Significant new coping mechanisms to help people with Parkinson's Disease (PD) have emerged from a Sydney hospital program pioneered by Professor Lynn Chenoweth from the Faculty of Nursing, Midwifery and Health at the University of Technology, Sydney.

Professor Chenoweth, who is Director of the Health and Ageing Research Unit at Sydney's War Memorial Hospital in Waverley, has launched the PD initiative in collaboration with the Hospital's Nursing Research Officer, Dr June Sheriff, and a multidisciplinary medical, nursing and allied health team.

The hospital program, the only one of its kind in Sydney that offers a comprehensive range of medical assessments as well as psychological counselling and support to the participants and their carers, has won the enthusiastic support of the first cohort comprising 35 PD patients and 35 carers.

The team has devised new strategies that enable the patients to control and improve debilitating and distressing aspects of their condition such as incontinence and constipation.

"We discovered that patients could feel when the bladder was full and could actually feel the expansion and contraction of the urethra and pelvic floor muscles," Professor Chenoweth said. "So the team's continence nurse adviser could teach them how to relax, contract and strengthen their pelvic floor muscles so that they empty their bladder on cue rather than resorting to pads."

Additionally, the program has succeeded in reducing and alleviating significantly the sense of isolation, emotional stress and clinical depression experienced by the patients and their carers.

As PD is a progressive neurodegenerative disease, with time neural damage increases, muscles weaken and the voice diminishes in strength. The program's speech pathologists help the PD patients to counteract slurring by articulating their words with greater clarity and projecting their voices, so that once again they can conduct normal conversations.

"If the damage to the nervous system is irreparable, they have to learn to create new neural pathways, which is what they've done in learning to speak correctly," Professor Chenoweth said.

Therapists also address the muscle paralysis that affects chewing and swallowing food and saliva by identifying and training the muscles that can be used in the process.

Team members also coach patients through multiple stages of a graded walking program, focusing on correct posture, movement and balance so that instead of shuffling they walk confidently and correctly, can transfer safely from one position or locality to another, and can manage distances, stairs and other challenging surfaces in interior and exterior settings.

"We teach them to balance, stand up straight, pull the chin up, tighten the stomach muscles, keep the back straight and look forward. We encourage them to pick up their knee, extend the leg and place the foot securely on the ground, all of which can be learnt.

"We're delighted that the program has enabled participants to maintain their social engagement with the world around them and to communicate more effectively. They no longer fall when they're outside and they can sign their names properly. They can have leisure pursuits and maintain their role in the family and society, which is sometimes more important than being able to clean one's teeth."