Hey D: I think the memory problem is where I get confused. For example, I evaluated a woman yesterday with advance Alz. He son, the caregiver, reports a recent and significant decline in his Mom's ability to ambulate, transfer, assist with toileting and bathtub transfers. (these are what I was referring to as 'functional symptoms')
Now, the question becomes is this a memory disorder or a movement disorder? And can't a memory disorder manifest itself as a movement disorder. In other words, can't a person forget how to move? Finally, doesn't PD eventually effect one's cognition, including memory? IF so, wouldn't PD them become a memory disorder. It seems that while etiology of PD and Alz may differ, the results of the diseases are similar. Ron ================================================= Tuesday, December 2, 2003, 10:31:02 AM, you wrote: LD> FUNCTIONAL SYMPTOMS? not sure what you mean here...but, for the LD> most part in PD there is a brain versus movement disorder and in AD it LD> is more of a memory issue LD> I think I answered your second question in my first LD> response.....no, I would not treat the same LD> My approach would be to assess the impairments that I feel LD> contribute to the functional deficit and attempt to offer intervention LD> that would improve the impairment thus function (i.e. weight training LD> to improve balance). The person with AD would not be able to understand LD> the weight training....so, I might use something more familiar to LD> improve balance (like dance moves) LD> So, did I answer your questions? 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> -----Original Message----- LD> From: Ron Carson [mailto:[EMAIL PROTECTED] LD> Sent: Tuesday, December 02, 2003 9:06 AM LD> To: Lehman, David LD> Subject: Re: [OTnow] Parkinson's disease / Alzheimer's LD> Hello David: LD> In your experience, are the 'functional' symptoms of PD and Alz similiar? LD> And if so is your treatment the same or would you treat a client with PD LD> different than a client with Alz? Granted ALL clients are individuals LD> requiring individual care but are their general treatment differences based LD> on the client's diagnoses? LD> Ron LD> ================================================= LD> 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 LD>> _______________________________________________ LD>> To unsubscribe, visit: LD>> http://otnow.com/mailman/listinfo/otlist_otnow.com LD>> The OTnow Mail Archive: LD>> www.mail-archive.com/[EMAIL PROTECTED] LD> _______________________________________________ LD> To unsubscribe, visit: LD> http://otnow.com/mailman/listinfo/otlist_otnow.com LD> The OTnow Mail Archive: LD> www.mail-archive.com/[EMAIL PROTECTED] LD> =============================================== LD> _______________________________________________ LD> To unsubscribe, visit: LD> http://otnow.com/mailman/listinfo/otlist_otnow.com LD> The OTnow Mail Archive: LD> www.mail-archive.com/[EMAIL PROTECTED] _______________________________________________ To unsubscribe, visit: http://otnow.com/mailman/listinfo/otlist_otnow.com The OTnow Mail Archive: www.mail-archive.com/[EMAIL PROTECTED] ===============================================
