Examination and Management of the Client With Parkinson's Disease, Updated

About the Course:
Parkinson’s disease (PD) is the second most prevalent neurodegenerative disorder (after Alzheimer’s disease [AD]), impacting approximately 1 million individuals in the United States, with 60,000 new cases diagnosed each year (Parkinson’s Disease Foundation, n.d.). Many physical therapists enter the field with a broad understanding of neurologic rehabilitation but lack specific training in the differential diagnosis, examination, and management of clients with PD. Currently, research in the physical therapy management of individuals with PD is quite robust, resulting in an ever-changing field of practice in response to new research findings. Therapists might lack information regarding the most valid diagnostic tests and measures and the most current evidence-based treatment techniques. Recent studies have developed new assessment techniques such as the Balance Evaluation Systems Test (BESTest) and shorter versions called the Mini-BESTest (Duncan et al., 2013) and the Brief-BESTest (Padgett et al., 2012). Although it has been well established that physical therapy is beneficial for people with PD (Tomlinson et al., 2012), evidence on best treatments is still growing.

This intermediate-level course is designed to provide physical therapists and physical therapist assistants with the information needed to appropriately examine and treat the client with PD, including differential diagnosis of individuals who exhibit signs and symptoms indicative of PD. In addition, the learner will be able to manage clients with PD by designing a comprehensive treatment program based on the use of appropriate outcome measures. Equipped with the most current evidence, the learner will be able to discuss and critically evaluate interventions directed at the specific body structure and function, activity, and participation deficits associated with PD.

Learning Outcomes:
  • After completing this course, the learner will be able to:
  • Describe the etiology and symptoms of Parkinson’s disease, including its four cardinal signs.
  • Describe the clinical course of Parkinson’s disease, its classification, and differential diagnosis of parkinsonian syndromes.
  • Describe the medical management of Parkinson’s disease.
  • Determine the optimal examination procedure, given the client’s individual presentation and current best evidence.
  • Compare and contrast current best physical therapy interventions for the management of the client with Parkinson’s disease.

About the Author:
Deborah Kegelmeyer, DPT, MS, GCS,
is a certified geriatric clinical specialist with more than 20 years of clinical experience. She is currently professor of clinical Health and Rehabilitation Sciences at Ohio State University, from which she graduated summa cum laude in 1983 with a Bachelor of Science in physical therapy and in 1990 with a Master of Science in allied medicine. She went on to pursue a doctorate in physical therapy from the Massachusetts General Hospital Institute of Health Professions in 2004. In 1988 she founded the first group exercise program in Franklin County, Ohio, for individuals with Parkinson’s disease and has remained active in local Parkinson’s support and exercise groups. She served as chair of the PD EDGE taskforce for the Neurology Section of the American Physical Therapy Association, creating recommendations for universal outcome measures for use in Parkinson’s disease. Dr. Kegelmeyer studies mobility and fall prevention in the elderly and those with neurodegenerative disease and works as a consultant in the Movement Disorders Clinic at Wexner Medical Center. She has written extensively, including several journal articles related to Parkinson’s disease, including “Reliability and Validity of the Tinetti Mobility Test for Individuals with Parkinson Disease” and “Assistive Devices Alter Gait Patterns in Parkinson Disease: Advantages of the Four-Wheeled Walker.”