What is Parkinson’s disease?

Name of Parkinson’s disease took its name from its discoverer, James Parkinson. Parkinson degeneration is a disease that attacks the brain due to a lack of dopamine in the brain.

More specifically, when the substantia nigra, a nerve cell in the brain, will be damaged, it stop producing the neurotransmitter dopamine, a chemical responsible for the movement of muscles in the body, it will hence causing disturbance called Parkinson’s disease.

Parkinson vulnerable age is 60 years although one of the 20 cases of patients attacks on aged 40. Parkinson’s disease prevalence in the world reached about 6.3 million. A total of 1.6 per 100 people over 65 years and one per 50 people above 80 years old attacked by Parkinson.

The main symptoms are movement disorders and non-motor disturbances. in many people with Parkinson’s, there is a cognitive disorder in a variety of difficulty of Parkinson. Parkinson diseases preventable and curable because the cause itself is difficult to know. When an individuals lost more than 80 supply of dopamine, a substance important in the process of sending signals between brain nerve cells to regulate the movement, then the individual will experience some symptoms of Parkinson’s such as:
1. shivering uncontrollably in the arms or legs when at rest.
2. rigid limbs.
3. slowed movement, impaired walking and balance disorders.

Parkinson’s disease had clinical symptoms as follows:
1. Bradikinesia (slow movement), disappeared spontaneously.
2. Persistent tremor.
3. Actions and movements that are not controlled.
4. Autonomic nervous disorders (sleeplessness, sweating, orthostatic hypo tension).
5. Depression and dementia.
6. Face like a mask (dry skin).
7. Frequency of nightmares that too often can be one of the earliest signs of Parkinson’s disease.
people who experience sleep disturbance REM (rapid eye movement / sleeping rough) and likes to kick and beat while sleeping, they will have high risk of dementia and Parkinson’s disease.

REM or rapid eye movement stage of sleep can be happen when people have a dream. People who sleep normally be ‘paralyzed’ effectively at this stage, because the brain enables the muscles to rest properly.

But people who have REM sleep disorder, they usually will experience nightmares and violent movements such as kicking and hitting while sleeping.

Note: Be careful in using materials that contain pesticides because of piling of pesticides in the body can cause Parkinson’s disease. therefore, the people whose job requires that he do a lot of contact with pesticides should be vigilant. Free radical metabolism of the body or substance that is poisonous to the nerves like iron, herbicides, pesticides, can cause degeneration of neurons (cells introductory impulses in the nervous system) and brain cell damage in substantia nigra. As a result, dopamine levels in the brain decreases.

Low levels of dopamine, can cause interference on the part of the brain that regulate movement that can be arranged (volunteers) and create movements that can not be regulated (involunteer).

To reduce these symptoms, it can be done with some therapies such as levodopa, carbidopa, and entacapone which helps people with Parkinson to control their body movements.

More complete explanation:
1. Anticholinergics to reduce excessive cholinergic transmission when the shortage of dopamine.
2. Levodopa, a precursor of dopamine, in combination with carbidopa, carboxylic acid inhibitor, to assist the reduction of L-dopa in the blood and brain repair.
3. Bromociptin, dopamine agonists that activate the dopamine response in the brain.
4. Amantidin which can increase the fraction of dopamine in the brain.
5. using mono amine oxidase inhibitors such as deprenil for delaying the onset of disability and the need for levodopa therapy.

Diagnosis and Intervention
1. Impaired physical mobility related to bradikinesia, rigidities marked by tremors, muscle and DS: client said it was difficult to do activities, DO: tremors while on the move.

Intervention:
Objective: To increase mobility.

* help clients daily exercise such as walking, cycling, swimming or gardening.
* Encourage clients to stretch and exercise as directed postural therapists.
* Wash with warm water and a client to do sorting to help muscle relaxation.
* Instruct the client to rest on a regular basis in order to avoid the shortcomings and frustrations.
* Teach for postural exercise and walking techniques to reduce the stiffness when walking and possibly learn to continue.
* Instruct the client to walk with an open leg position.
* Create a client raised his hand with consciousness, lift the foot when walking, use the shoes for walking, and walking with step length.
* Tell the client to walk to the rhythm of music to help improve the sensory.

Evaluation: client sessions of physical therapy, facial exercise 10 minutes two times a day.

2. Fulfillment of nutritional disorders: less than body requirements, its related to the difficulty like : moving food, chewing, and swallowing, marked by DS: client said it was difficult to eat, weight is reduced DO: thin, weighing less than 20% ideal body weight, pale conjunctiva, and pale mucous membranes.

Intervention:
Objective: To optimize the nutritional status.

* Teach your clients to think while swallow-shut lips and teeth together, lifting the tongue with food on it, then move to the back of the tongue and swallowing, lifting his head backward.
* Instruct client to chewing and swallowing, using a second wall of the mouth.
* Tell the client to consciously control the accumulation of saliva and swallowing by holding the head periodically.
* Provide a sense of security to the client, with a stable eating and using the equipment.
* Encourage eating in small portions and add a snack (a snack).
* Monitor your weight.

Evaluation: the client can eat three times in small portions and two snacks, no weight loss.

3. Impaired verbal communication related to the decline in speech and facial muscle stiffness characterized by: DS: client / family say there is difficulty in speaking DO: elusive words, pelf, his face stiff.

Intervention:
Objective: To maximize the ability to communicate.

* keep the complications of treatment.
* Refer to speech therapy.
* Teach your clients and facial exercises using breathing methods to improve the words, volume, and intonation.
* Breath-in before speaking to increase the volume and number of words in sentences each breathe.
* Train to speak in short sentences, reading aloud in front of the glass or into a voice recorder (tape recorders) to monitor progress.

Evaluation: the lack of difficulty in speech, words can be understood.

In addition, also introduced music therapy, which helps disabled start a movement based on music rhythm.When listening to music, the brain becomes active to stimulate active listening and moving again. it is also creating a relaxed atmosphere, and improve patient mood. Rhythm help sufferers to get up and move. each patient differences in response to the music that you listen to them. there are after hearing the gamelan and angklung became engaged. all were influenced emotion or past and cultural background of the patient. Stimulation must done just 30 minutes, every day or at least twice a week. in addition to helping Parkinson’s patients moving, listening to music that they like also help patients who have sleeping difficulty become easy to sleep. Meanwhile, other than music therapy, there are also therapies conducted by gymnastics, dance, meditation, nutrition, and therapeutic recreation in nature. To cure Parkinson’s disease must continues to get better results.