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Evaluation and Rehabilitation of Parkinson's Disease Ryoji Nakanishi 1 , Hiroaki Yamanaga 1 , Shinichi Nojiri 2 , Toru Ideta 3 1Department of Rehabilitation Medicine & Neurology, Kumamoto Kinoh Hospital 2Department of Physical Therapy, Kumamoto Kinoh Hospital 3Intractable Neural Disease Center, Kumamoto Kinoh Hospital Keyword: パーキンソン病(Parkinson's disease) , パーキンソン病統一スケール(Unified Parkinoson's Disease Rating Scale:UPDRS) , パーキンソン体操(Parkinson gymnastics) , 訪問リハビリテーション(home visit rehabilitation) , 生活の質(quality of life:QOL) pp.658-670
Published Date 2013/8/18
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Abstract : Hoehn and Yahr (H-Y) staging and the Unified Parkinson's Disease Rating Scale (UPDRS) are commonly used for clinical evaluation of Parkinson's disease (PD). Iodine-123 metaiodobenzylguanidine (MIBG) myocardial scintigraphy and single photon emission computed tomography (SPECT) are useful for the differential diagnosis of PD from other Parkinsonism. Additionally, gravicorders or gait analysis systems and upper limb voluntary movement analyzing systems may be helpful for the quantitative evaluation of parkinsonian symptoms. From the early stage of H-Y, PD patents should be informed and coached about rehabilitation programs by expert therapists. Educational and health promotional gymnastics are the main programs used in stage Ⅰand Ⅱ. Muscle stretching exercises, postural exercises, balance training and activity/ instrumental-activity training are needed in stage Ⅲ and Ⅳ. Finally, preventing changes due to disuse and lightening the caregiver load are the main purpose of rehabilitation in stage Ⅴ. It is very important to understand not only the patients' clinical stages but also their personal situations such as their life-stage and life-style and their family situation. Home visit rehabilitation is useful to discover the actual daily living problems faced by patients and their families. Then, evaluation according to the International Classification of Functioning, Disability and Health (ICF) is available to clarify and solve the problems. With the progression of the clinical stage, patients need many social resources. Therefore, medical social workers (MSW) should be a part of the rehabilitation team to support the home care of patients from their incipient stage.


Copyright © 2013, The Japanese Association of Rehabilitation Medicine. All rights reserved.

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電子版ISSN 印刷版ISSN 1881-3526 日本リハビリテーション医学会

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