Osteopathic Manipulative Treatments to Improve Functionality of Parkinson’s Disease: Case Study

Background: Parkinson’s is a progressive neurodegenerative disease, second most common neurodegenerative disease. Standard of care is generally pharmacologic treatment with Levodopa, as it manages the bradykinesias, tremors and rigidity. The muscles become rigid with increased tone; symptoms can become exaggerated by pain, spasms and facial restrictions. Several methods of adjunct therapy are researched and attempted to improve the quality of life in patients with Parkinson’s disease. Applying OMT to the joints and key muscles of posture/walking, improve the severity rigidity, allowing for increase usage of muscles; resulting in improvement in QoL and ADLs. Case Information: The patient is an 80-year-old male presenting to OMM Clinic seeking to improve function with Parkinson’s disease. The patient initially presented with mild Parkinsonian symptoms- such as minimal shuffled gait, worsened balance, and restricted sits to stand. Pharmacological treatment was Carbidopa 25mg- levodopa 100mg QID. He ambulates, when pain and rigidity symptoms are worse with bilateral walking poles. The gait was described as minimal shuffle, minimal rigidity of elbows and worsened throughout presentation. OMT was performed by a board certified osteopathic physician, and was applied regularly to major joints. The patient reports after OMT, he has improved range of motion and gait. A witnessed participation that occurred between the patient and the researcher revealed that the patient walked in with rigidity and need for walking poles, but walked out with smooth gait no assistive devices. Conclusion: While Parkinson’s disease is a progressive neuromuscular disease, quality of life can continue to remain stable with adjunct therapies such as OMT and exercise. This case demonstrates that improved movement and postural stability can occur after addressing range of motion, leading to improved QoL. With rigidity, muscles can become restricted and exaggerated pain/spasms. While neurodegeneration is of central origin, the peripheral manifestations are pain and shortened muscle fibers from chronic tone with OMT to remain relaxed for greater lengths of time. OMT treatments target these muscle fibers by attempting to reset the muscle spindle reflex. With improved hamstrings, hip flexors, and decreased flexion bias of the torso, this patient was able to stand with better posture and improved fluidity.