Multidisciplinary Rehabilitation & Holistic Care in Parkinson’s Disease

Written by Dr Anuka Parapuram, Rehabilitation Specialist at MetroRehab and Royal Rehab Private Hospitals.

Parkinson’s disease (PD) is a multi-system neurodegenerative disorder characterised by motor and non-motor symptoms. It is a global phenomenon affecting 1 per cent of people over 55 years of age. Symptoms of PD include impairment of speech, swallowing, gait, movement and balance, which can affect a person’s ability to carry out day-to-day activities.

More than 90 per cent of patients with PD will have issues with their speech and swallowing, which can result in inactivity, embarrassment and social withdrawal, according to self- reported data. Additionally, cognitive and behavioral changes are other non-motor symptoms that can occur early in PD.

The strongest evidence of efficacy of rehabilitation occurs through early intervention. Rehabilitation plays a key role in maintaining mobility, balance and endurance, and preventing secondary complications from reduced physical activity.

The European Physiotherapy Guidelines for Parkinson’s disease recommends patient-centred care, as it is associated with greater wellbeing and physical functioning. Recent empirical evidence also suggests exercise programs may be an effective way to delay or reverse functional decline, as exercise may trigger neuroplasticity in the brain.

At MetroRehab and Royal Rehab Private Hospitals, we offer two programs specifically designed for people with PD:

PD Warrior®, a high-intensity exercise program with cognitive retraining to slow the symptoms of PD, and Lee Silverman Voice Therapy LOUD, an intensive speech treatment program to improve hypophonia.

The teams provide goal-orientated, patient-centred programs with the aim of improving the quality of life with PD patients.

Case Study: Wayne

Sixty-seven year old Wayne was diagnosed with Parkinson’s disease in 2020. Soon after, he was referred to Royal

Rehab Private Hospital to benefit from a personalised multidisciplinary therapy program.

At Wayne’s first session, the team assessed his function and the impact of PD on his quality of life, before helping him set goals for his program. He wanted to improve his balance to reduce the risk of falling; retain his fine motor skills; and regain strength in his speech.

At the end of his program, Wayne’s quality of life score had improved significantly. PDQ-39 is a PD questionnaire that assesses how often someone with the disease experiences difficulties in their daily activities. Wayne’s score had improved from 37 to 15, indicating that his condition is having less of an impact on him and his daily life.

Wayne also participated in speech therapy, which helped him increase the volume of his voice, allowing him to communicate more confidently.

“My tip for others is this — go into rehabilitation as soon as possible,” said Wayne.