Parkinson’s Disease

What is Parkinson's Disease?

Parkinson's disease is a progressive disorder of the central nervous system affecting more than 1.5 million people in the United States. Clinically, the disease is characterized by a decrease in spontaneous movements, gait difficulty, postural instability, rigidity and tremor. Parkinson's disease is caused by the degeneration of the pigmented neurons in the substantia nigra of the brain, resulting in decreased dopamine availability. The major symptoms of the disease were originally described in 1817 by an English physician, Dr. James Parkinson, who called it "Shaking Palsy." Only in the 1960's, however, pathological and biochemical changes in the brain of patients were identified, opening the way to the first effective medication for the disease.


Men and women alike are affected. The frequency of the disease is considerably higher in the over-60 age group, even though there is an alarming increase of patients of younger age. In consideration of the increased life expectancy in this country and worldwide, an increasing number of people will be victims of Parkinson's disease.


Administration of the drug levodopa has been the standard treatment for Parkinson's disease. Once it reaches the brain, levodopa is converted to dopamine which replaces the same substance not present in sufficient amounts in Parkinson's patients. Treatment with levodopa does not, however, prevent the progressive changes of the brain typical of Parkinson's disease. The drug may also produce side effects in some people, due to its change to dopamine before reaching the brain. The simultaneous administration with levodopa of substances inhibiting this change allows a higher concentration of levodopa to reach the brain and also considerably decreases the side effects. Some new drugs have recently been approved offering a wider choice of medications for the patient, while others are under investigation in this country and overseas in an effort to obtain better therapeutic results with fewer side effects. Highlands has collaborated with our medical director of neurology, Dr. Luis Acosta, to host patient education seminars regarding the use of apomorphine, the new drug for "freezing episodes."

The importance of activity

Physical activity improves general health and emotional well-being. The disabling movement symptoms of PD, however, often cause a person to reduce physical activity. This can decrease strength and stamina, and make muscles more rigid. An exercise program is an important component in the overall treatment of PD. Exercise and physical therapy can put muscles through their full range of motion and promote strengthening of critical muscle groups. This can help maintain mobility and balance. Specific exercises can be performed to strengthen the muscles of speech and swallowing. These exercises are tailored to the patient's needs by a speech-language pathologist.

Rehabilitation at Highlands

Treatment plans are developed on an individual basis and are very specific to each individual's needs. Therapists teach patients and their caregivers exercises to increase mobility and techniques to deal with specific trouble areas such as freezing episodes, getting in and out of bed and getting up from a sitting position, and performing self care tasks. Rehabilitation can help people who are in various stages of Parkinson's -- from the recently diagnosed to those who have had Parkinson's for many years.

What will I do in rehabilitation?

Rehabilitation therapy enhances the lives of people with Parkinson's disease. A program of physical therapy and occupational therapy can help people learn movement strategies:

  • How to roll over and get out of bed more easily
  • How to rise from a chair or get out of a car
  • Therapists sometimes suggest simple devices to assist with daily activities, such as:
  • Shower grab bars
  • Shower stools
  • Elevated toilet seats

Occupational therapists and physical therapists have experience finding ways to help people button shirts, cook and generally keep their lives going. They know about special kinds of utensils that help keep food on a spoon or a fork. Even people with serious tremor, slowness or rigidity can use these utensils to feed themselves without making a mess. In addition to allowing people to enjoy their meals, this kind of therapy helps people maintain their independence and self-respect. Speech therapy can also be valuable in improving certain voice problems.

What is a rehabilitation program?

Under your doctor's direction, rehabilitation specialists at Highlands come together to provide a treatment program specifically suited to your needs. Physicians who specialize in rehabilitation are called physiatrists. The number of services you receive will depend on your needs. Services may include:

  • rehabilitation nursing
  • physical therapy
  • occupational therapy
  • speech-language pathology
  • recreational therapy
  • nutritional care
  • social work
  • psychiatry/psychology
  • chaplaincy
  • patient/family education
  • support groups

How can I learn more about Highlands?

Talk to your doctor, nurse or healthcare professional. You or your family members are welcome to come to Highlands for a tour. The best way to learn about the rehabilitation programs that we have to offer is to visit and see for yourself. No appointment is necessary.

If you are living with Parkinson's disease, therapy can help increase your endurance, strength, general fitness and energy level and also elevate your mood and decrease your anxiety. Contact us for more information.

Getting You Back to Better

We create a seamless continuum for patients and physicians to ensure that you get the best care possible.