Rehabilitation measures in Parkinson’s disease constitute an important complement to drug therapy.
Parkinson’s disease is the second-most common degenerative disorder of the central nervous system; the incidence is about 100 to 150 per 100,000 population. In Austria, approximately 12,000 patients are affected. 2–3% of the population over 80 years old suffer from this condition. Rehabilitation measures in Parkinson’s disease constitute an important complement to drug therapy. The most common rehabilitation goals in neurorehabilitation are: Improvement of gait, balance, strength and endurance, voice and fine motor skills, and reduction of tremor. Furthermore, the focus is on optimization of drug therapy, treatment of autonomous symptoms such as orthostasis, fluctuating or very low blood pressure values, constipation, or bladder disorders.
Entire staff trained
Since its opening in 2010, the Neurological Therapy Center Gmundnerberg has been specializing in rehabilitation of patients with Parkinson’s disease. The center uses a concept for Parkinson patients developed in the USA and based on exercise and speech therapy. The so-called LSVT© – Lee Silverman Voice Treatment – therapy program includes movement and voice exercises that can be easily integrated into everyday life after the rehab hospitalization. The program is quite well known in the US; in Europe, VAMED is one of the institutions implementing this program, having not only carried out, with 75 participants, the largest training in this field, but also trained and certified the entire staff at the Neurological Therapy Center Gmundnerberg for the application of the therapeutic program.
In the LSVT BIG© movement concept, standardized movement exercises are applied to improve speed and extent of movement in patients with Parkinson-typical mobility disorders. The training takes place in sitting and standing postures, during walking and actions of daily living that are relevant to the patient. The training comprises 16 treatment units during four weeks, a personalized training in an individual setting for one hour, a daily home exercise program, and daily exercises for activities of daily living. In studies, the following improvements were observed in patients with Parkinson’s (1):
- Faster walking with larger steps
- Improved balance
- Better mobility of the upper body
- Improvements in activities of daily living, for example in personal care or in the householdWhich patients are eligible for the LSVT© program? (1) Fox et al. (2012). LSVT LOUD and LSVT BIG: Behavioral treatment programs for speech and body movement in Parkinson disease. Parkinson’s Disease, 2012, Article ID 391946, 12 pgs.
- According to present knowledge, LSVT BIG® is particularly suitable for patients in the early and middle stages of the disease. By starting treatment with the LSVT BIG® method early in the course of the disease, progression of the movement restriction is to be delayed. Quality of life and independence are to be preserved as long as possible.
- The voice concept LSVT LOUD© improves both voice and speech in people with Parkinson’s disease by treating the physical pathology on which the voice disorder is based. Treatment is focused on improving vocal volume and on direct transfer into everyday communication. In a before-after comparison, in a majority of patients the voice volume is improved; furthermore all patients report improvement of their communication abilities.
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