Parkinson’s disease patients, especially in the end stages of the disease, often have a significant amount of muscle atrophy. This muscle wasting or loss of muscle tissue could be due to reduced physical activity because of the symptoms of Parkinson’s disease or if bedridden. Added to the reduced or lack of physical activity, an additional factor to take into account is that Parkinson’s disease is in most cases a disease of old age, a period of life where some amount of normal muscle wasting is to be expected.
Physiotherapy and a home exercise program for Parkinson’s patients do help to prevent this muscle atrophy to a certain extent. Apart from muscle atrophy, some amount of cerebral or brain atrophy is also to be expected in people suffering from Parkinson’s disease, which is in excess to that found in normal people, taking into account the age of the patient in both circumstances.
Signs and Symptoms of Atrophy in Parkinson’s Disease
The muscles of the body may look small and show decrease in bulk. There will be loss of tone and weakness in the muscles. There may be difficulty in standing and walking when the leg muscles are involved or generalized weakness of the body may be present. Muscle twitching or spasms, often painful, may occur especially in the legs.
Dementia and decreased cerebral function may occur as a result of cerebral atrophy, where the brain cells and tissues gradually decrease and cause the brain to shrink. There may be associated problems with speech and vision too.
Diagnosis of Atrophy in Parkinson’s Disease
Diagnosis can be made by taking the history and by examination of the patient.
CT scan or MRI can help in diagnosis, both for muscle as well cerebral atrophy.
Treatment of Atrophy in Parkinson’s Disease
Since the main cause of muscle atrophy in Parkinson’s disease is restricted movement and reduced physical activity, these issues have to be addressed aggressively for prevention as well as treatment of atrophy. Because of their symptoms of rigidity or lack of muscle co-ordination, people with Parkinson’s disease tend to avoid physical activities.
They have to be motivated to do simple aerobic exercises such as walking, cycling or swimming if their condition permits. Aquatic exercises which are performed in a warm pool help to improve muscle tone. Exercises to involve full range of movement of the body, especially the arms and legs, should be encouraged. Yoga and Tai chi exercises help to improve muscle tone and improve strength in the muscles.
For the bedridden patient or in those who cannot undertake these forms of exercise, a physiotherapist could help with other forms of passive exercises and limb movements. Many patients find benefit with massage therapy although this is not as effective as rehabilitation physiotherapy treatments.
In addition, good nutrition is very important in improving muscle bulk and reversing or preventing some amount of muscle atrophy. A reduced protein intake will speed up the loss of muscle bulk and in Parkinson’s patient with a poor diet, this will exacerbate the problem of muscle atrophy.
Adequate treatment of Parkinson’s disease itself as well as certain drug treatment may be of some help to relieve symptoms of cerebral atrophy. However stopping this form of atrophy with conservative measures is unlikely.