Effect of low impact exercises with behavioral relaxation therapy on tremors, upper limb function and disability in patients with Parkinson’s Disease

Background: The Parkinson’s Disease (PD) is a “complex neurodegenerative disorder, a second most common neurodegenerative disorder next to Alzheimer’s disease caused by deficiency of a neurochemichal ‘Dopamine’ in the nigrostriatum systemâ€. Tremor is a major motor cardinal symptoms in parkinson’s. The current pharmacological treatments carbidopa and levodopa combination, Anticholinergics and surgical interventions deep brain stimulation, Stereotactic thalamotomy are choice of treatment in severe cases and less published evidence on tremors. Clinical findings suggests that tremor increased by stress and usually physiotherapist suggests patients to practice meditation, yoga, breathing exercises and other relaxation techniques to reduce tremor. Objectives: The study will investigate effect of low impact exercises with behavioral relaxation therapy techniques on Parkinson’s tremor. Methodology : It will be a prospective experimental Randomized control study . 30 Hoehn and Yahr scale Stage III-IV Parkinson’s, and tremor dominating patients were randomly allocated into experimental and control group. Pre and post tests will be taken using Fahn’s Tremor rating scale (FTRS) , Bain and Findley Tremor ADL Scale ,9 hole peg test. Interventional Group will receive low impact exercises with Behavioral Relaxation Therapy (BRT) Techniques and Control group will receive conventional physiotherapy protocol and relaxation exercise thrice a week for 5 weeks under supervision of Physiotherapist and follow up after 6 weeks.

Keywords : Low impact exercises ,Behavioral Relaxation Therapy, Tremor, Upper limb function, Disability, Parkinson’s Disease.