Resources
• American Occupational Therapy Association • www. aota. org • This informative website includes neuro-rehabilitation links and informative articles.
• Centers for Independent Living( CILs): These locally-managed, state-funded centers, run by individuals with disability, are great sources for help with home modification, community mobility, and assistive technology. There’ s probably one near you.
• www. acl. gov / programs / aging-and-disability-networks / centers-independent-living
• Independent Living Aids: This online medical supply store also carries assistive devices for vision difficulties, mobility needs, and daily living. • www. independentliving. com
• Maxi Aids: This online medical supply store specializes in visual assistive devices.
• www. maxiaids. com
• Neuro-Optometric Rehabilitation Association: This educational site has information on treating diplopia, dry eye, visual tracking difficulties, etc., with links to neuro-optometrists in your area. • www. noravisionrehab. org
• Performance Health: This online medical supply store has tools for falls prevention, mobility, daily living, and more. • www. performancehealth. com
PSP and Constipation
Lawrence I. Golbe, MD 55
As we age and our metabolism slows, so does the process of elimination. Constipation is a common problem for the elderly, all the more so for people diagnosed with chronic neurological disorders such as progressive supranuclear palsy( PSP), multiple system atrophy( MSA), corticobasal degeneration( CBD), and Parkinson’ s disease.
What is constipation?
Constipation is defined by both frequency and quality of bowel movements. No“ normal” bowel movement frequency applies to everyone. If the stool is so hard that its passage is difficult, or if long intervals between bowel movements produce abdominal discomfort, then constipation is present and should be treated. Other symptoms of constipation may include bloating, lethargy, and general abdominal discomfort.
Scientific Basis In parkinsonian disorders, clusters of cells in the spinal cord that control the action of the intestines degenerate. In Parkinson’ s disease, the nerve cells in the intestines themselves undergo the same sort of degeneration as those in the brain and spinal cord. In such disorders, reduction in bowel movement frequency, or even constipation, may precede— by many years— the limb movement problems. There is even a respectable theory that the cause of Parkinson’ s disease is a toxin, perhaps ingested, perhaps produced by normal intestinal bacteria, that is absorbed into the tissues of intestines, where it starts to cause constipation and only later reaches the brain.