Parkinsonism or parkinsonian syndrome group is of disorders which manifests as tremor, disturbances in voluntary movement (rigidity, bradykinesia or akinesia) and impairement in the balance and automatic reactions.
This syndrome do occur in various conditions, of which Parkinson's disease is quite common.
Parkinson's disease was observed by james Parkinson in the year 1817. It took about 100 years to be well verse with the pathology of this disease condition and the treatment was partially achieved by the introduction of Levo-dopa in the year 1960.
A. Idiopathic: The etiology is not understood. Example of this type of parkinson's diease, where there is degeneration of neurons in the substantia nigra and corpus striatum. It occurs usually in late adult life, progress slowly, and kills the patient by 10-15 years after the onset.
B. Vascular: Multi-infarct disease(arthreosclerotic parkinsonism).
C. Infection: Infection by various viruses, most commonly influenza virus may be causing parkinsonism like features. It is termed as encephalitis lethargica that causes focal insult to the brain matter.
D. Due to toxicity: Certain toxic chemicals like manganese, carbon disulfide, carbon monoxide, cyanide exposed in various occupation can cause diffuse damage to the brain exhibiting parkinsonian syndromes.
E. Various drugs: Phenothiazines, butyrophenones, tetrabenazine can cause Parkinsonism.
F. Multiple system degeneration that occurs in condition like Alzheimer disease shy-Drager syndrome, supranuclear opthalmoplegia, Wilson's disease, etc. can cause parkinsonism.
H. Traumatic: Multiple brain damage commonly encountered in boxers usually causes parkinsonism. This types of parkinsonism. This types of parkinsonism are called as punch boxers syndrome.
REDUCTION OF RIGIDITY IN PARKINSONISM
Rigidity has been found to reduce, to some extent, by generalized relaxation technique. Generalized relaxation can be obtained by vestibular stimulation that can be achieved by various rocking techniques. Rocking can be achieved by the use of adult vestibular ball, rocking or rotating chair, and cradle. Rhythmic initiation, which is a technique of PNF, can be used to reduce rigidity. This technique, which involves progression of exercise from passive to active assisted to active without any increase in tone, has been found to be very effective in reducing rigidity of the trunk.
Generalized relaxation techniques like Jacobson’s technique of progressive relaxation, yogasana, transdental meditation, biofeedback, savasana, etc. can also be used.