Movement Deficits in Parkinson's Disease and Restorative Occupational Therapy

By Shah, Surya; Nolen, Ann | New Zealand Journal of Occupational Therapy, September 2006 | Go to article overview

Movement Deficits in Parkinson's Disease and Restorative Occupational Therapy


Shah, Surya, Nolen, Ann, New Zealand Journal of Occupational Therapy


Abstract

This paper focuses on movement deficits that interfere with smooth execution of movement following Parkinson's disease. Difficulty in initiating, slowness in executing, inhibition of a current movement and preparation for a new movement as well as, switching between sets of movements, and freezing are explained.

Effectiveness of occupational therapy has been difficult to establish with methodological flaws in research. However, measurements that quantify movement deficits and the neuroinvestigative evidence based activities and contexts in occupational therapy could restore movement capabilities. Such focussed movement restitution in occupational therapy would, in turn, increase participation in daily life and improve the quality of life.

Key words

Parkinson's disease, movement deficit, occupational therapy, measurement outcome

Parkinson's disease (PD) is a chronic progressive neurological condition with reported incidence of 1:5 in western nations and a condition commonly requiring occupational therapy. A review of occupational therapy literature indicated there is a vast amount of information available on many aspects of PD. This includes: cardinal symptoms, self-care ability, ability to interact with the environment, home health and general care, nutritional matters, medications, coping, functional therapies, family education, general fitness, person and occupational centred occupational therapy, and overall quality of life (College of Occupational Therapists, 1996; Deane, Ellis-Hill, Dekker, Davies, & Clarke, 2003; National Parkinson Foundation, 2002). The above approaches utilise compensatory or adaptive methods such as independence in activities of daily living despite the loss suffered by PD, to improve the quality of life of the persons with PD. New pharmaceutical agents, surgical approaches, and brain stimulation focus on movement deficit restitution. However there is practically no information on specific aspects of restorative occupational therapy addressing the type, the degree, or the quality of deficit in movement ability, its measurement and the neurological basis of intervention.

Therefore this paper focuses on: (i) movement deficits and resulting impairments (ii) the need for quantifiable assessments to show a specific change in the quality of movement performance, and (iii) the restorative approaches in occupational therapy as they relate to restoring the quality of the movement deficits. Awareness and application of quantifiable assessments and intervention strategies are vital for occupational therapists to positively impact neurological recovery. This restorative focus in turn will allow increased participation in daily occupations and improved quality of life in persons with PD.

Movement deficits in Parkinson's disease

To explain restitution of movement deficits in Parkinson's disease, this section focuses on the deficits, mechanisms of the deficits, the deeper brain nuclei associated with the execution of smooth movement, and measuring the quality and neurological evidence for activity based occupational therapy.

Akinesia refers to difficulty in initiating movement and paucity of self-generated voluntary movement (Bear, Connors, & Paradiso, 2001) whereas bradykinesia from strial dopamine deficiency results in slowness in executing movement. The slowness comes from increased reaction time, delayed correction of an inaccurate attempt, prolonged time to recommence correct movement, and easy fatigability. Akinesia and bradykinesia are closely related but can be independent, and present in the absence of rigidity (Paulson & Stern, 1997). With Akinesia, automatic execution of learned motor plans is altered, but with dyskinesia resulting from the administration of neuroleptics, the motor plan could be executed by alternative movement strategies. This indicates that in dyskinesia, the form of motor plan is preserved but individual motor programs, which make up the motor plan, are distorted (Bear, Connors & Paradiso, 2001; Marsden, 1994). …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Movement Deficits in Parkinson's Disease and Restorative Occupational Therapy
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.