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Dementia Brain Problems

Alzheimer’s Disease

Although there are natural physiological changes that occur with age, memory loss is neither normal nor a natural process of aging. It is important to take a proactive role in retaining the strength, resiliency, and vitality of the brain. Research has shown that just as the body needs strength-building exercises to maintain muscle strength, so does the brain.


Parkinson’s Disease and Exercise

Parkinson’s disease is the second most common neurodegenerative disorder after Alzheimer disease.  Unfortunately, the incidence of Parkinson’s disease has not declined, and its impact is seen in all races.  This is due in part to the fact that the population of the world is greater than ever before and increasing. In addition, people are living longer than in previous generations, and the baby boomer generation, one of the largest generations in history, has reached old age.

Risk factors for Parkinson’s disease include:

Age: Risk of Parkinson’s disease increases with age.  The average age of onset for this disease is 55 years and the rate of incidence increases steadily until the age of 90.

Gender: Men have a higher risk for Parkinson’s disease than women.

Family history: Individuals with a family history of Parkinson’s disease are at a higher risk for Parkinson’s disease. Moreover, it is said that those with affected first-degree relatives double their risk of Parkinson’s disease.

Agricultural work: Individuals exposed to pesticides and herbicides have a greater risk of developing Parkinson’s disease symptoms. Drinking well-water and living in rural areas have also been associated with an increased incidence of Parkinson’s disease.

Head Trauma: Head trauma can be a risk factor for Parkinson’s disease as is seen in the case of boxers. One study showed that trauma to the upper cervical region, head, and neck was a risk factor for Parkinson’s disease. However, in some cases it took years for these symptoms to appear.

The exact cause of Parkinson’s disease is unknown.  Regarding the molecular events that lead to the development of this disease, there is still some uncertainty in terms of what causes the neurodegeneration seen in Parkinson’s disease. The current hypothesis is that Parkinson’s disease may result from the interaction between environmental factors and genetic susceptibility.

The primary symptoms for PD are deficiencies in motor performance due to the loss of the dopamine pathways in the brain. Decreased dopamine production in the substantia nigra in the brain causes the 4 primary motor symptoms:

  • Bradykinesia: described as slowness in the execution of movements while performing daily activities.
  • Rigidity or Stiffness: caused by an involuntary increase in tone of the limbs and axial musculature.
  • Resting Tremor: Found primarily in the arms and hands and can be socially bothersome. Resting tremors are less disabling since they often vanish with the initiation of activity (especially in the early stages of Parkinson’s disease).
  • Postural Instability: manifested in a slow speed of walking, shortened stride length, narrowing of base of support, and leaning towards one side.

Exercise should be targeted for the primary motor symptoms with exercise and occupational therapy to improve quality of life. Recommended program components include:

  • Posture, gait, mobility
  • Fall risk reduction
  • Cardiorespiratory health
  • Strength and function
  • Depression and Anxiety
  • Joint health

Exercise prescription for clients with PD includes: (ACSM)

  • An individualized program
  • Cardiorespiratory: use guidelines for healthy adults
  • Muscular Fitness: use guidelines for healthy adults
  • Flexibility: slow, static exercises for all major and minor joints in the body including the upper torso, spine, and neck.
  • Neuromotor Exercises: help with balance, gait, and postural instability. Clinicians use a gait belt or parallel bars to ensure safety depending on the severity of the symptoms.  Include functional exercises to improve ADLs and quality of life.

PD exercise therapy includes intervention with many kinds of exercise modes. Both personal training and group fitness have been successful in helping to manage the disease and reduce the symptoms. There is not strong evidence at this point to show that exercise prevents PD, but it is believed that exercise may play a role.  Exercise is however the mainstay for symptom management and slowing disease development.

Want more on this topic? Register for June’s upcoming webinar:

June M. Chewning BS, MA has been in the fitness industry since 1978 serving as a physical education teacher, group fitness instructor, personal trainer, gym owner, master trainer, adjunct college professor, curriculum formatter and developer, and education consultant. She is the education specialist at Fitness Learning Systems, a continuing education company.

References and Resources:


Why is Breakfast Really That Important?

Brain health is directly related to blood sugar levels (glucose homeostasis) in the body.

The information in this article is taken from the American Academy of Sports Dietitians and Nutritionists (AASDN) continuing education course “The Science of Nutrition.”

