Rehabilitation of Patients Suffering from Parkinson's Disease by Normotensive Therapy

Abstract

Neurodegenerative injuries lead to disabilities, such as sensory and motor disturbances, with patients often losing their balance, and falling as a consequence. Moreover, capsuloligamentary adhesions often occur, which create stiffness and secondary retractions due to the lack of mobilization of the periarticular structures. These complex clinical pictures, when interlinked, are even more important when simultaneously the patients suffer from recurrent diseases, such as degenerative rheumatism. Parkinson’s disease, this public health issue, is evaluated through clinical criteria, as there are as many forms of Parkinson’s disease as there are various cases. Personalized and adaptable physiotherapist option is therefore necessary. The syndrome associated with Parkinson’s disease is characterized by a motor disorder, an akinesia combined with one of the following symptoms: extra pyramidal stiffness, tremor and postural instability. A depressive syndrome, a cognitive decline, and more or less disabling pain, come on top of the clinical picture. The patients frequently suffer from cramps or painful contractions, which mainly affect (74%): calves, neck, lumbar rachis, and which are more or less combined with dystonia. Comorbidities make the treatment even more complex. And it is always difficult to know, when considering the symptoms and their origin, whether it is Parkinson’s or other illnesses which are to blame. These comorbidities should always be taken very seriously, and be properly treated, as they have an influence on the patient’s mobility fluctuations (1). Normotensive Therapy reinitiates the movement, it treats stiffness, pain, and lack of mobility. 68% of patients, whatever the stage of the disease they are in, suffer from concomitant illnesses such as: arthritis which can affect shoulders and knees and make the postural syndrome even worse, undefined chronic pain, arterial hypertension or heart pathologies. Unfortunately taking drugs often triggers rheumatism symptoms, and either contributes to their development, or keeps them going and makes them worse (2). The drugs intake is, on top of that, one of the main risk factors of fall among the elderly, and therefore complicates the rehabilitation. These drugs intake is a real risk factor whatever the patient’s residence, autonomy and independence level are, as it underlines poor health condition and pre-existent fragility. The drugs classes which are mostly to blame are :