Motor Effects of Dopamine Replacement: Taking the Positive with the Negative

Abstract

&NA; Dopamine replacement, with levo‐dopa, is the mainstay of pharmacologic treatment of Parkinson disease (PD). Although the benefits of dopamine replacement on clinical rating scales are well documented, many physical therapists may not be aware of the specific effects of levo‐dopa on the cardinal motor impairments in persons with PD. This paper reviews the positive and negative motor effects of dopamine replacement and discusses the implications for physical therapy practice. Through an increased understanding of the motor effects of dopamine replacement, physical therapists will have an improved ability to distinguish between the basic pathophysiology of PD, the complications of dopamine replacement, and how rehabilitation interventions may be affected by these factors.