There are so many misconceptions and misinformation about nutrition. Everyone wants to believe they are eating to properly fuel their body and prevent disease. There is one clear path to learn how to separate fact from fiction when it comes to nutrition information. For some reason, many people prefer to follow the nutrition fads, instead of trying to understand how the body works. The best path to optimal nutrition is to learn how the body responds physiologically to food.  When you understand how the body works, then you will understand how to fuel the body properly.

So, is breakfast important? Is Breakfast important from a physiological standpoint? What should you eat for breakfast? Let’s explore how the body works to answer these questions.

If we define breakfast as the first meal consumed at the start of our day, then yes, breakfast is very important.  As you may have heard, it is the most important meal of the day for most people. One reason why is Glucose Homeostasis.

Glucose homeostasis is one of the highest levels of homeostatic control in the human body. Normal fasting blood glucose in a healthy individual is between 70 and 100 mg/dl. This range is regulated primarily by the hormones insulin, glucagon, epinephrine, and norepinephrine.

Many cells in the body have insulin receptors which bind insulin allowing glucose to enter the cell. These cells are known as insulin-dependent cells and most cells in the body are insulin dependent. Insulin acts like a key, opening the door so the cell can let the glucose enter.

Although most cells in the body are insulin dependent, there are also some non-insulin-dependent cells that do not have insulin receptors (red blood cells, nerve cells, cells involved in vision, etc). These non-insulin-dependent cells are quite different in that insulin has either little or no effect on glucose utilization or uptake. Another distinguishing factor is that these cells can only use glucose as an energy source. So nervous system and brain cells, vision cells, and red blood cells need a healthy level of glucose available in the blood stream in order to function properly and remain healthy.  They can’t store glucose in the cell, but having glucose available at all times is imperative for proper cell function and cell health.

These cells are particularly at risk for damage when blood glucose levels in the blood stream are not within normal range for any extended period of time. Therefore, prevention of damage to these cells requires glucose levels to be maintained within the homeostatic range. This homeostatic control helps to explain why conditions like Diabetes are so dangerous. If the body is not able to naturally maintain normal blood glucose levels, critical cells in your brain, nervous system, eyes, and blood will be damaged.

The glucose time curve refers to a finite amount of glycogen that can be stored in the body and the processes that occur when glycogen stores are depleted. We know that glycogen is stored in the liver and if adequate carbohydrates are consumed to maximize liver glycogen storage, this glycogen can provide about 12-16 hours of glucose for non-insulin dependent cells. Once this glycogen is depleted the body must produce glucose from other sources.

Let’s say that a normal, healthy individual consumes a healthy, carbohydrate rich meal at 6 pm. The meal should provide adequate glucose for about 4 hours, taking the individual to about 10 pm when this individual goes to bed. During the evening, while sleeping, the body still requires glucose which can be obtained from liver glycogen stores. Assuming this individual gets an adequate 8 hours of sleep, this individual wakes at 6 am and only has about 4 to 8 hours of glycogen remaining in the liver. This makes a healthy, carbohydrate rich breakfast important.

If breakfast is skipped, then somewhere around 10 am the body starts to search for other means of obtaining the vital glucose to sustain the cells that must have it.  The only option is a process called Gluconeogenesis which is the making of glucose from non-carbohydrate sources in the body. The body will break down stored proteins to obtain glucogenic amino acids and convert them to glucose. The body CANNOT make glucose from stored fat.

During gluconeogenesis, the body is getting the needed glucose, but at a very high cost. The nitrogen that is removed from the amino acids must be excreted from the body. Also, the primary location for the body to obtain whole proteins for gluconeogenesis is skeletal muscle. This muscle that we have worked so hard to build and maintain is now being catabolized for survival. This is so dangerous that the body will only allow it to occur for up to 48 hours. At that point, so much damage has been done that the body moves to another metabolic process that steals amino acids form muscle tissue to survive known as Ketosis. However, brain and nerve cells cannot use the “fake” glucose and damage to the brain, blood and nervous system begins.

So, the bottom line?  DO NOT SKIP BREAKFAST… skipping breakfast starves and damages your brain, nervous system, blood, and eye cells.  It is vital to eat healthy carbohydrates for breakfast, especially if you are going to exercise in the morning, to make sure you have plenty of circulating glucose in your blood to feed your non-insulin-dependent vital cells.  Eat a breakfast that includes foods like oatmeal, whole grain breads, whole grain cereal, and fruit.  FEED YOUR BRAIN!  Preserve it, don’t starve it.

