PARKINSONS & PARKINSONISM-MANAGEMENT (GAIT)

SUMMARY

GAIT DISTURBANCE
1. Gait retraining, cued training (level 2).
2. Stationary bicycle, arm ergometers and treadmill training: to restore diminished reciprocal limb movement & improve step-length (level 2).

BALANCE
3. Frenkel's exercises: for coordination to maintain lower extremity positioning during gait.
4. Treadmill training, balance training, wobble-board or balance-feedback trainers, Taichi, Qigong: to improve alignment & postural-reflexes (level 2).

FREEZING
5. Mgm of freezing: visual targets, lines on the floor, marching music/metronome, combined treadmill training and cueing, compensatory manoeuvres to restore movement after freezing.

EQUIPMENT & ENVIRONMENT

6. Heel-lifts and assistive mobility devices: to counter tendency to topple backwards.
7. Removal of environmental obstacles & trip-hazards.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].