What is the difference between physiotherapy and occupational therapy for Parkinson's?

occupational Therapy

In the course of their illness, people with Parkinson's suffer from an increasing limitation of their everyday abilities. The simplest activities and previously automated movement sequences are no longer possible or only possible to a limited extent.

Put simply, occupational therapy aims to counteract these creeping restrictions. This includes not only physical but also mental mobility. The aim is therefore to maintain the patients' independence for as long as possible.

This independence is not limited to household and self-sufficiency. Most patients want to practice their profession for as long as possible and here occupational therapy can make a valuable contribution through appropriate training.

Typical applications are:

• Fine motor exercises
• Memory training (recently with the help of computers)
• Attention exercises
• Use of aids (buttoning aid, stocking puller, tremor spoon, etc.)
• Optimization of the apartment
• Painting, handicrafts

As is often the case, the relatives play with the Therapy plays an important role and so it is also the task of occupational therapy to educate, advise and involve relatives in the therapy.

Physical therapy

The most noticeable symptoms of Parkinson's, besides the tremor, are the restrictions in mobility due to stiffening, slowing down and shrinking.

It is the aim of physiotherapy to counteract this and numerous studies show that the improvement in symptoms through suitable and, above all, regular and long-term physiotherapy is significant.

It uses neuroplasticity - i.e. the ability of our brain to change itself - in order, among other things, to train and relearn certain movements that are difficult for the patient through targeted exercises. In addition, special symptoms of illness, such as gait blockages or an increased tendency to fall, can be alleviated through physiotherapeutic measures.

Similar to occupational therapy with fine motor skills, physiotherapy helps with movement problems in everyday life and trains the use of aids and techniques, such as

• laser pointer
• Counting out loud to resolve movement blocks
• Strength and stretching exercises

A special form of therapy is LSVT Big. The focus here is on training large movements, which are intended to counteract the reduction in the movement amplitudes. The method comes from the USA and the positive effect has been proven in many studies. The therapy lasts 4 weeks with 4 training units each. Then it goes on with special exercises for at home.

Many Parkinson's clinics, physiotherapists and occupational therapists are now trained in LSVT BIG. There are still ambiguities with the cash settlement, especially with resident therapists. I am aware of cases in which the therapy could be billed to occupational therapists, but not to physiotherapists, although both were certified.

It is therefore worth asking the prescribing neurologist for suitable therapists or contacting the health insurance company directly in advance.