Case Study 4
Parkinson’s Disease
History
65yr old male, Parkinson’s diagnosed 2016. On medication: cocareldopa x3 daily, rasagiline x1 daily. Keen walker, previously was attending PD Power class but had stopped. Complaining on persistent right shoulder pain on reaching arm into a coat or back pocket. Pain levels around 6/10.
Problem List
R shoulder pain on outer 1/3 elevation
Poor scapular stability limiting effecting return to neutral from all positions
R shoulder reduced ROM outer 1/3 medial rot
R shoulder reduced ROM inner range med rot
R mild foot dystonia
Goals identified
Return to PD class attendance: achieved
Pain free hand behind back to L4/5: achieved
Pain free hand behind back to T10 with scapular stability: achieved
Number of treatment sessions = 8
Dates of treatment 10/9/19- 18/12/19. Length of treatment reflects time required to effectively strengthen scapular stability and coordinate with necessary increase in range of movement at the shoulder complex.
Outcome measures
- PDQ 8 assessment = 5, discharge = 10. This measure was not reflective of the patient’s problem, more an assessment of his PD symptoms, consider using a different one in future.
- Range of movement hand behind back: Assessment = L4/5 with pain 6/10 at discharge pain free able to reach T10.
