World Parkinson’s Day is marked on April 11 to raise awareness of Parkinson’s disease (PD).
As the world celebrates this day, let’s take a dive into the need for rehabilitation as a key component of Parkinson’s care in Ghana.
Parkinson’s disease is the world’s second most common neurodegenerative disorder after Alzheimer’s disease.
In Ghana, it is the third most common neurological condition and first hypokinetic (slow) movement disorder.
It is a progressive condition that affects both motor functions, such as tremors (shaking), rigidity (muscle stiffness), slowed movement, and poor balance and non-motor functions, including pain, sleep disturbances, orthostatic hypotension (sudden drops in blood pressure), memory problems, and behavioural disorders.
Together, these symptoms significantly reduce mobility, independence, and quality of life. Although the cause of PD remains unknown, it occurs more frequently in older adults and men and currently has no cure.
Current medical approaches
Medical management relies heavily on pharmacological treatments, particularly levodopa-based medications, and surgical interventions such as deep-brain stimulation.
Throwing and catching of ball as an aerobic activity for balance and agility is essential for people with Parkinson’s disease
However, as the disease progresses, many people with PD (PwPD) develop resistance to medication, leading to complications such as freezing of gait (the sensation of feet sticking to the ground), postural instability, swallowing difficulties, cognitive decline, and increased caregiver burden.
Role of rehabilitation
Rehabilitation is, therefore, increasingly recognised as a vital component of PD care, aiming to reduce disability, restore function, and improve quality of life.
Evidence shows that physiotherapy, speech therapy, and occupational therapy can enhance motor and cognitive function, support daily activities, and sustain improvements over time.
Physiotherapy is the most widely used, likely due to its greater availability across healthcare systems, with structured gait retraining shown to yield benefits lasting up to a year after only four weeks of therapy.
Regular physical activity has also been linked to slower disease progression, reinforcing the concept of “exercise as medicine” and the importance of early referral to rehabilitation services, comprehensive assessment, and patient-family education.
Rehabilitation
Despite strong evidence, rehabilitation remains underutilised worldwide, particularly in Africa. A review of 12 studies from high-income countries reported usage rates ranging from as low as 0.9 per cent for occupational therapy to 62.5 per cent for physiotherapy.
In Ghana, while most PwPD are aware of rehabilitation options such as physiotherapy, speech therapy, occupational therapy, and exercise programmes, far fewer actually use them.
Among 75 PwPD surveyed, 68 per cent reported awareness, but only 44 per cent engaged in physiotherapy, with none accessing occupational or speech therapy.
The main barriers were systemic: over 90 per cent reported lack of referral from neurologists or doctors, and half were unsure of rehabilitation’s benefits.
When referrals did occur, they were often late and prompted by walking difficulties, tremors, balance issues, pain, or muscle weakness.
Patterns of physiotherapy use revealed both engagement and significant drop-off, with about three in five PwPD discontinuing treatment after an average of 4.5 months.
Leading barriers included transport difficulties, treatment costs, unmet recovery expectations, limited family support, worsening co-morbidities, and service availability issues.
Physiotherapy sessions were typically weekly or monthly, focusing on gait retraining, strengthening, flexibility, and balance exercises tailored to individual needs.
Home-based activities such as walking and stretching were considered vital for continuity, yet more than a third of PwPD reported no routine home programme.
Takeaway and recommendations
These findings highlight both the value of physiotherapy and the fragility of sustained rehabilitation access.
Practical barriers such as non-referrals, transport and treatment costs, and service continuity remain central challenges.
Addressing these issues through improved professional dialogue, enhanced referral pathways, expanded rehabilitation units, increased availability of expert rehabilitation professionals, insurance coverage, and public awareness campaigns is essential to ensure equitable access to rehabilitation in Parkinson’s care.
Call to action
It is important for healthcare professionals to make early referral which leads to a lasting impact.
Rehabilitation is medicine, so healthcare professionals should prescribe it. Multidisciplinary care begins with healthcare professionals.
For policymakers, policy change today means better Parkinson’s care tomorrow.
Accessible rehabilitation is not a luxury; it’s a right. Investing in rehabilitation means an investment in independence for all who need it.
The writer is a Lecturer, University of Health and Allied Sciences, Ghana and Coordinator, PD Support Group, Ghana
Writer’s email:
Source:
www.graphic.com.gh