Tottori J. Clin. Res. 9(2), 126-130, 2017

Successful physical therapy to enhance self-efficacy and expand the range ofactivity - A case of Parkinson’s disease Kenta Nakashima1), Makoto Sawada1)*, Yasuji Imai1), Tatsunori Murakami1),
Tamotsu Katoi1), Shogo Usui1), Mitsuru Doi2)
1) Department of Rehabilitation, NHO Tottori Medical Center2) Department of Neurology, NHO Tottori Medical Center*Correspondence: m_sawada@tottori-iryo.hosp.go.jp
Abstract
This paper reports a female patient with Parkinson’s disease in her mid-seventies, who had been energetic
and actively participated in society until the experience of a fall decreased her self-efficacy and narrowed her
range of activity. With the outpatient rehabilitation goal of improving her physical functions and expanding her
range of activity, exercise therapy and other intervention approaches to enhance her self-efficacy and promoteher behavioral change were provided. Through these approaches, the patient’s physical functions improved,with reduced fear of falling and her self-efficacy enhanced. Her range of daily activities also expanded,
consequently enabling her to resume social participation. Tottori J. Clin. Res. 9(2), 126-130, 2017
Key words: Parkinson’s disease (PD), falls, outpatient rehabilitation, social withdrawal, self-efficacy.
Introduction
In Parkinson’s disease (PD), falls are a causeof ADL limitations. They also lead to physicaldysfunction, reduce the frequency of going out,
and narrow the range of activity. Fear of falling isanother problem, which increases the risk ofsocialwithdrawal
duetodecreased
self-efficacy1).
Outpatient rehabilitation is effective toimprove PD patients’ physical functions.
However, intervention based only on exercise,such as muscle training, has been reported to be
insufficient to improve their activities of dailyliving (ADL) and quality of life (QOL)2),
although their physical functions such as lower
limb muscle strength, walking ability, and othermotor functions improve to some extent.
This paper reports a female patient with PD
in her mid-seventies, who had been energetic andactively participated in society until theexperience of a fall decreased her self-efficacy
and narrowed her own range of activity. With theoutpatient rehabilitation goal of improving her
physical functions and expanding her range ofactivity, exercise therapy and other intervention
approaches to enhance her self-efficacy andpromote her behavioral change were provided.
Through these approaches, the patient’s range ofdaily activities expanded, consequently enabling
her to resume social participation
Patient
Age: Mid-seventies.
Sex: Female.
Chief complaint: Walking difficulty.
Past medical history: The patient had experienced
a compression fracture of the second lumbar
vertebrae 1 year previously.
Present medical history: PD symptoms, such as
resting tremor, muscle rigidity, a tendency tobend or flex forward, and gait disturbance, had
begun to appear 2 years previously. Stumbling on
a rice bag placed at the side of the entrance hall,
she fell backward. This experience had decreased
her frequency to go out. She had been treatedwith anti-PD drugs in our facility for 1 year. To
improve her walking ability, outpatient
rehabilitation had started.