Parkinson's Disease - Alliance Rehabilitation

Allied health services for Parkinson’s Disease for Townsville & North Queensland

At Alliance Rehabilitation, our multi-disciplinary team offers therapy for participants who are experiencing the effects of Parkinson’s Disease. While there is no cure for Parkinson’s, identifying symptoms and implementing an action plan, most people can remain active and retain a good quality of life. Treatments can vary and our team at Alliance Rehabilitation plan a treatment specifically around an individual and their needs and goals. There is always room to make changes to address progression as needed

What is Parkinson’s Disease?

Parkinson’s Disease (PD) is a progressive neurological condition that can affect anyone. It is the second most common neurological condition, after dementia, with 38 people being diagnosed every day in Australia.

Parkinson’s is complex and impacts people in different ways; symptoms appear when the brain cannot make enough dopamine to control movement properly. Dopamine is a chemical which is responsible for motor control and reward motivated behaviour. The lack of dopamine causes loss of coordination, reduced movement, and heightens feelings of anger. PD is a lifelong, progressive disease, which means symptoms worsen over time.

The brain struggles to link actions into automated behaviour and requires more mental energy to put movements together. People with Parkinson’s Disease perceive movements to be normal when it is actually small and slow. These changes are occurring over time, so the brain does not see it as a problem. This causes changes such as walking with small steps, having stiff joints, writing with small handwriting, reducing facial expressions, and speaking softer. It is possible for people with Parkinson’s to change movement patterns and make new ones by activating muscles and retraining the brain.

What causes Parkinson’s?

The causes of Parkinson’s Disease are unknown but there are theories of contributing factors such as genetics or environmental factors being a cause. Keep up to date with all the latest information from Parkinson’s Australia.

Young Onset Parkinson’s Disease (YOPD)

This occurs when someone is diagnosed at age 50 or younger, 20 per cent of Australians living with Parkinson’s are under the age of 50. The average age of diagnosis is 60. Similar to PD, symptoms and rate of progression varies from person to person. YOPD is diagnosed the same as PD but it is suggested that three symptoms are more common for people with young onset Parkinson’s. These are:

Slower disease progression – it may originally present as a stiff arm or shoulder before progressing.
Increased rate of dyskinesia – an involuntary movement that can affect one area or the entire body.
Increased rate of dystonia – painful and prolonged muscles contractions.

Motor Symptoms
Non-motor Symptoms

Motor Symptoms

Motor (movement) symptoms of Parkinson’s Disease can include:

Tremor (initially asymmetric)
Dyskinesia – involuntary movement that can affect one area or the entire body
Bradykinesia – slow movements
Joint and muscle rigidity
Slow movement
Freezing and/or festination
Hypomimia – facial masking – uneven smile & lack of facial expression
Micrographia – small writing
Lack of arm swing
Smaller steps
Hypophonia – Soft voice
Dystonia – painful, prolonged muscle contractions
Dysarthria (speech difficulty) & dysphagia (trouble swallowing and eating food and drink)
Cardiopulmonary functioning
Sialorrhea/ Hypersalivation – drooling or excessive saliva

If you are experiencing symptoms, please consult your GP before engaging in therapy.

Non-motor Symptoms

Non-motor symptoms of Parkinson’s Disease can include:

Reduced to no sense of smell
Sleep issues – secondary insomnia, thrashing, vivid dreams
Depression and anxiety
Psychosis
Fatigue
Constipation and weight loss
Light headedness
Urinary frequency and urgency
Excessive sweating
Increased risk of melanoma
Obsessive control
Dry mouth
Reduced libido
Bradyphrenia – slow thoughts
Reduced eye blinking
Cognitive impairment – memory difficulties, multitasking

If you are experiencing symptoms, please consult your GP before engaging in therapy.

LSVT Big and Loud

Our programs for people with Parkinson’s disease (PD) are based on the principle that the brain can learn and change (neuroplasticity). The aim of the intensive programs offered through our service is to improve people’s ability to make bigger movements and bigger sounds. Our specialist interdisciplinary team can then help you generalise these skills for different functional activities and situations in your daily life.

