The term "movement disorder" describes a variety of neurological conditions that affect coordination, speed, balance and fluidity of movement. Disease or damage to the basal ganglia, located at the base of the brain, usually causes these disorders. Physical therapists cannot cure any of these conditions, but they can help their patients achieve basic movement functionality.
Types of Disorders
The numerous types of movement disorders inflict a variety of symptoms. Ataxia, which affects the spinal cord, causes jerky movements and coordination problems. Dystonia produces prolonged muscle contractions, postural misalignment, and twisting and jerky movements. Parkinson's disease progressively affects the brain cells that control muscle movement, causing shaking or tremors, unsteady gait and muscle stiffness on one or both sides of the body. Huntington's disease also affects the brain cells, and causes jerky movements in the arms, upper torso or face.
Therapeutic Goals
Physical therapists have multiple functions when working with clients with movement disorders. Because such patients usually have some sort of balance problem, the therapists may visit their homes and check for hazardous conditions, such as loose throw rugs, poor lighting and slippery surfaces. Physical therapists also help their patients avoid fatigue by teaching them energy-saving movement patterns, as well as exercises that improve overall body awareness to avoid falls.
Therapy and Prevention
The International Encyclopedia of Rehabilitation details the results of numerous studies that link physical therapy with preventing the progression of Parkinson's disease. A 2002 study published in the "Journal of Neuroscience" found that physical inactivity accelerates the degenerative process of the disease. Studies performed in 2005 and 2009 found that exercise therapy was more effective than medication and surgery in treating Parkinson's symptoms. In contrast, early physical therapy does not alter the course of Huntington's disease, but it may help control the depression that often accompanies the condition.
Techniques
Exercises that focus on strength, flexibility and balance play a key role in physical therapy for movement disorders. In fact, stability ball training, commonly seen in fitness centers, actually originated as a form of physical therapy for movement disorders. Swiss physical therapist Susanne Klein-Vogelbach developed the functional kinetics technique, which emphasizes maximum movement performance with a minimal amount of effort. She used exercise balls, massage and mobilization methods to enhance movement patterns in people with neurological movement disorders. For patients with gait disorders, the authors of "A Practical Approach to Movement Disorders" recommend visual cues, such as stepping over an object, and auditory cues, such as walking to the beat of a metronome.
References
- Health Communities: Movement Disorders Overview
- "A Practical Approach to Movement Disorders";Hubert Fernandez, Ramon L. Rodriguez, Frank M. Skidmore; 2007
- International Encyclopedia of Rehabilitation; Physical Therapy - Exercise and Parkinson's Disease; Fátima Rodrigues-de-Paula, PT, Ph.D.
- Huntington's Disease Society of America; Physical and Occupational Therapy Family Guide Series; Suzanne Imbriglio, PT
- Brief Description of Physiotherapeutic Methods of Treatment
