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CLINICAL PROVIDERS

Who should be on your care team?

Neurologist

A Movement Disorder Specialist is a neurologist who has completed two years of extra training (a fellowship) in movement disorders, a subspecialty in neurology. With this level of experience, a movement disorders specialist will be more familiar with the range of available PD medications, how they work, and their possible side effects. A specialist is also more likely to discuss the role of clinical trials.
Your primary care provider will refer you to a neurologist.
Neurologists will diagnose PD and manage medication. They will adjust medications based on symptoms and tests.

Speech Therapist

Parkinson’s causes movements to become smaller and slower over time, which can impact the complex system of movements in the face, mouth, throat and chest involved in speaking and swallowing.
Parkinson’s can affect awareness and perception, making it difficult for people with PD to recognize speech, voice and swallowing changes.
Working with a speech-language pathologist is the main treatment for speech and swallowing difficulties in Parkinson’s.
Early evaluation and treatment can improve quality of life and help reduce and manage more serious speech and swallowing issues later.

Physical Therapist

Physical therapists can be helpful at all stages of PD.
Exercise and staying active play important roles in living well with Parkinson's disease (PD), from diagnosis throughout the course of disease. Physical therapy helps people with PD keep moving.
Recent research suggests that physical therapy — including gait and balance training, resistance training and regular exercise — may help improve or maintain PD symptoms.
PT's can create exercise programs with a "Just Right Challenge" - not too easy and not too difficult.

Occupational Therapist

Occupational therapists match your personal strengths with activities and an environment that will help you reach your goal.
OT's role is to identify strategies that will allow you to continue doing activities that are important to you.
Adapting activities of daily living as PD progresses.
- Bathing, grooming, toileting, cooking
Increasing participation in meaningful activities through adaptive equipment, environmental modifications, neuromuscular reeducation, and so much more.
Perform home health assessments to extend independence.

Psychologist

It can be scary to address your mental health. Sharing your experiences may feel vulnerable. Sometimes it is easier sharing thoughts and emotions to a non-family member or friend.
Psychologists and psychiatrists can provide strategies to manage depression, anxiety, hallucinations, and memory.
- Psychologists focus on therapy and counseling.
- Psychiatrists are medical doctors who are qualified to prescribe medication and administer medical treatments for mental health disorders.

Nutritionist

A balanced diet is a foundation of good health. For people with Parkinson’s disease (PD), a balanced diet is even more important.
In PD, there are some foods that may help to ease symptoms and help brain health, while others can affect the way medications work.
While there are many things about PD that cannot be changed, the informed choice of diet can help people to live better with the disease.
Nutritionists can develop customized meal plans for their clients.
They can make adjustments as PD progresses and swallowing challenges arise.

Ophthalmologist

Visual deficits associated with PD may include: dry eyes, blurriness, double vision, abnormal saccades (rapid, jerky eye movements), difficulties with perception and identifying contrasts.
Impaired vision can increase your risk of falling because you may not visually see things clearly or accurately and your depth perception may be affected.
It is strongly encouraged to be proactive and have routine eye exams with ophthalmologists to monitor eye health.
Optometrists = primary eye care.
Ophthalmologist = specialized training in diagnosing and treating eye diseases.

Dentist

People with Parkinson’s disease face specific challenges related to oral health, but with proper care, many of these challenges can be managed.
It is important for patients, caregivers, and dental professionals to work together to ensure that oral health is prioritized, and that both preventive and therapeutic strategies are implemented to maintain a healthy mouth.
Regular dental visits, proper oral hygiene habits, and a holistic approach to managing Parkinson’s symptoms are key to supporting the dental health of people with Parkinson’s disease.

COMPLIMENTARY THERAPIES

Products and practices taken alongside ("complement") conventional medicine.

MANIPULATIVE THERAPIES

Acupuncture

Acupuncture is an ancient form of Chinese medicine. It involves a therapist inserting thin needles at particular points on your body.
Traditional practitioners believe that energy flows round the body through channels which, when blocked, can cause illness. The role of acupuncture is used to unblock the channels.
Qualified practitioners make acupuncture safe. Some minor side effects are short-lived, but may include: slight pain, bleeding or bruising where the needle pierced the skin, and feeling sick, drowsy, or faint after treatment.
Some studies suggest it may help ease chronic back and neck pain, and reduced frequency of headaches.
Acupuncture is not regulated by the government.

Acupressure

Similar to acupuncture but without the needles, acupressure targets "acupoints" along Traditional Chinese Medicine (TCM) body's 14 meridians or energy-carrying channels.
TCM theory that energy ("Qi") flows along highways (meridians) and when they get blocked, it can be like a traffic jam. The idea behind acupressure is that pressing on these “acupoints” can help clear the traffic jam, letting your energy flow smoothly again.
Acupressure is a type of massage you can do on your own.
This treatment may reduce stress, relieve pain, digestive problems, and allergy symptoms, and help with sinus pressure.

