Abstract
A 60-year-old woman with Parkinson disease (PD) treated by Levodopa / carbidopa intestinal gel (LCIG) began physical therapy (PT). Before inducing LCIG therapy, she had six hours off time a day, and she have not walked outside for six years due to the fear of off time freezing. Scores for depression and anxiety on the Hospital Anxiety and Depression Scale (HADS) were 14 and 11, respectively. Symptoms of depression and anxiety as well as impaired endurance and balance were confirmed. While maintaining LCIG treatment, physical therapy (PT) was started with a focus on tasks to improve endurance and balance. Activity goals were decided with the patient. She stopped experiencing episodes of off time four months after PT was introduced and her HADS scores for depression and anxiety decreased to 6 and 3, respectively. She achieved the activity goals she had set, and outings became part of her daily routine. When introducing PT alongside LCIG treatment, patients and therapists should decide the activity goals together and work on activities that address the problems identified by the pre-PT assessment.
