3. Occupational Therapy:
Occupational therapy is necessary to ensure independence in activities of daily living by these patients. Occupational therapy is more or less same as physical therapy except that it focuses mostly on upper limb and is relatively on a miniature scale.
I. Exercises of Upper Limb:
Exercises of upper limb are aimed at maintaining, strength, bulk, range of motion, coordination, proprioception and dexterity. These targets are achieved with the help of strengthening, stretching, fine motor coordination training and hand dexterity training by using colored beads or pegs and hand cycling to promote reciprocal movements. These exercises are not only carried out at rehabilitation facility but a home exercise plan is also made and care-givers are trained in it.
II. Transfers and Mobility:
These patients are specifically made to practice transfer skills and safety skills in order to prevent any injury while ensuring functional independence.
III. Adaptive Equipment:
Adaptive equipment is necessary to compensate for motor, sensory and coordination deficits in order to achieve functional independence. The adaptive equipment that can be used for the rehabilitation of patients with Parkinson’s disease include velcro closures, raised toilet seat, grab bars, utensils with built-up handles, universal cuff and key-holders.
4. Speech and Swallowing:
All 4 components of speech including respiration, phonation, articulation and resonation are affected by this disease. There are certain exercises that are carried out to address these problems including deep breathing exercises and diaphragmatic exercises. Other exercises that can be helpful in this regard include exercises of the muscles of mouth, face and tongue. Dysarthria can be specifically addressed with articulatory speech training.
Assessment of swallowing is done with modified barium swallow and patients are taught compensatory strategies for safe swallowing.
5. Psychological Interventions:
Counselling of patient, family and care-givers about the disease process, prognosis and treatment options is very much necessary in order to make them accept treatment and ensure good compliance. All of them should get continuous psychological support in order to prevent and treat disease related psychological problems, which include depression, anxiety and at times psychosis.