Managing Parkinson's Fatigue with Physiotherapy
Written by Thi Ngo - UPG Physiotherapist
In Australia, Parkinson's disease is the second most common neurological condition, with around 38 new cases diagnosed every day, according to the Shake It Up Australia Foundation. People living with Parkinson's experience a variety of symptoms, including freezing, muscle stiffness and balance problems, as well as mood disorders, urinary incontinence, anxiety, apathy and depression. While there's no cure for Parkinson's, a recent study suggests that exercise can slow down the progression of the disease and improve the quality of life for those living with it.
One of the most prevalent symptoms is extreme tiredness, feeling overwhelmed, and mental confusion, which makes it hard to start or complete tasks - this is known as fatigue. It is a feeling of deep tiredness that does not improve with rest. About half of people with PD report that fatigue is a major problem and one-third say it is their most disabling symptom. It can worsen people's physical function and increase their risk of falls. Although, exercise might not be the first thing that comes to mind when dealing with fatigue. Research has shown that people with Parkinson's who engage in exercise programs experience positive changes in balance, walking speed, and ability to complete their activities of daily living.
Physiotherapy plays a vital role in addressing fatigue in Parkinson's disease. Physiotherapists create tailored exercise and rehabilitation plans to improve functional ability, endurance and overall quality of life. They also teach self-management skills, including symptom monitoring and providing education on coping techniques. By focusing on these strategies and exercises, physiotherapists empower individuals to manage their fatigue better and enhance their daily lives, offering a holistic approach that combines physical and self-management support. These exercise routines can be incorporated into a person's daily schedule, helping to build muscle memory, ensure consistency, and boost confidence. Physiotherapists closely monitor progress, gradually adjusting the duration or intensity of exercises over time, all while keeping a watchful eye on their fatigue level using clinical measurements and subjective and objective outcome measures.
In summary, physiotherapy plays a critical role in managing Parkinson's fatigue by addressing both the physical and mental aspects of this symptom. Through a combination of exercises, balance training, energy conservation techniques, and personalised care, physiotherapy empowers people living with Parkinson's and their families to better cope with this condition, improve their overall quality of life, and maintain their independence for as long as possible.
Don't hesitate to discuss your fatigue concerns with your physiotherapist. This step is key to effective rehabilitation and injury prevention for people living with Parkinson's disease
REFERENCES
Choi, H., Cho, K.-H., Jin, C., Lee, J., Kim, T.-H., Jung, W.-S., Moon, S.-K., Ko, C.-N., Cho, S.-Y., Jeon, C.-Y., Choi, T. Y., Lee, M. S., Lee, S.-H., Chung, E. K., & Kwon, S. (2020). Exercise Therapies for Parkinson’s Disease: A Systematic Review and Meta-Analysis. Parkinson’s Disease, 2020, 1–22. https://doi.org/10.1155/2020/2565320
Elbers, R. G., Verhoef, J., van Wegen, E. E., Berendse, H. W., & Kwakkel, G. (2015). Interventions for fatigue in Parkinson’s disease. Cochrane Database of Systematic Reviews, 2015(10). https://doi.org/10.1002/14651858.CD010925.pub2
George, D. D., Baer, N. K., Berliner, J. M., Jones, J., & Kluger, B. M. (2021). What Fatigue Means to Persons Living with Parkinson’s Disease? A Qualitative Study. Movement Disorders Clinical Practice, 8(6), 919–924. https://doi.org/10.1002/mdc3.13270
Hirsch, L., Jette, N., Frolkis, A., Steeves, T., & Pringsheim, T. (2016). The Incidence of Parkinson’s Disease: A Systematic Review and Meta-Analysis | Neuroepidemiology | Karger Publishers. Neuroepidemiology, 46(4), 292–300. https://doi.org/10.1159/000445751
Kwon, K.-Y., Park, S., Lee, E. J., Lee, M., & Ju, H. (2021). Association of fall risk factors and non-motor symptoms in patients with early Parkinson’s disease. Scientific Reports, 11(1), 5171. https://doi.org/10.1038/s41598-021-84720-w
Lin, I., Edison, B., Mantri, S., Albert, S., Daeschler, M., Kopil, C., Marras, C., & Chahine, L. M. (2021). Triggers and alleviating factors for fatigue in Parkinson’s disease. PLOS ONE, 16(2), e0245285. https://doi.org/10.1371/journal.pone.0245285
Parkinson’s Australia. (2022). PARKINSON’S SYMPTOMS | Parkinson’s Australia. Parkinsons Australia. https://www.parkinsons.org.au/parkinsons-symptoms
Pigott, J. S., Kane, E. J., Ambler, G., Walters, K., & Schrag, A. (2022). Systematic review and meta-analysis of clinical effectiveness of self-management interventions in Parkinson’s disease. BMC Geriatrics, 22(1), 45. https://doi.org/10.1186/s12877-021-02656-2
RACGP. (2023). Graded exercise therapy: Chronic fatigue syndrome. RACGP. https://www.racgp.org.au/clinical-resources/clinical-guidelines/handi/handi-interventions/exercise/graded-exercise-therapy-chronic-fatigue-syndrome
Sayyaed, A., Saraswat, N., Vyawahare, N., & Kulkarni, A. (2023). A detailed review of pathophysiology, epidemiology, cellular and molecular pathways involved in the development and prognosis of Parkinson’s disease with insights into screening models. Bulletin of the National Research Centre, 47(1), 70. https://doi.org/10.1186/s42269-023-01047-4
Shake It Up Australia Foundation. (2023). About Parkinson’s. Shake It Up Australia Foundation. https://shakeitup.org.au/understanding-parkinsons/
Image by <a href="https://www.freepik.com/free-photo/old-woman-feeling-well-home_16137259.htm#query=FATIGUE%20OLDER&position=15&from_view=search&track=ais">Freepik</a>