SPECIFICS OF APPLYING PHYSICAL THERAPY TO TREATMENT OF PARKINSON DISEASE

Parkinson's disease was discovered and described more than 250 years ago by J. Parkinson. It is the most common chronic disease affecting mostly elderly people (over 60 years of age) and in most cases men. Initially, James Parkinson described the disease as shaking palsy, due to the main symptom of the condition. Risk factors for Parkinson's disease include: age, genetics, gender and exposure to toxins. At the heart of the disease lies the progressive destruction of neurons that produces the neurotransmitter dopamine in the black substance. With the course of time, this leads to insufficient production of dopamine, and when its amount is reduced to 70% - motor and non-motor manifestations of the disease are observed. Parkinson's disease can be recognized by the following symptoms: muscle rigidity, tremor, slowness of movement, hypokinesia, postural disorders, autonomic, cognitive and psychological disorders, problems with speech and swallowing. The quality of movements in patients depends on their environment, care provided at home and medical treatment prescribed. Hoehn and Yahr described five stages of the dis-ease; three types of progression mark the transition from one stage to another. This scale, introduced in 1967, is known as Unified Parkinson's Disease Rating Scale. The 3 types of progression are differentiated depending on the stage of Parkinson's disease - a fast progression, a mild progression and a slow one. Nearly every author admits usefulness of applying different rehabilitation measures and drug treatments to combat minor symptom complexes, which appear due to forced akinetic lifestyle, muscle contractures, various deforming arthritis or pain syndromes. Regular rehabilitation can slow down the pro-gression of symptoms. The purpose of physical therapy is to prevent or reduce the rate of symptoms progression and to promote adaptation of patients to existing motor disorders. The task of physical therapists is to find the optimal strategy to train performing those movements that are difficult, to encourage the independence of peo-ple. Individual program for each patient should be devel-oped to address the existing problems of a specific per-son. Each session should be focused on training those muscle groups and movements that will help overcome the existing movement disorders caused by the disease. The body massage has a positive effect; it also promotes normalization of CNS functions, and restores muscular mobility. The therapists apply combined methods of manual classical massage and trigger point massage. The preferred types of massage technique are long gliding strokes, kneading, and rhythmical strokes to an area being worked on in order to stimulate nerves, muscles, and circulation. The purpose of occupational therapy is to ensure the independence of the patients in daily activities from outside help, to equip their environment with comfortable and safe things, where everything is in close proximity. Due to biological reaction, the patients develop the ability to control the position of center of gravity, which helps them to move without loss of balance. It is advisable to introduce physiotherapy into treatment: hydrotherapy (fresh, sodium chloride, iodine-bromine, sulfur baths, oxygen hydrotherapy) and electroconvulsive therapy.