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理学療法

Physical therapy aids in balance issues, shuffling gait and Parkinsonian features prominent in people with LBD.  PT helps facilitate range of motion in lower extremities which improves movement and motor function overall, especially in the legs. Activities consist of balance, dancing, and leg strengthening exercises.

Once of the most prominent signs of Lewy Body dementia is the shuffling gait, stiffness in movement that can be physically limiting, and an increasing inability in walking and range of motion. The loss of physical mobility can often present a danger for those suffering with LBD.  Physical therapists address issues to help patients become more mobile, stronger in their core and legs, help them establish stability and balance, as well as bringing more visuo-spatial awareness . Balance exercises  (for shuffling gait to prevent falls) and fall prevention are practiced through marching, walking, flexibility exercises, dance and coordination between upper and lower body, common language and prompts for physical activities.

Aerobic and learning based exercise could be protective in aging individuals and those with neurodegenerative disease and also aids in minimizing depression. Learning based exercises can also help keep memory sharp and increased blood flow helps oxygenate the brain. Physical therapy covers all of the above in a safe manner that addresses a individuals’ needs and gives them needed attention. Exercises increase strength, flexibility and help facilitate range of motion in lower extremities and improve movement and motor function overall, especially in the legs. These exercises address balance issues, shuffling gait, rigidity and other Parkinsonian features prominent in LBD patients. Normal rhythmic symmetric movements are said to be best, and dancing to music is particularly beneficial for decreasing stiffness. Aerobic exercise increases oxygen activity and neurotransmitters to keep our heart, lungs and nervous system healthy as well as promote good posture.  Visuo-spatial challenges can also be addressed with physical therapy as more repetitive activity can help a person to gauge distance and range of motion. Besides aerobics performed with patterns, exercises that challenge the individual to change activity, rhythm or direction–known as random practice–benefit those with Parkinson’s disease. Since patients with Parkinsons’s have difficulty, what can be beneficial is shifting from one activity to another, or in performing two activities at the same time. For instance: swinging hands and marching, singing and lifting knees. Again, exercises that require balance and body adjustments are important along with tempo-based activities such as dancing, cycling, marching, and skipping which maintain repetitive and reciprocal movement. This variety of activities can and should be practiced at home to address continuity and increased strength of the patient.  Music can also be added to create a sense of fun and caregivers and care partners can participate to create a sense of bonding.

Also, exercises that promote learning, focus and attention are helpful.

(pdcenter.neurology.ucsf.edu)

Exercises:

Walking outside or in a mall

Dancing (can be combined with exercise too)

Tai Chi

ヨガ

Stepping over obstacles

Marching to music with big arm swings

Aerobics

Exercises that promote cardio pulmonary fitness:

Paced walking at different speeds and inclines

Hiking using walking sticks (modified)

Swimming with different strokes that provide good motor learning and increase heart rate

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