Hello David:

In  your  experience,  are the 'functional' symptoms of PD and Alz similiar?
And  if  so  is  your treatment the same or would you treat a client with PD
different  than  a  client  with  Alz?  Granted  ALL clients are individuals
requiring  individual care but are their general treatment differences based
on the client's diagnoses?

Ron

=================================================
Tuesday, December 2, 2003, 9:25:18 AM, you wrote:

LD> My understanding and experience of the mental changes/dementia due
LD> to PD are related to the decrease in dopamine within the
LD> nigro-striatal-cortical connections to the frontal lobe.  The mental
LD> changes occur as the disease progresses.  It seems to cause a decreased
LD> emotional investment in the movement I may be assessing (i.e. gait). 
LD> Therefore, this has been discussed as being one of the reasons for the
LD> lack of initiation in P w/ PD.

LD> Also, long-term use of L-Dopa can lead to schizzophrenic type dementia.

LD> My approach to EVERY person with AD or PD is individualized and
LD> never based soley on the diagnosis....certainly establishing where the
LD> person is in regards to mental status is the start, for this will let me
LD> know if I should use cerebral or primitive mechanisms in my approach to
LD> treating the movement deficit.

LD> Seems like most of the people with AD that I have treated were in
LD> LTC facilities and were at the later stages.  I would use very
LD> common/familiar tasks (i.e. bicyle/dance/walk) for mobility training. 
LD> The person with PD may not respond as well given the side effects of
LD> meds and the freezing issues associated with movement in the later
LD> stages.  However, in early stages, I can use cueing and strength
LD> training to improve balance and gait.



LD> David A. Lehman, PhD, PT
LD> Associate Professor
LD> Tennessee State University
LD> Department of Physical Therapy
LD> 3500 John A. Merritt Blvd.
LD> Nashville, TN 37209
LD> 615-963-5946
LD> [EMAIL PROTECTED]



LD> Hello:

LD> What  differences  if  any do you all see in the way that Alzheimer's versus
LD> Parkinson's diseases manifest themselves in your clients?

LD> Are your treatment approaches different based solely on the disease?

LD> Thanks,

LD> Ron


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