Cognitive behavior therapy Cognitive therapy should be aimed at strengthening the individual’s belief in his or her abilities and teaching ways of dealing with stressful situations. A major goal is to change any self-defeating behaviors that individuals may have. Using assigned tasks and self-observation, patients gradually drop the perceptions that they are helpless against the pain that dominates their lives and shift to the perception that pain is only one negative factor in their life and that it can be managed. Such therapy can be provided through individual counseling with a Physical therapy There are a number of interventions for the management of fibromyalgia that are best suited to the discipline of physical therapy. These interventions focus on strategies for pain relief and strengthening and stretching exercises. Hydrotherapy is a frequently used strategy. The use of moist heat over painful areas of the body dilates blood vessels, which increases blood flow and the transport of oxygen and nutrients to the affected areas. Cold packs reduce swelling by constricting blood vessels over affected areas. 16 Aqua therapy, the use of swimming and other types of water exercises, is also quite
therapist, classes, or self-paced programs available on CDs or through other media. Cognitive therapy is especially important for setting limits, a critical behavior for individuals with fibromyalgia to learn. A cognitive therapy program will typically include activities such as keeping a diary, confronting negative thoughts, setting limits, seeking out pleasurable activities, prioritizing tasks, and accepting relapses. useful. Water buoyancy helps to reduce the stress on muscles and joints as well as to improve flexibility. 17 Low impact, low-speed aerobic exercises can help to maintain flexibility and reduce pain. It is important that exercise does not place additional strain on joints. 17 Other physical therapy strategies include: 16 ● Deep tissue massage. ● Exercises to relieve pain. ● Stretching and strengthening exercises. ● The use of TENS units (transcutaneous electrical nerve stimulation).
PARKINSON’S DISEASE
Parkinson’s disease (PD) is a slowly progressive neurologic condition that affects the motor system. The four primary symptoms are tremor, stiffness of the limbs and trunk, slowness of movement, and impaired balance and coordination. As the symptoms worsen, daily activities such as walking and dressing become impaired, and feelings of depression and anxiety are common. PD is the most common of the major movement disorders, a category of conditions characterized by a central nervous system malfunction that results in the muscles not receiving appropriate messages from the brain. What is Parkinson’s disease? Parkinson’s disease occurs because of a breakdown in the communication between the brain and the muscles. The chemical dopamine, a neurotransmitter, is manufactured in a deep area of the brain called the substantia nigra . Dopamine stimulates cells in the basal ganglia, a region at the base of the brain that controls muscle movement. Causes The reasons the substantia nigra cells die are unknown. A family history of PD is present in 5-10 percent of patients. 1 The focus of researchers looking into causes for PD has been on genetics and environmental exposures. In a small number of cases, genetic mutations are responsible for PD. However, these mutations have not been found in most Symptoms and progression of Parkinson’s Parkinsonism is the name for the collection of symptoms that includes tremor, stiffness, slowness of movement and unsteady gait. Many neurologic disorders other than Parkinson’s disease are characterized by parkinsonism. There is no definitive blood test or imaging study to diagnose PD. Thus, Parkinson’s disease is diagnosed only when a neurologist has ruled out all of the other possible causes of parkinsonism. Clinicians may order brain scan and laboratory tests as part of the process of eliminating other diseases as the cause of symptoms. Ruling out other causes and diseases is important because the treatment options and long-term outlook are different for PD. The most common initial symptom in PD is tremor, which usually begins on one side of body and often involves either an arm or
The reported prevalence of PD varies, but most estimates put the number of people with the disease in the United States at 1 million to 1½ million. Some 50,000 new cases are diagnosed each year, and that number is expected to rise as the population ages, because PD most often affects people over the age of 50, with the average age of onset at 60 years. The disease affects 1 in 100 people over the age of 60, according to the National Parkinson Foundation. When it affects people before age 40, it is called young-onset Parkinson disease . Of the million-plus people with PD, an estimated 5-10 percent are in this younger age group. Parkinson’s occurs in all races, but it is somewhat more prevalent among Caucasians. It is also occurs slightly more often in men than in women. With PD, for reasons that are as yet unknown, cells in the substantia nigra unexpectedly and prematurely die, thus reducing the production of dopamine. Symptoms of PD appear when about 70-80 percent of the dopamine-producing cells have been destroyed. PD is not a fatal illness, and it has not been shown to shorten people’s lives. people with the disease, and researchers are reasonably certain that genetics alone do not cause PD. Some researchers are investigating a link between PD and long- term exposure to environmental toxins such as pesticides and heavy metals. Toxins such as manganese and carbon monoxide cause diseases that resemble PD, but the vast majority of individuals with PD have not been exposed to them. a leg. The individual then begins to experience a generalized slowness of movement, known as bradykinesia . Even the early symptoms of tremor and bradykinesia can cause problems with the daily activities of living, such as cutting food and getting dressed. Impaired mobility can affect many aspects of life, such as making it difficult to get in or out of a car and to turn over in bed. Over time (in some, five years or longer), symptoms spread to the other side of the body. The muscles, particularly the flexor muscles, become permanently hypertonic. A stooped posture is common. The disruption in the motor systems produces an unsteady gait, and there is a lack of arm swing on the affected side. Because these symptoms appear gradually, older
EliteLearning.com/Physical-Therapy
Page 107
Powered by FlippingBook