This is seen in the clinical practice that Parkinsonism, chorea, spasmodic torticollis and tics are most common than the other disorders.

                  The various disorders of the extrapyramidal interference are :

    (1) Parkinsonism
    (2) Hepato - cellular degeneration, Wilson's disease
    (3) Sydenham's chorea - St. Vitus' dance,
    (4) Huntington's chorea
    (5) Athetosis
    (6) Kernicterus
    (7) Spasmodic torticollis, wry neck,
    (8) Tic - Habit spasm, etc.

                                 O.T. aims are :

        1. To prevent anxiety
        2. To overcome confusion
        3. To relieve rigidity
        4. To improve Co-ordination
        5. To strengthen muscles
        6. To give gait training
        7. To correct posture
        8. To prevent development of contractures and deformities.
        9. To give A.D.L. training
      10. To check / prevent development of complications.
      11. To contribute to speech training.
      12. To give writing training
      13. To give pre- vocational and vocational training.

               As it is already said that the most common disorders are Parkinsonism and chorea. The general treatment plan discussed here is as follows :

( 1 ) To allay anxiety :
                     This is a peculiar feeling experienced by the patient to have a handicap or the disease. The patient  is  very  curious  to know  about  the  prognosis  of  the illness. Be a good listener so that you give a sympathetic hearing to the patient. Tell him  that he will be able to do things for himself without any assistance but in due course of time. The therapist should reply to his questions. Do not make any false statement in front of him about his illness. Try to direct his attention to pleasant things than to his disability. Encourage listening to radio, T.V and film shows, plays and concerts. This should not be done immediately but should follow after winning the confidence of the patient and acceptance of his illness. He should be made an optimistic so that he takes life as it comes.

( 2 ) To Over come confusion :
                     This will be bizarre feeling. The patient may feel in a fix about his illness. The confusion may be due to befall of illness or if the symptoms are due to degeneration of the cortical substance. This is the problem confronted by the occupational therapists mostly. Much of the confusion will be over after allaying anxiety. And if confusion is a complication due to mental changes, should be treated accordingly in consultation with the psychiatrist.

( 3 ) To relieve rigidity :
                      This is the phenomenon, which complicate the condition of the patient due to contractures. The movements should be in full - arc motion, e.g.

                           I. Shoulder wheel
                          II. Overhead Pulley
                         III. Multipurpose Wheel
                        IV. Sanding etc.

               When affected parts are put to movement, shall improve range, muscle strength, circulation and the development of contractures shall also be checked.

              To check tremors in hand, give a newspaper or a pair of gloves to the patient to hold in the hands.

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