Is true that tremor (involuntary shaking of body parts such as limbs or face) is one of the most commonly known symptoms in Parkinson but not all patients with symptoms of shaking are having Parkinson’s disease. Parkinson’s disease affects people in various ways and each PD patient presents uniquely.
Moreover, tremors can also be seen in other conditions like atypical Parkinsonism (disorders which mimic Parkinson’s disease), essential tremor, drug-induced tremor, alcohol-related tremor, etc. It is also important to note that the tremor caused by PD is characterized by tremor at rest (shaking when muscles are relaxed) and often begins on one side of the body (David Charles et al, 1999).
Other common symptoms include:
- Stooped posture
- Stiff arms and legs
- Slow movement (bradykinesia)
- Problems walking, balancing and lose of coordination
- Changes in speech
- Changes in writing (smaller in handwriting)
The following are tips to help you understand more facts about Parkinson’s disease.
Myth 1: Parkinson’s is only a movement-related condition.
Fact: In addition to motor symptoms, it also has non-motor symptoms like depression, anxiety, sleeping disorder, constipation, urinary incontinence, hypotension, etc.
Myth 2: Only the elderly get Parkinson’s disease.
Fact: This is not entirely true. Even though the majority Parkinson’s diagnoses at age 60 and above but it can occur at any age. Some people get it under 20 (this is called juvenile-onset Parkinson’s) and others under 50 (young-onset Parkinson’s). Actor Michael J. Fox and NBA player Brian Grant are examples of people who were diagnosed in their 30s. About 5 to 10% of Parkinson’s patients are diagnosed under age 50.
Myth 3: As long as patients active in exercise, they do not need to take Parkinson’s medications.
Fact: A combination of exercise with medication therapy is crucial to improve Parkinson’s symptoms. PD is a progressive neurodegenerative disorder that is characterized by the depletion of DA due to the degeneration of neurons in the substantia nigra pars compacta (SNpc) and to a lesser degree the ventraltegmental area (VTA) (Petzinger et al, 2015). Parkinson’s medication such as Levodopa (Duopa, Rytary, Sinnemet) serve a role to supply the depletion of Dopamine in Parkinson’s patient but exercise that incorporates aspects of motor learning, such as skill(yoga, Tai Chi, treadmill running) and aerobic exercise is needed to improve the dopamine receptor expression so that to enhance its efficiency in binding with the Dopamine to produce better motor control (Petzinger et al, 2015).
Myth 4: Parkinson’s disease is caused by genetics.
Fact: The exact cause remains unknown. Scientists and doctors are studying both environmental and genetic factors and their impact on PD and their research currently suggests that less than 10% of Parkinson’s disease cases have a true genetic link.
Myth 5: Parkinson’s is fatal
Fact: Even though Parkinson’s disease is a progressive motor disease with multiple motor and non-motor symptoms, it does not cause fatality directly like a heart attack. Proper care with medications and a sufficient amount of exercise can help to slow down the progression of the disease or even improve the life span of PDs by improving the quality of life.
Myth 6: The only treatment for Parkinson’s disease is medication.
Fact: There is a surgical treatment available for advanced Parkinson’s disease, which is deep brain stimulation (DBS) to manage uncontrollable tremors. Other management such as exercise, lifestyle modification (become more active) and therapies (music, dancing or Tai Chi) help to maintain a sense of independence and a better quality of life for a longer period of time.
Parkinson’s has no cure until now. But, medications, surgery (DBS), physiotherapy, and lifestyle modification help patients to control symptoms. (Source: Getty/Thinkstock)
Article by Chang Sok Hooi
Physiotherapist from Your Physio Penang
References:
Charles, P. David, et al. “Classification of Tremor and Update on Treatment.” American Family Physician, 15 Mar. 1999.
Fayyaz, M., Jaffery, S. S., Anwer, F., Zil-E-Ali, A., & Anjum, I. (2018). The Effect of Physical Activity in Parkinson’s Disease: A Mini-Review. Cureus, 10(7), e2995.
Klein C, Westenberger A. Genetics of Parkinson’s disease. Cold Spring Harb Perspect Med. 2012;2(1):a008888.
Petzinger GM, Holschneider DP, Fisher BE, et al. The Effects of Exercise on Dopamine Neurotransmission in Parkinson’s Disease: Targeting Neuroplasticity to Modulate Basal Ganglia Circuitry. Brain Plast. 2015;1(1):29-39.