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.