FUNCTIONAL SYMPTOMS?  not sure what you mean here...but, for the most part in PD there 
is a brain versus movement disorder and in AD it is more of a memory issue


I think I answered your second question in my first response.....no, I would not treat 
the same

My approach would be to assess the impairments that I feel contribute to the 
functional deficit and attempt to offer intervention that would improve the impairment 
thus function (i.e.  weight training to improve balance).  The person with AD would 
not be able to understand the weight training....so, I might use something more 
familiar to improve balance (like dance moves)

So, did I answer your questions?  

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




-----Original Message-----
From: Ron Carson [mailto:[EMAIL PROTECTED]
Sent: Tuesday, December 02, 2003 9:06 AM
To: Lehman, David
Subject: Re: [OTnow] Parkinson's disease / Alzheimer's


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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