Movement Disorders

UNDER CONSTRUCTION 25.10.24

Original Editor - Lucinda hampton

Top Contributors - Lucinda hampton  

Introduction

Movement disorders is a subspecialty of neurology that focuses on a variety of conditions that are characterized by hypokinetic, hyperkinetic, or abnormally coordinated movements. Movement disorders, commonly encountered by physiotherapists, comprise a large group of neurologic disorders. There is no laboratory findings or other studies that are diagnostic for these conditions.

Movement disorders may refer to abnormal movements or to syndromes that cause these abnormal movements. These movements are categorised into two groups:

• Hypokinetic (slowness, stiffness of loss of movement) disorders
• Hyperkinetic disorders

Some of the more common movement disorders encountered are Parkinson disease, Dystonia, essential tremor, Huntington disease and Wilson disease.. They also include: parkinsonism, myoclonus, chorea, ballismus, ataxia, Tourette syndrome, dyskinesia, akathisia, restless limbs.

• Within the U.S. there are half a million people with dystonia, a million people with Parkinson’s disease, and more if you include Parkinsonian diseases and about 10 million patients with essential tremor.

Treatment

The care of movement disorders is highly individual. Each patient has to be evaluated in an ongoing fashion to decide the appropriate treatment regimen. It may involve eg physiotherapy, speech therapy, occupational therapy , medications, or a surgical procedure.

Advances in the treatment of movement disorders offer new strategies in symptomatic management of motor and nonmotor symptoms, with atypical neuroleptic agents reducing the incidence of tardive dyskinesia. Unfortunately, neuroprotection and effective restorative therapy for degenerative diseases remain elusive. Neuroimaging techniques still need refining so the disease progression at the cellular level can be followed.

Physiotherapy

The physiotherapist assesses the individual's needs and develops a tailored treatment plan. Their overall goals are to maintain muscle strength, preserve joint range of motion, improve posture and balance, reduce fall risk, and help the person maintain functional independence for as long as possible as their condition progresses.

A physiotherapist working with people who have movement disorders can provide several interventions with the goal of improving function and quality of life. Key areas include:

1. Stretching exercises to maintain flexibility and prevent contractures
2. Strengthening exercises to help maintain muscle function and ability to perform activities
3. Balance and coordination training
4. Posture education and exercises for sitting, standing, and lying positions
5. Gait re-education and training to improve walking ability
6. Prescription of appropriate mobility aids when needed
7. Joint mobilization techniques
8. Spasticity management
9. Functional activity practice to maximize independence
10. Education on lifestyle modifications, fatigue management, and exercise routines

Neurorehabilitation aims to reduce the impact of these movement disorders, lessen constraints on ADL, and promote more social participation. Advancements in wearable technology, eg virtual reality and noninvasive brain stimulation, give promising avenues for rehabilitation, the many sides nature of neurological disorders requires ongoing research and collaboration to improvetreatment strategies.

Viewing

The below 6 minute video discusses care and treatment for Parkinson’s disease, essential tremor and dystonia. Movement disorders deal with complex movements such as walking, playing the piano or writing.

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Healthcare Unfairness

Healthcare unfairness affects people living with movement disorders, along with their care partners, their families, and their communities. These injustices are many sided and strongly influence the quality of health care, education, and research opportunities they receive.

Persons with motor disorders experience health inequities in terms of increased mortality, morbidity, and limitations in functioning when compared to the rest of the population.

To promote fairness recommendations include adopting fair models of multidisciplinary care, palliative care, home visits and virtual health, improving the success of education strategies (for example by focusing on cultural humility and cross-cultural communication), and giving people and communities power (for example by promoting and supporting community-initiated quality improvement and research projects).