Parkinson's treatment program discussed at Lunch and Learn seminar

July 5, 2013

Cody Paty, a physical therapist at Rolling Plains Memorial Hospital talked about the hospital's recent treatment program offered for those who suffer from Parkinson's disease at the recent Lunch and Learn Seminar. (Photo by Melissa Winslow)

The recent Lunch and Learn Seminar at Rolling Plains Memorial Hospital (RPMH), held last Thursday, discussed the hospital's recent treatment program offered for those who suffer from Parkinson's disease, a program called LSVT-BIG.
Presented by Cody Paty, a physical therapist at RPMH, the first part of the program offered some background information on the disease.
Each year, anywhere from 50,000 to 60,000 new cases of Parkinson's disease are discovered. It affects one million people in the United States, while 4 to 6 million people worldwide suffer from Parkinson's disease.
In 2005, around 340,000 cases were reported. Since that time, the number has doubled. Within the general population, there are 11 Parkinson's disease cases for every 100,000 people.
Paty explained that a person's genetic makeup predisposes them to the disease. He made the reference that while the genes are like a loaded gun with Parkinson's disease, a person's environment and other factors will pull the trigger to release the ailment.
The new treatment offered locally is LSVT (Lee Silverman Voice Treatment) -BIG. Silverman suffered from Parkinson's disease, and doctors spent much time in treating her.
Within her treatment, Silverman was asked to speak louder and hold her sentences longer. As a result, her general speech improved, along with her cognition and word recall.
The program was initially developed in Scottsdale, Arizona in 1987 for speech, in which the treatment was known as LSVT-LOUD. However, doctors began to work if the treatment could have the same effects on movement.
Ten years later, incredible results were found from the LSVT-BIG treatment for movement, and it has taken years to design the program.
The focus of the treatment is to increase the aptitude of movement through the use of seven, sustained stretching exercises. Similar to yoga positions, two sitting and five standing exercises are used.
To determine if a person might have Parkinson's, various questions will be asked to the patient. The questions range from when movement patterns first changed, the most significant problem with movement, if activity has decreased, the status of a person's balance and posture, fatigue, freezing during movement, and changes in hand movements.
While most people notice the onset of Parkinson's disease through hand tremors, it can be an indication that more is going on. Sometimes, writing tests will be administered to learn more about hand movements.
A complete evaluation will be done with a patient to check their sitting and standing, how they start and stop moving, walking direction, fatigue, range and motion, and strength. Should LSVT-BIG treatment be used, specialized movements are created thereafter by having the patient select five trouble spots to work on.
Throughout the treatment, a person's functional tasks will change. Research on the treatment has shown that brain patterns change, which carries over into the muscles.
With Parkinson's disease, the "get-go" signal in the brain is too small, along with the signals in the brain to stop and start moving. Thus, LSVT-BIG helps to reprogram the brain to do what is more normal.
Within the therapy, videotaping is also used to show the patient how they move and step. Many Parkinson's patients may think that they are overstepping, but the video will prove otherwise so that a patient can be convinced to move bigger.
Additionally, as the person moves bigger, their movement will become faster. However, Paty stated that faster movement is not necessarily important throughout the treatment.
Furthermore, home exercises are part of the treatment, but the overall therapy will not be effective if the home exercises are not done. At the hospital, therapy is administered 4 hours a week for four weeks.
The sooner the treatment is initiated, the better the results will be seen. Many doctors are becoming more aware of the signs and symptoms of Parkinson's disease, allowing them to treat it earlier.
Paty demonstrated the seven exercises to the audience. When seated, patients are asked to reach to ceiling and sides, while some of the standing exercises require a person to step forward, to one side, and twist their body.
When functional tasks are later implemented, some patients hope to have better movement in getting out of a car, opening a closing a flip phone, and roll to one side in their bed. among other tasks. Some hierarchal goals are also set, so that a patient can accomplish daily tasks--like playing a round of golf of taking a shower--in an efficient way.
However, some patients may be limited in the treatment, especially those who have knee, hip and back problems. Modifications are then used, and improvements can still be seen.
All patients can receive handouts and photos of the exercises, and they are also given a form to track their therapy. In most cases, a patient will have to exercise once a day at home when they take part in treatment at the hospital, or two times a day on the other days.
A brief question-and-answer session was also held, in which Paty stated that a sedentary lifestyle will lead to a faster progression of Parkinson's disease both physically and mentally. He added that area doctors have been made aware of the new treatment offered in Sweetwater as well.

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