Our LSVT Big program runs four days a week for four weeks and trains the brain in the opposite thinking to how PD perceives movement. It trains the brain to move big with lots of energy. The program is split between Occupational Therapy and Exercise Physiology with two sessions for each a week. The program is intensive and requires a lot of energy. It helps the brain to understand when you move big, this is a normal way of moving and when you move big you can walk faster and will not have as many falls.

LSVT Loud is run by our Speech Pathologists and works on voice training for four days a week for four weeks. It helps train the brain to change its pathways and think when you speak loudly, this is a normal way of speaking. We are confident with exercise and speech training you will experience a positive change and improvement.

Building a Care Team:

Speech Pathology

Speech pathologists’ study, diagnose, and treat communication disorders including difficulties with speaking, listening, understanding language, reading, writing, social skills, fluency, and voice.

They work with people who experience dysphagia (difficulties moving food around the mouth and swallowing) and aphasia (difficulty talking, reading, writing, or understanding people). Dysphagia is most common in people with Parkinson’s Disease. It can present as coughing when eating or drinking, difficulty swallowing medication, sensation that food is stuck, poor control of saliva, difficulty breathing or discomfort during meals, and slow, effortful eating and drinking.

A speech pathologist will assess you, identify any deficits, and work to develop a rehabilitation plan to meet your goals. This can include exercises, strategies, techniques to improve your swallow, and rehab to strengthen muscle groups. Other activities include functional phrase and speech practice – identifying a list of key phrases to get across what you want to say consistently and clearly. Drill based activities are also used to target areas of impairment and articulation problems as well as difficulties with finding the right word.

Tremors can affect handwriting and speech pathology can help address this issue with exercises. Our speech pathologists can provide you and your family/ care team with education and necessary tools for how to overcome or how to facilitate reduced word finding problems. They can also assess if you are safe with your diet and fluids or if you may be at risk of aspiration. Read More >

Dietetics and Nutrition

Unplanned weight loss can be a problem with Parkinson’s Disease due to the symptoms associated with it. Losing a sense of smell can affect the taste of food, slowness of movement can make eating more difficult, and dysphagia can leave someone at risk of aspiration (choking). Fatigue, nausea, and tremor can also impact meals times.

Dietitians ensure proper hydration and nutrition requirements are met by providing individualised dietary advice. Dietitians help you get the correct nutrients and recommend supplements or foods with a different consistency. Your diet is vital to staying healthy and is important when living with Parkinson’s. Read More >

Occupational Therapy

Occupational Therapists are a large part of Alliance Rehabilitations Parkinson’s Disease management team. They optimise function and independence for daily activities. Occupational therapy involves re-learning everyday activities and your therapist can help with day to day tasks, return to work, social interaction, or leisure activities.

Your OT can help develop your skills and confidence with managing these activities. They may also suggest equipment which can help your recovery. Our occupational therapists work with you to identify specific goals based on your symptoms and the progression of your PD to ensure they work to your strengths and help you achieve those goals.

An OT can: assess your difficulties and help you and your family understand them better, adapt activities for you to improve your abilities and independence, teach you strategies and techniques to overcome any difficulties, provide aids and equipment, perform a home assessment, and advise on your return to work. An OT can assist with seating recommendations and aids and equipment to help with mealtime. They can also address any hand coordination issues and work to ensure this does not limit you in your day to day life. PD should not get in the way of activities you love, and an OT can help you find ways to minimise your symptoms so you can continue doing it. Read More >

Driving with Parkinson’s

We provide driving assessments for participants hoping to return to driving following a Parkinson’s Disease diagnosis. Driving is considered a very freeing form of independence and removing it can cause depression, employment challenges, and reduced social connectedness. Parkinson’s Disease can raise concerns with driving as your medication can cause drowsiness, as well as, symptoms affecting reaction time, ability to handle multiple tasks at once, and arm or leg shake.

Alliance Rehabilitation provides off road and on road assessments and we have state of the art Tyromotion equipment and a driving simulator to help assess if driving is still a possibility. Read More >

Physiotherapy and Exercise Physiology

The most important tool in Parkinson’s Disease management is exercise. Exercise prescription can preserve your independence and delay disability. We can provide strategies to overcome difficulties with execution of tasks, and awareness of the progression of the disease.

