limb – Bilateral shoulder flexion and Abduction
. Lower limb -- Dorsiflexion (non weight bearing)

7. MMT
Overall Strength
Left side -:
Grade 4,5
Right side :-
4,5
Grip Strength Testing :- Left hand
:- Right hand
Balancing Scale :- Berg Balance Scale
Investigations :- MRI

8. DIAGNOSIS :
Parkinson’s

9. TREATMENT :
 For Muscle Flexibility :- Active Rom
:- passive Stretching for – shoulder flexors, Abductors,
Hip Extensors
. :- PNF Technique – Hold or contract Relax
 For posture. :- Postural Awareness
 . :- Extension Exercises
 . :- Postural Mirror
 . :- Patient instruct lie supine with pillow for upper
thorax
 For Rigidity. :- PNF
:-Deep breathing exercises
:- Muscle Relaxant technique

10.  For Tremors :- Relaxant Technique
:-Yoga
:- Meditation
. :- Weight in hand
 For Balance. :- Swiss ball
. :- Wobble board exercises
. :- Weight Shifting
. :- Sit to stand
. :- Weight bearing exercises
. :- Toe off

11.  For gait training :- Go slow
. :- Improve stride length and velocity
. :- Cadence
. :- Reciprocal arm movement
 For Strengthening :- Using Thera band, free weights
 For Coordination. :- Frenkel`s Exercise
:- Tip to tip
. :- Tip to nose

12. Thank you