Physiotherapy for people with movement disorders arising from basal ganglia dysfunction

Two of the most common diseases of the basal ganglia are Huntington’s disease (HD) and Parkinson’s disease (PD). In this article we compare and contrast the aetiology, pathogenesis and movement disorders associated with HD and PD, as a basis for deriving a framework for physiotherapy practice for people with basal ganglia dysfunction. Although much has been written about therapy for PD, little is known about the effects of allied health interventions on outcomes in HD. It is possible that strategies used to optimise movement in PD could also be beneficial for select movement disorders in HD because PD and HD share some common pathological features and symptoms. Movement disorders common to HD and PD include hypokinesia, akinesia and dyskinesia. Secondary musculoskeletal and cardiovascular changes can also occur as a result of inactivity or disuse. A framework for physiotherapy practice for people with basal ganglia disorders is proposed, based upon scientific evidence from the movement disorders literature. For both conditions, the major aim is to teach people how to by-pass the defective basal ganglia structures and to use frontal neural pathways to control movement. Belinda Bilney*, Meg E Morris, Sonia Denisenko. Physiotherapy for people with movement disorders arising from basal ganglia dysfunction. New Zealand Journal of Physiotherapy 31(2): 94-100.