Intensive programs for Parkinson’s Disease run by our physiotherapists & exercise physiologists assist with: Balance, Strength, Walking, Coordination, Stiffness, Freezing & Gait.

Alliance Rehabilitation offers group practice which can help with PD. We offer low to high functional groups for strength and fitness such as upper limb groups, hydrotherapy, and supervised practice.

Once a client is familiar with the exercises, they are encouraged to participate in the small groups which are run by an allied health assistant (AHA). This encourages independent practice and allows for increased intensity of practice. We encourage family members and support workers to assist in these small groups too if required. This allows for carryover of exercises into the home environment.

Hydrotherapy is an excellent option for PD as it is an aquatic based therapy. In everyday life we have a lot of gravity weighing us down and you may find it difficult to lift your arms or not have enough muscle strength to do it against gravity, but in the pool, because you’re so supported, you can move, and reach, and turn. It gives you a greater exercise capacity than if you were to participate in land-based therapy. Being in the pool is also a different experience as there is no risk of falls and the warm water alleviates pain. Read More>

Psychology

Psychologists are part of the Parkinson’s Disease multidisciplinary care team and help to work through any grief or depression which may come with a diagnosis of PD. The chemical changes in the brain from Parkinson’s can cause anxiety and depression. Our psychologists work with you to manage and treat any symptoms you may be experiencing. Adapting to the disease can be difficult and may include many adjustments to your life. A psychologist can give you tools with how to cope with overwhelming or difficult feelings and can provide help for your family. Our psychologists use a variety of techniques but will always work to find the best approach for you. Read More >

Social Work

Social workers can provide support, counselling, and information to people living with Parkinson’s Disease. Our social worker can help you navigate the health care system and provide community resources. They can also assist you with applications and advocacy during your rehabilitation. Read More >

How is Alliance Rehabilitation different?

We are a community rehabilitation facility and work across multiple disciplines to provide a comprehensive service. Our community approach allows us to tailor a program to each individual and ensure we are meeting your goals. Our clinicians work together to aid in your rehabilitation, and this gives everyone a clear picture of who you are as a person, so we can focus on helping to ease your symptoms of Parkinson’s Disease. Our LSVT Big and Loud Programs are designed specifically to help with PD, and we aim to help you reach your goals and see an improvement. No matter what your circumstances were like before your diagnosis, we want to assure you Alliance Rehabilitation is working to ensure you succeed and regain the quality of life you deserve.

Referral Options

There are multiple ways to book in to see our team – the referral streams best suited for Parkinson’s Disease are:

National Disability Insurance Scheme (NDIS)

Alliance Rehabilitation is a registered NDIS provider and we aim to provide all Australians under the age of 65, who have a permanent and significant disability, with the reasonable and necessary support they need to enjoy an ordinary life and achieve their goals. We have a dedicated coordination team to help you in your rehabilitation journey. NDIS sessions typically run for one hour and are funded under your plan. Read More >

Veteran’s Health Services (DVA)

Our team can provide services to Department of Veteran’s Affairs veterans or entitled persons with a valid GP referral. The valid form is a D904 and allows you to see a clinician for a cycle of visits. Each visit is funded by the DVA – certain services require assessment for suitability and funding such as hydrotherapy and group sessions. A DVA session is typically 30 minutes but can differ depending on the reason for referral. Read More >

Private and Corporate

We accept all private and corporate referrals. We have an online referral form you can fill out for us to contact you or you can call and book. We also accept referrals through Medical Healthcare Plan, CTP and other insurers, private health funds, and community organisations such as My Aged Care. Initial sessions are one hour and following sessions are scheduled at the clinician’s request. Read More >

Outreach

We also travel to different locations in North Queensland, so location is never a barrier to your health and recovery. Our main office is in Townsville with outreach locations available in Ayr, Charters Towers, Richmond, Hughenden, Ingham, Palm Island, and Magnetic Island.