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Not sure where is best to post this, but hope someone may have some advice. I have a client with PD who has dyskinesia of his mouth/jaw. I am wondering if anyone has any advice on exercises or treatment techniques that may help. Would a mouth guard (like those worn for people who grind their teeth) be of any use as a sort of "resting splint"?
Any advice much appreciated.
Thanks
Tara
Hi TaraMa
It is a very interesting question. Sorry to sound negative but I think you need to be realistic about whether physiotherapy can help dyskinesia. As far as I know there is absolutely no evidence for physiotherapy for dyskinesia and given the the pathophysiology of dyskinesia in the PD patient (usually levadopa toxicity) I think it is unlikely that you can do anything for it. At some point I think there was an interest in biofeedback for dyskinesia but was found to be wanting. Sorry - couldn't find any reference. There are things we can help patients with PD with but dyskinesia isn't one.
RE: a mouth guard if the patient is experiencing bruxism due to the dyskinesia then an appropriate mouth guard might protect their teeth. However the complex and large range of motion of the disorder might mean the mouth guard becomes dislodged which could cause the patients problems and there could be a safety issue here. You could certainly trial one but I would keep a close eye on how it goes - discuss it with a dental colleague - preferably one with a knowledge of neurological disorders.
Thank you for your reply.
Yes it is nice to hear others aknowledge that we cannot really do anything for dyskinesia (I have been debating this with colleagues from other disciplines for a while who insist physiotheapy can help). My hope however was that he might get some relief with mouth opening type exercises and maybe a mouth gaurd to protect his teeth.
Thanks again for your input.
Tara
Hi Tara
That sounds a very reasonable plan. All the best with his mangement
Geoff
Dear TaraMa,
As a paediatric physio I can agree with you to a certain extent. New research into brain and nerves is ongoing and new techniques are the result, we do not know what the future will bring.
If you were to read the case study I have done on a little girl with Rett syndrome and you were to try the same technique?
One colleague of mine has already tried the same tape on a Parkinson patient of his. This patient had similar problems, and the tape helped him to a certain extent.
Its a new technique and very easy to do so... if you are interested..... please let me know and I will send you more practical information.
go to ANEID - Pharmaceutical Products - under news medical taping, go to first bulletin for the article.
Esther