As discussed in Part 1, postural imbalances are endemic in the Parkinson’s Disease population. These postural imbalances inevitably lead to an impaired ability of the individual to balance and increases the likelihood of both single-incident and recurrent falling incidents. Addressing postural imbalances is a powerful tool that the professional can utilize…
Parkinson’s Disease or PD is a chronic, progressive disease that affects the nervous system and the part of the brain that controls movement, posture, and balance. PD occurs in men more often than women and most commonly targets those over age 50.
As epidemic as postural imbalances are in the general public, the rate of postural abnormalities in the Parkinson’s Disease (PD) population are clinically diagnosed in one-third of cases. This number is also quite likely very optimistic compared to practice.
One of the most expansive areas of study and treatment for Parkinson’s Disease (PD) lies in the various biological pathways associated with the disease progression. Of these pathways, the c-Jun N-terminal Kinase (JNK) pathway has received the spotlight for its integral role in disease pathology.
With the recent push for getting everybody moving, for some, Health Screening, Exercise Testing, Exercise Prescription as well as Fitness Programming are all areas where professional guidance may be necessary. The knowledge and experience of multiple Healthcare and Fitness Professionals combined provides a holistic approach for a lifetime of optimal health and well-being.
Parkinson’s Disease is known as a motor system disorder and there is currently no cure. When individuals have decreased levels of dopamine changes start to begin. A tremor of the hands, face, legs, and other body parts may be noticeable at first then more pronounced symptoms become apparent when the disease progresses. At this point, individuals may have trouble walking, talking and participating in daily activities.
Exercise is known to help ease the symptoms of Parkinson’s disease. In my experience, clients work on physical as well as vocal exercise. Each of my clients is doing something daily. It is good to mix up your workouts so you practice different movements. You may find yourself working with a Physical Therapist as well as Personal Trainer.
When working out in the gym, it is important to start with a ten minute warm- up and shorter sessions, slowly working up to a thirty minute workout. Seeking the help of a personal trainer is very beneficial since each person with Parkinson’s is different. Personal Trainers can prescribe safe exercises, and show you what level you should begin working out.
My client, Mary, works on a combination of different exercises such as, weight and cardiovascular training, Rock Steady Boxing (a kickboxing class for Parkinson’s Disease), LSVT BIG and LSVT LOUD. We rotate exercises each session so I can see what she is practicing and go over it with her.
The LSVT exercises are originally given by a Physical or Occupational Therapist. These are big movement exercises to help with stiffness and prevent shuffling of the feet. LSVT LOUD are vocal exercises which are prescribed by a Speech Language Pathologist. Click here to find an LSVT Practitioner in your area.
It is important to remember to take certain precautions when working out at home. Pick up your feet if you take walks to avoid falling and have someone go with you. Make sure to remove throw rugs in the room you choose to exercise in. Practice balance exercises near something that is sturdy to hold on to. Avoid working out in rooms with poor lighting so you do not trip.
In conclusion, exercise, is very important for anyone with Parkinson’s Disease. The more you move, the less stiff your joints will become. Land and pool exercises are a great choice for increasing flexibility, mobility, and balance. When working out at home, choose a safe environment that has bright lights and non slip floors.
Robyn Caruso is the Founder of The Stress Management Institute for Health and Fitness Professionals. She has 15 years of experience in medical based fitness. Contact Robyn by email at: tsmi.caruso@aol.com
References:
http://www.ninds.nih.gov/disorders/parkinsons_disease/parkinsons_disease.htm
http://www.webmd.com/parkinsons-disease/guide/parkinsons-exercise
http://www.webmd.com/parkinsons-disease/news/20121106/exercise-good-parkinsons
The benefits of health coaching for managing chronic diseases has been growing in popularity for the past decade and contrary to popular belief, a health coach is not someone who is just providing guidance on weight loss. The concept of activation is a crucial component to managing healthy behaviors and for those diagnosed with Parkinson’s Disease (PD) or other neurological conditions, the ability to adhere to exercise programs can be a challenge.
According to Terry Ellis, assistant professor at Sargent College and Director of the Center for Neurorehabilitation, a virtual coach was effective in helping individuals diagnosed with PD adhere to a daily walking regimen. After one month of coaching, Ellis’ study demonstrated a 100 percent retention rate among participants due to the ability of the coach to build social and emotional relationships.
For those living with neurological conditions, both the availability and accessibility to exercise programs for this population can be a limiting factor. For those with advanced symptoms, driving themselves to an exercise class is not possible and can place an added strain on their caregiver to coordinate such processes. A health coach can be just what is needed to link the patient to the outside world by which they feel connected socially and emotionally. This can provide enough motivation for them to engage in the necessary level of exercise the can significantly reduce symptoms related to PD or other neurological conditions.
Health coaching for this population should focus primarily on:
Resources
Ellis, T. (2013). Feasibility of a virtual exercise coach to promote walking in community dwelling persons with Parkinson Disease. American Journal of Physical Medicine and Rehabilitation. Vol. 92, Issue 6, pp. 472-485. Doi: 10.1097/PHM.0b013e31828cd466.
Parkinson’s Disease is a degenerative condition causing tremor and motor impairment. Though PD is not fatal, complications from the disorder can be severe and there is no known cure. Parkinson’s has been related to the loss of dopamine (a hormone) secreting neurons in the midbrain area called the substantia nigra. With a decrease in the production of dopamine, the ability to regulate the body, movements and emotions are lost.
Recent research findings have shown that a minority of clients with Parkinson’s do fine without any form of rehabilitation. However, the majority of studies have shown that clients improved in their ability to do daily living activities in response to physical therapy rehabilitation. 62% of research participants who received physical therapy intervention had a successful outcome relative to 38% of the participants in the control group who had a successful outcome. (Murphy & Tickle-Degnen, 2011). In another research project, Tests Predict Falls in Parkinson’sPatients, published in the June 23, 2010 issue of Neurology, looked at 101 Parkinson’s patients who were able to walk without aids. They tested for symptoms such as visual function, balance, gait, strength, reaction time and proprioception. Those who did poorly on the balance tests, mobility tests and coordinating multi-joint movements were more prone to falls (42%).
People with minor motor system disorders to severe disorders will find that physical therapy can help with the rigidity, slow movement patterns, postural instability, impaired balance and coordination that seem to evolve along with this disease. The physical therapist will evaluate for Functional Gait Testing, Functional Reach Testing, Timed Get Up and Go Test, Bed mobility screening and orthopedic evaluations for mobility and strength.
After the evaluation, the physical therapist may set up a specific exercise or movement lesson that uses high amplitude movements that overcome bradykinesia and hypokinesia (activating excessively slow motion).
My personal experience with Parkinson’s patients is one of inquiry, fun and resolution. We even use dance as a means of increasing balance and coordination. When it is a mobility problem like getting out of bed, the physical therapist will create a home program with specific exercises for your needs. When it is a postural instability issue, we will work with balance/gait on different surfaces as well as strengthening for your back, legs, abdomen and torso.
Let the field of physical therapy evaluate and assess what we can do for you!