Acknowledgement
We would like to thank Mariella Graziano, Physiotherapist, Luxembourg, for her contributions to this section.
As the course of Parkinson’s progresses, symptom control by drugs can start to diminish. Motor blocks (also known as freezing ), balance impairments and falls become more common. Many people also experience anxiety, fatigue and depression.
Loss of confidence is common and many people tend to reduce the risk of falls and balance problems by limiting their activities.
At this stage of Parkinson’s, the physiotherapist will concentrate on aspects such as falls prevention, improvement of transfers, gait, reaching and grasping objects. This may include:
In the advanced stages of Parkinson’s, the interventions described above will continue. Other strategies that the physiotherapist might use will depend to a large extent on the severity of the problems that the person is experiencing at this point. Their aim will be to maintain as much ability as possible. This may involve assisted exercises.
If the person is very disabled, their mobility may be limited and the intervention might also focus on advice to overcome some of the problems that can occur as a result of immobility – e.g. the prevention of pressure sores and contractures (chronic loss of joint movement).
A mental state of melancholia, unhappiness or sadness characterized by decreased energy, reduced interest in sex, suppressed appetite, too much sleep or sleep disturbance, a pessimistic sense of inadequacy, a despondent lack of activity, despair, and discouragement.
A condition marked by extreme tiredness, inability to function due lack of energy and a general state of lethargy, usually accompanied by a feeling of weariness, sleepiness, or irritability. Fatigue may be acute or chronic and be both physical and mental.
See section on fatigue.
A symptom of advanced Parkinson's disease where the person becomes ‘glued’ to the spot for a few seconds or minutes before being able to walk.
See section on Freezing.
A term that describes anything associated with the heart (cardio), lungs, blood vessels (vascular) and/or circulatory system.
Having to do with the movement of a part of the body.
