parkinson’s disease

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what is parkinson’s disease?

Content is medically reviewed by:

Shruti Bangera, Masters In Neurological Physiotherapy, Senior Physiotherapist & SME, Portea

Parkinson’s disease is basically a neurodegenerative disorder that affects the dopaminergic neurons in the substantia nigra area of the brain, which is essentially responsible for dopamine production. Dopamine is the chemical that is responsible for carrying messages around the brain. For example – when you feel the need to itch, it is dopamine that carries the message to the nerve cells that controls the muscles you need, to itch yourself.

what are the symptoms of parkinson’s disease

The Parkinson’s disease symptoms are gradual and often get unnoticed. And as such it is essential to keep a careful watch for its symptoms that include;

Chief symptoms

  • Tremors
  • Limb stiffness
  • Slowness
  • Improper gait and balance

Secondary Symptoms

  • Anxiety
  • Depression
  • Dementia
  • Cognitive Impairment
  • Sleep behavior disorder
  • Loss of sense of smell

causes for parkinson’s disease

There is no clarity regarding the cause of Parkinson’s disease. However, a lot of speculation is made regarding the genetic, hereditary and environmental factors involved with this disease. Some genes have been found to be linked to the disease. Although hereditary causes of the disease is quite rare, but 15% of Parkinson’s patients have been found to have a family history of it.

what are stages of parkinson’s disease

There are 5 stages of Parkinson’s disease that is supported by the Parkinson’s Foundation; they are as follows;

  1. The first stage of Parkinson’s disease is characterized by mild symptoms that do not affect the person’s quality of life and daily activities are not much affected.
  2. In the second stage of the disease, the symptoms worsen, making day to day activities more difficult and takes longer time to complete a simple task.
  3. Stage 3 also referred to as mid stage. It is around this stage that Parkinson’s starts getting severe and causes difficulties in the performance of daily activities like dressing, eating, brushing etc. Individuals also tend to lose balance and are more to falling and hurting themselves.
  4. At stage 4, Parkinson’s disease gets very severe and the patient requires assistance in their daily activities and also walking
  5. Stage 5 is the advanced stage of Parkinson’s disease rendering a person completely helpless. Such person’s require complete monitoring and assistance with living.

diagnosis for parkinson’s disease

A well trained neurologist is best equipped to make diagnosis. There are no specific tests available that can diagnose Parkinson’s disease. However, doctors do order blood tests and a range of imaging tests like MRI, ultrasound of the brain, SPECT, PET scans to rule out any other disorders with similar symptoms.

average age of parkinson’s patients

Parkinson’s usually affects people over 60 years of age, but there have been found exceptions to this and some people have been diagnosed at the age of 40 and even younger.

what is parkinsonism?

Parkinsonism is a blanket term given to a range of movement disorders that exhibit symptoms similar to the Parkinson’s disease. A majority of people suffering from a form of Parkinsonism have idiopathic Parkinson’s. Parkinson’s disease or Idiopathic Parkinson’s is the most common form of Parkinsonism. Idiopathic essentially means that the cause is not known for the disease.

types of parkinson’s disease and parkinsonism

The different types of Parkinson’s disease and Parkinsonism are

  1. Corticobasal Degeneration
  2. Dementia with Lewy bodies
  3. Drug induced parkinsonism
  4. Essential tremor
  5. Multiple System Atrophy
  6. Progressive Supranuclear Palsy
  7. Vascular (Arteriosclerotic) parkinsonism

parkinson’s disease treatment

There is currently no cure for Parkinson’s disease presently. However, medication, physiotherapy and in a few cases surgery might prove beneficial.

Medication: Though medications don’t cure the patient of Parkinson’s, it provides a lot of control on the symptoms of the disease, which brings much relief to the patients.

Physiotherapy for Parkinson’s disease: Physiotherapy for Parkinson’s disease forms a very important component in Parkinson’s treatmentThe main idea behind offering physiotherapy to Parkinson’s patients is to address the issues of mobility, flexibility, posture and balance.

Physiotherapy offers great help in the maintenance of patient’s mobility and balance, thereby offering functional independence to them. Physiotherapy exercises also help to mobilize stiff joints and provide flexibility to tight muscles.

Apart from that Physiotherapy also retrains the patients to perform daily activities in a safer manner. In fact Parkinson’s disease treatment guidelines highly advise the inclusion of physiotherapy in the treatment of Parkinson’s

Surgery: Surgery is not readily advised inParkinson’s treatmentonly in a few selected cases is surgery advised. Typically, when the patient has reached advanced stage of the disease and has unmanageable motor symptoms is surgery advised.

Surgery for Parkinson’s is of three types namely;

  1. Pallidotomy – Pallidotomy surgery destroys the globus pallidus, which is a part of the brain that is believed to make the patient very rigid in movement. After Pallidtomy surgery, the patient tends to become less rigid and feels ease in symptoms like tremors and balance instability.
  2. Thalomotomy – Thalomotomy surgery brings relief from tremors. In this surgery a part of the thalamus (part of the brain) is destroyed, as it is believed to be the cause behind tremors.
  3. Deep Brain Stimulation – This is the final form of all Parkinson’s treatment. Deep brain stimulation is provided when no other therapy and medications are found to work. In this surgery, doctors implant electrodes in selected areas of the brain, to control the impulses that cause Parkinson’s. Another device is inserted in your chest to control the impulses emitted from the electrodes and a wire runs under your skin, connecting the device to the ‘lead’ in the brain.

Researchers have been experimenting with stem cell therapy, where dopamine producing cells are extracted from stem cells. However, this therapy is still at a nascent stage and more research is needed for it to become of some value.

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Myths about Parkinson’s:

A lot of myths and misconceptions are attached with Parkinson’s disease. Here are a few myths debunked about the disease;

  • Parkinson’s is a movement related disease – Parkinson’s disease involve both motor and non motor symptoms like, tremors, impaired balance, depression, REM sleep behavior disorder, etc.
  • Tremors are the chief indicator of Parkinson’s – Tremors although are one of the many symptoms of Parkinson’s, each person affected with Parkinson’s display unique variations of the symptoms. And tremors can also be seen in cases of stroke, multiple sclerosis and brain trauma injury.
  • Parkinson’s disease is curable – Parkinson’s has no cure up till now. However, medications and physiotherapy help in managing and controlling the symptoms.
  • Only older people are diagnosed with Parkinson’s – This is not entirely true, although a large number of patients with Parkinson’s are over the age of 60, in many case early onset  and teen onset has even be detected.

how can we help on parkinson’s treatment?

People affected with Parkinson’s require physiotherapy for maintaining and strengthening physical capability and quality of movement in everyday life. During the initial sessions, our well – trained physiotherapist mainly focuses on providing education and self-management to the patient. Physiotherapy exercises helps to offset the consequences of Parkinson’s and minimize deterioration in strength, endurance, flexibility and balance. Towards the later sessions, the physiotherapist will focus on improving gait, balance, manual activities and reduce fall risk.

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