Interested in learning more? Gain a fundamental understanding of science-based nutrition concepts in the course The Science of Nutrition. The goal is to allow you to be able to better separate the science-based food and nutrition information from the plethora of misinformation, to properly advise and communicate about nutrition with your clients.

Compiled by June Chewning. June M. Chewning BS, MA has been in the fitness industry since 1978 serving as a physical education teacher, group fitness instructor, personal trainer, gym owner, master trainer, adjunct college professor, curriculum formatter and developer, and education consultant. She is the education specialist at Fitness Learning Systems, a continuing education company.


Back pain

Chronic Pain

Hey! Did you know that all pain is all in your head?  It doesn’t mean you don’t have real pain when something to cause pain happens, or that chronic pain is not real.  Feelings of pain are very real and are initiated by the brain for a very important basic reason…to keep you safe.

The study of the neuroscience of pain has changed considerably in the past 10 years.  It is now believed that the sensation of pain is a necessary function that warns the body of potential pain or of actual injury.  The process starts with the nociceptor detecting a potentially painful stimulus from the skin or an internal organ. Neurotransmitters (chemical messengers) transmit the signals through the nervous system and spinal cord to the brain. In essence, how the brain processes the signals causes an appropriate or inappropriate pain response.

One example is a child falling and skinning his knees.  He gets up and continues to play as if nothing happened.  Then another child or adult reacts to the blood running down his legs, he looks, his brain responds differently to the neurological stimulus, and suddenly there is pain.  Initially the brain did not register the experience as painful, however the next time the child falls, he will probably immediately register the skinned knees as painful. Experience plays a role in the pain response.

The pain response can also be overridden by the brain in circumstances that are life threatening.  For example, a soldier who runs to safety with a serious gun-shot wound. The brain, due to past experience, can conversely register the event as much more painful or life threatening than necessary. For example, someone who was bitten by a poisonous snake may brush it off as being scratched by a stick, until they realize they have a life-threatening injury. But the next time they get scratched by a stick, they may respond as if they were bitten by a poisonous snake.

According to Elliot Krane in his Ted Talk “The Mystery of Chronic Pain,” after an injury or surgery, the nervous system can sometimes get what is going on wrong.  Approximately ten percent of the time, the nerves and glial cells (play a vital role in modulation, amplification, and distortion of sensory experiences) that interact in the pain response develop into a feedback loop that can become distorted. This altered feedback can make chronic pain become its own disease.

Dr. Maria Sykorova-Pritz in her course “Application of Water Exercise for Pain Management” describes how chronic pain is not simple, but very complicated.  The body, mind, emotions, and behavior can become entwined in the chronic pain cycle. Pain medication is often prescribed for chronic pain. Rampant prescription of pain medication is believed to play a large role in the opioid epidemic in the United States.  Although pain medication is often prescribed for chronic pain, it does nothing to unravel the combination of physical, emotional, and behavioral factors that are now believed to cause chronic pain.

There is growing evidence that chronic pain is caused by multiple factors including cognitive, physiological, and behavioral factors. If you are working with clients or interacting with a family member with chronic pain, it is important to understand that it is not just simply a physiological response to pain. It is important to effectively influence a client’s attitude, cultural background and belief system-which influences social norms and perceived behavioral control.  To achieve the highest positive health/fitness results among the chronic pain population, it is important to know and understand your client as a whole person.

As we start to look for alternative ways to deal with chronic pain and its aftermath, a combination of physical therapy/exercise and emotional/behavioral counseling is emerging as the tools of choice.  Using the practice of yoga and water therapy/exercise to relieve and even cure chronic pain are proving to be viable and more effective alternatives than pain medication. Statistics from the Institute of Medicine indicate that more than 100 million Americans suffer with chronic pain, thus creating a viable niche for those wishing to work with clients with chronic pain. Now that more is known about chronic pain, its potential causes, the chronic pain cycle, and how to treat it effectively, education is key to working with this population in need.  Proper treatment and compassion for chronic pain sufferers can help end the opioid crisis and help people beat chronic pain to live pain free lives without addiction and suffering.

For more information about the psychology and treatment of chronic pain management, see Dr. Maria Sykorova-Pritz’s continuing education course “Application of Water Exercise for Pain Management.

Compiled by June Chewning. June M. Chewning BS, MA has been in the fitness industry since 1978 serving as a physical education teacher, group fitness instructor, personal trainer, gym owner, master trainer, adjunct college professor, curriculum formatter and developer, and education consultant. She is the education specialist at Fitness Learning Systems, a continuing education company.