- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And together we are the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- Brad, today, you want to talk about Parkinson's,
basically, what it is and- - Right, a little history.
- maybe a few treatments.
- Brief history, and demonstrate the common symptoms,
- Sure. - and what it looks like,
- and then how to treat it.
So, first of all,
Parkinson's, they've known about it for years.
Dr. James Parkinson in 1817, English doctor, discovered it
and did some.
- These things are always named after somebody, aren't they?
- Yeah, so he did some writings on it,
some studies on it that have been documented.
And what it is,
is a degenerative disorder of the nervous system,
the central nervous system.
They do not know for sure what causes it.
There are some theories, I'm not gonna get into that,
but basically it's idiopathic,
or they don't know what causes it.
- What's the cause. - Mm-hmm.
Symptoms, the most significant symptoms on onset are,
typically, shaking, rigidity,
in other words, real stiffness in the arms or the legs,
oftentimes it's in the legs, slow movement,
flexed forward posture.
And I'll show you a little more examples of that
in just a minute.
- One case, everyone always talks about pill rolling.
- Sure - The hands start to,
it looks like they're rolling a pill,
but they're actually just getting some rigidity,
I mean, not rigidity, some spasticity, almost, up there.
- Right, right. Exactly.
- So, the other thing is they have,
what they call a paucity of movement,
which means they really have difficulty initiating movement.
- Right. - If you've ever seen that.
- Yeah. Oh yeah.
- Quite often, we'll have a patient that they'll come
to a doorway and they stop walking
and they just can't, because they have to think
about going through the door, they just can't do it.
- Right. - So.
- Right, their mind is doing it, but the body isn't
- The body's not reacting.
- Right. - Right.
- Typically people 50 and over,
everyone knows Michael J. Fox.
Sure. I think that's pretty not commonly known.
Muhammad Ali's got Parkinson's.
- Remember, Michael J. Fox said his started
in his little ring finger,
little shaking and he couldn't stop it.
And he couldn't figure out what it was.
- Yeah.
I'm gonna demonstrate, I just was working
with a gentleman with this, and that's why
I wanted to make this film, kinda reminded me of that.
And I thought there's a lot of people that aren't sure.
And they're wondering if a relative has it
because they're seeing some of these symptoms,
- Right. - With walking,
they'll get up, and the person may need a cane already
in this case, this gentleman did,
but oftentimes it's a flex forward posture,
one of the symptoms.
And then like Bob had said, just to get started
they'll, kind of, wanna go and then they won't go.
And finally things will get going.
It'll be short, choppy steps.
But oftentimes after they get moving
about 20 feet or so, it'll smoothen out.
- Be fine, right.
- And they're doing well,
then they look relatively normal again.
Exactly.
- And their balance often isn't bad,
once they get started - Right. It is amazing.
'cause at first and, and oftentimes when they have to turn,
make a sharp turn and you'll see one leg
sometimes they'll do more like this will start to turn
and that leg will just be like it's glued to the floor.
- Yeah. It seems like anytime they have to make a decision.
- Right.
- You know, once it's rolling and it's automatic
then it's not a problem.
Sure.
- And oftentimes what you can do is verbal cues, or say
take bigger steps, slow down and take bigger steps
lift your feet off the floor.
And sometimes that's enough to help them get going
into that rhythm. - Right.
- Exactly.
- And as far as other treatments, typically, you know
you gotta keep the person safe.
If they're gonna need a cane, fine.
Oftentimes a walker.
- Right.
- They do make some very expensive walkers that
has a laser light on it for visual cue.
That's something that...
- And also has a beeping sound on it.
An audio sound. - Right, for audio cue.
Yeah, and those do help.
Right.
- We've used one.
Do you know how much they cost, roughly?
- They're a lot.
Yeah. They're not cheap.
I don't see a lot of people with them at all.
- Usually paid for
by insurance when I see them, 'cause they're so expensive.
- So if you have some conservative treatment that you can do
or you can purchase, we're gonna go through one
that you can do with someone else is just simple stretching.
- Right.
Because they're rigid,
the muscles tend to tighten up on them.
- Yeah.
- And then when they tighten up,
it makes the rigidity even worse.
- Right.
- And the other thing which I should say
real quickly, Brad, is that there is a lot
of neurological diseases that, that aren't Parkinson's
but act like Parkinson's.
Yeah, sure.
And there's a lot of 'em that,
I've had people where they just didn't even diagnose.
Sure. And there's also medications that'll make you
get Parkinson-like symptoms.
- Sure. - So,
- Right.
- You have to worry about that.
Yeah. So this is something you really need
to get it to the medical community,
get some expert opinion. - Right, obviously.
- For treatment on stretching.
Oftentimes it's the calf muscle or hamstrings are tight.
So you're gonna do this.
I like to stretch it like this and dorsiflex,
we call it or stretch the ankle.
- So he's got his forearm
against my bottom of my foot or he is got...
Yeah.
- And sometimes you may have to hold it
and stretch pretty hard.
And you know, you don't wanna have any pain
but typically it won't be painful.
They say, oh, it feels like a good stretch,
and you're gonna hold it sometimes for 30 seconds
to a minute, you're gonna get a little bit tired
and you know, that's just part of it.
- Right.
- Hamstrings, if you come up to here and the knee
doesn't straighten out...
You have a tight hamstring.
- Oh.
- There, you may have to have a hand here
and stretch it out slowly.
If you sit down and their knee goes straight out like this,
- You're doing pretty well.
You probably don't have to spend much time
on the hamstrings.
Right.
- And the same goes with the arms,
I'm just talking about the legs
'cause we're referring to gait in this video
- You know, their chest is gonna get tight.
Their muscles are gonna get tight.
They're all getting pulled over.
So the hallelujah stretch would be a good one for them.
- Oh sure, in a seated position.
- Yep. So they're sitting down and they're gonna lift way
up and get real large, trying to, for a good stretch.
- Okay.
- So.
- Another thing is that circular motion of a bicycle
and you're not gonna use a, you're gonna use a
a recumbent bike or you can get one of these devices
called a respirator.
You can pick these up for around $50,
- Mind just holding that.
- less or minus.
Now they oftentimes have these hoops in there and
sometimes it's hard to get your feet in there.
So you don't always have to do that, but whatever
just get the person in there so that you can
- Yeah, this works great for reciprocal movement.
So you are working one and the other and it's just,
it's really a great one to break
up the rigidity of Parkinson's.
- Right.
- And you know, it's one they can do
while they're watching TV
So, and this is obviously a lightweight thing
that you could put, you know, nearly anywhere, right?
So it's just an easy, no excuse system
for getting some exercise.
- Yep. Easy, not too expensive.
You can go and buy a recumbent bike as a chair,
and a bicycle, I don't know if you wanna spend
that much money.
That's a real good idea as well.
- So you want to keep things stretched out.
You want to keep things moving.
I mean, that's the key with Parkinson's,
you know, it's very easy to fall into that rigidity
and tightness and, then suddenly it gets
to the point where you can't go back from that anymore.
Right.
- So once again, Bob,
we've got some more information, helpful for these people
that are gonna carry them
out with their families
and themselves to be more flexible, more vibrant.
- Aren't we great. Oh,
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- Thank you.
Take care.