Benefits of Neck Bracing: Parkinson’s Disease
What is Parkinson’s disease?
Parkinson’s disease is a progressively degenerative disorder of the nervous system, resulting in motor and gait disturbances, and in more advanced cases, cognitive and behavioral problems. The symptoms of Parkinson’s disease result from the abnormal accumulations of protein (Lewy bodies) in the dopamine-producing cells of the substantia nigra, which is a segment of the midbrain.
Parkinson’s disease primarily manifests as a movement disorder with four cardinal symptoms: tremor, rigidity, bradykinesia, and postural instability.
- Tremor is the most identifiable and most common symptom of the disease. This is typically observed at rest, but disappears with voluntary movement or during sleep.
- Rigidity is defined as the increased stiffness and resistance to movement. This is cause by the increased muscle tone, and can either present as cogwheel or uniform rigidity. This symptom is typically accompanied by pain, and affects the muscles asymmetrically.
- Bradykinesia is the slowness of movement seen in patients with Parkinson’s disease. There is difficulty along the entire movement course, and this symptom can be disabling for patients.
- Postural instability can be seen in patients during the later stages of the disease. This can cause gait imbalances, or worse, falls and accidents during ambulation.
What is the treatment for Parkinson’s disease?
There is no cure for Parkinson’s disease, and there are no medications that have been shown to reverse the damage from the disease. However, current therapies attempt to address the symptoms, particularly the motor abnormalities.
Medications such as levodopa and dopamine agonists are used in addressing the dopamine deficiencies brought about by the disease. Monoamine oxidase B (MAO-B) inhibitors such as seligiline and rasagiline have been shown to be useful, although associated with more adverse effects that levodopa. Other drugs such as amantadine and anticholinergics have also been shown to improve the motor symptoms of patients, although further evaluation and study is still needed before they can be recommended as therapies.
Rehabilitation is a key component of the treatment for Parkinson’s disease. Some studies have shown that speech and movement problems can be improved with physical therapy and rehabilitation programs. Physiotherapy, strength and conditioning exercises can be helpful in addressing the symptoms of muscle stiffness and pain.
Occupational therapists can also help the patient with their activities of daily living, thereby improving their independence and quality of life. Strengthening exercises have been shown to be of use for patients who are showing signs of muscle weakness and atrophy. Numerous alternative and complementary therapies have also been explored, although evidence is still scarce as to their effectiveness.
How is neck bracing useful for Parkinson’s disease?
Neck bracing is useful when the disease starts to affect the ability of the patient to control his head and neck, which may be seen in the later stages of the disease. Keeping the patient’s neck in a brace ensures that the patient maintains a patent airway, reducing the risk of death from aspiration pneumonia, which is twice as common in Parkinson’s disease patients compared to the general population.
Applying a neck brace can also be useful in treating injuries secondary to falls form postural instability. Keeping the neck in a stable and braced position secures the neck from further instability and the risk of the aggravation of injury and/or reinjury. Neck bracing can also be integrated into the physical therapy and rehabilitation programs, allowing the neck to maintain stability during the therapy sessions. The pros and cons of placing a neck brace will vary for each case, and should be discussed with a licensed physician prior to any decision being made.
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Bonnet AM, Jutras MF, Czernecki V, Corvol JC, Vidailhet M. Nonmotor Symptoms in Parkinson’s Disease in 2012: Relevant Clinical Aspects. Parkinson’s Disease. 2012.
Ferrari CC, Tarelli R. Parkinson’s Disease and Systemic Inflammation. Parkinson’s Disease. 2011. http://dx.doi.org/10.4061/2011/436813