Parkinson’s Disease Case Study
73 years old man diagnosed with Parkinson’s Disease (PD), x 7 years. Recent onset of macular degeneration.
Challenges and Strengths:
- Decreased postural stability and righting reactions with some rigidity affecting both his static and dynamic balance. Recent increase in his medication is presently halting the progression of his symptoms.
- Increasing incidents of falls in the driveway and once recently in his bedroom.
- Symptoms of Parkinson’s Disease and ability to walk fluctuate throughout the day due to the medication cycle.
- Irregular and sloped surfaces, fatigue, and walking at night increases the risk of falls.
- Intact cognition.
- Widower. Lives alone.
- Lives in a bungalow with ramped access.
- Remains socially active and continues to attend his PD-specific exercise classes.
- Has recently purchased a rollator for use in the community. Stored in garage.
- Rollator doesn’t access bathroom if used indoors.
Two mobility aids: 1) Rollator with slow-down brakes and 2) standard frame walker with 4 fixed wheels. A single mobility aid isn’t sufficient to meet the patient’s needs for safe support.
Inside his home, the patient uses both walking aids to continue living independently. The patient began using the rollator throughout most of the home but at night a walking frame with more stability than the rollator is required for night time toileting. At night he is at an increased risk for falls due to grogginess and decreased vision. Various accessories were trialed on a standard frame walker including combinations of fixed and swivel wheels of different sizes, autostop brakes, and plastic skis.
He concluded he felt most secure with four 3” fixed wheels. The widest base of support was maintained by placing the wheels on the outside of the frame rather than the inside for maximum stability. This configuration of walker was still able to pass through the bathroom door. Slow-down brakes were added to his rollator to increase his control on the ramp, in the driveway and at the community centre where his classes are held.
Parkinson’s Disease Case Study prepared by Janet Alexander PT for Walker Facts; for other case studies, please refer to www.walkerfacts.com