REHABILITATION OF A PATIENT WITH PARKINSONISM
A ) PROPER FOOT POSITIONING
B ) PROPER STEP TAKING ABILITY
C ) PRESCRIBING EXERCISES IN RHYTHMIC FASHION ( movements coupled with musical or drum beating rhythm
D ) PRESCRIBING AEROBIC EXERCISES - to improve endurance , strengthening of back extensors and abdominal muscles for upright posturing
E ) Relaxation techniques to decrease rigidity
F ) Slow rhythmic rotational movements
G ) Gentle range-of-motion and stretching exercises to prevent contractures, quadriceps and hip extensor
H ) isometric exercises
I ) Neck and trunk rotation exercises
J ) Back extension exercises and pelvic tilt
K ) Proper sitting and postural control (static and dynamic); emphasize whole body movements
L ) Breathing exercises stressing both the inspiratory and expiratory phase
M ) Functional mobility training, including bed mobility, transfer training, and learning to rise out of a chair by rocking; may require a chair lift
N ) Stationary bicycle to help train reciprocal movements
O ) Training in rhythmic pattern to music or with auditory cues such as clapping may help in alternating movements.
P ) Standing or balancing in parallel bars (static and dynamic) with weight shifting, ball throwing
Q ) Slowly progressive ambulation training (large steps using blocks to have patients lift legs, teaching proper heel-to-toe gait patterns, feet 12-15 inches apart, arm swing; use inverted walking stick, colored squares, or stripes as visual aids)
R ) Use of assistive devices (may need a weighted walker)
S ) Aerobic conditioning (swimming, walking, cycling)
T ) Frequent rest periods
U ) Family training and home exercise program
V ) Adaptive equipment evaluation, including Velcro closures, raised toilet, grab bars, eating utensils with built-up handles, and key holders