Occupational Therapy for Parkinson’s Disease

Occupational Therapy (OT) for Parkinson’s disease (PD) aims at enabling people to complete their everyday activities. By improving skills, showing different ways to complete tasks, or introducing certain handy equipment, an occupational therapist can help the PD fighter perform everyday tasks with ease. Being able to do jobs by themselves instills a sense of confidence among PD fighters. This, in turn, saves them from severe depression and anxiety.

Just like other health disciplines for PD, OT should be customized to serve the patient’s individual needs. While one PD fighter may need help learning various strategies to manage their tremors, another may need to learn coordination exercises to maintain functional use of his hands.

Usually, a patient-centred, top-down approach (initially focused on functional challenges) is adopted during OT assessment and intervention. After assessment, the therapist also makes recommendations on equipment needs and home safety. OT takes help of arm and hand therapy, handwriting aids, work equipment modifications, leisure skill development, manual or electric wheelchair use, and dressing and grooming aids to treat the PD patient.

How does Occupational Therapy for PD work?

Despite medication, PD patients develop a progressive disability during the course of the disease. Reasons for impaired functional performance can include the disease progression, environmental restrictions, medication regimes, fatigue, depression, freezing, and lack of motivation or other cognitive impairment. Since PD fighters experience limitations in fine motor coordination, they face difficulty with manipulating items such as buttons, makeup and other small items around the house.  

OT works on improving the patient’s motor abilities, helping them learn skills needed for performing self-directed activities (also known as occupations). These activities include personal grooming, preparing meals and performing other daily jobs. By dividing a complex activity into its component parts, PD fighters perform the whole sequence of actions. This strategy improves coordination and help PD learn how to carry out planned actions. OT aims to change PD fighters’ elements of the environment that limit their activities of daily living.

What does Occupational Training program include?

Occupational therapist and PD patient’s expectations should be focused on the same functional goals. Both, Acquisitional Occupation (targeted towards the restoration of impaired skills) and Adaptive Occupation (focused on adapting to new environment) approaches should employ attentional strategies, cognitive and sensory cueing techniques, and conductive education methods.

Conductive education that include rhythmically facilitated practice of basic movements required for daily living tasks, should be used to improve handwriting, gait, and other forms of movement control, employing group-based exercises. Several activities that one can do to increase coordination, include:

  • In-Hand Manipulation (rotating items in palm such as Chinese medicine balls)
  • Finger Isolation
  • Dynamic Movements (sewing, knitting, and cross stitching)
  • Manipulating small nuts and bolts

Cueing techniques can aid performance of personal and domestic activities among PD fighters. Cues by-pass the PD patient’s underactive basal ganglia and elicit and enhance the performance of functional activities by employing alternative manual control mechanisms.

A therapist may also make Motivational Interviewing (MI) a part of OT process to promote adherence to a treatment plan, which can be used in the treatment of a broader area of diseases that are influenced by behaviour.