Massage

A massage therapist may use various techniques including stroking, kneading, and rubbing to manipulate the body using pressure. Massage may be gentle or vigorous and may focus on one area or the whole body.
May help with circulation.
Massage therapy should not hurt, although there may be some discomfort if pressure is applied to injured areas, or where your body is very tense.
Massage may not be suitable for people with certain medical conditions, a history of blood clots, or weak or broken bones.

Chiropractor

Chiropractic is a licensed health care profession that emphasizes the body’s ability to heal itself. Treatment typically involves manual therapy, often including spinal manipulation. Other forms of treatment, such as exercise and nutritional counseling, may be used as well.
The purpose of the manipulations is to improve joint motion and function. Manipulations are most commonly done on the spine, but other parts of the body may also be treated in this way.
Most commonly used for conditions involving the musculoskeletal (muscles and spinal) systems: muscles, bones, joints to relieve pain.

MIND & BODY PRACTICES

Yoga

Yoga is an ancient and complex practice, rooted in Indian philosophy. It began as a spiritual practice but has become popular as a way of promoting physical and mental well-being.
There are many different yoga styles, ranging from gentle practices to physically demanding ones.
Used by many for flexibility, stress relief, and relaxation.
Some evidence that gentle yoga can improve mobility, balance, strength, and flexibility.
There are many ways to find yoga classes:
- YouTube videos, gym classes, yoga studios

Meditation

Meditation refers to a variety of practices that focus on mind and body integration and are used to calm the mind and enhance overall well-being
Easy to learn, takes practice.
May help reduce stress, improve concentration, decrease anxiety, improve sleep
Many ways to find free meditation:
- Apps: UCLA Mindful, Insight Timer, Mindfulness Coach, Smiling Mind...
- YouTube videos
- Spotify & Apple Music

Tai Chi

Originated as an ancient martial art in China.
Involves a series of slow gentle movements and physical postures, a meditative state of mind, and controlled breathing.
May be beneficial in improving and preventing falls in older adults and PD.
Studies have shown small positive effects on quality of life and pain management.

ENERGY THERAPIES

Reiki

Developed in Japan.
'Reiki' translates to universal life energy in Japanese.
Reiki is a complementary health approach in which practitioners place their hands lightly on or just above a person, with the goal of directing energy to help facilitate the person’s own healing response.
Based on an Eastern belief in an energy that supports the body’s innate or natural healing abilities.
Can help with stress, pain relief and mood.

Qi Gong

Pronounced "chi gong."
It involves using exercises to optimize energy within the body, mind, and spirit, with the goal of improving and maintaining health and well-being.
Qigong has both psychological and physical components and involves the regulation of the mind, breath, and body’s movement and posture.
Improvement in balance, fall reduction, pain, constipation, and sleep.
Dynamic (active) qigong techniques primarily focus on body movements, especially movements of the whole body or arms and legs.
Meditative (passive) qigong techniques can be practiced in any posture that can be maintained over time and involve breath and mind exercises, with almost no body movement.

ALTERNATIVE MEDICAL SYSTEMS

Ayurveda

Ayurveda is a traditional Indian medical system. It's called a system because it involves more than one technique. Each person has a different treatment plan.
Combines treatments like diet and lifestyle advice, herb supplements, and physical treatments such as full-body massage and meditation.
In practice for nearly 5,000 years.
Emphasizes balance of mind, body and spirit with the environment and restoring harmony.

Cannabis

Medical marijuana is legal in California for adults over the age of 21 years old.
Everyone has different reactions to medical marijuana. Studies have not clearly supported the use of marijuana for PD.
Small studies with possible benefits:
- Anxiety, depression, neuropathic pain, anxiety
- Improves sleep quality, fewer disturbances, decreased time to fall asleep
- Reduction of neuropathic pain

Chinese Medicine

In existence for nearly 3,000 years.
Called "Traditional Chinese Medicine (TCM)"
Focuses on restoring balance of life force (chi).
TCM practitioners use various psychological and/or physical approaches (such as acupuncture and tai chi) as well as herbal products to address health problems.
Incorporates herbal medicine, acupuncture, acupressure, and dietary modification.

Homeopathy

Homeopaths believe conditions can be cured by giving someone an extremely diluted dose of a remedy that, in large doses, would trigger the symptoms.
Homeopathic products come from plants (such as red onion, arnica [mountain herb], poison ivy, belladonna [deadly nightshade], and stinging nettle), minerals (such as white arsenic), or animals (such as crushed whole bees).
Treatments are individualized to each client.
Developed in Germany over 200 years ago.

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