How Do We Know Exercise Helps People With Parkinsons
We keep telling you that exercise is important . But what is the evidence that these exercise techniques really help people with PD? Lets review three of these types of exercise tai chi, yoga and dance and look at the data as to how effective they are for people with PD.
Tai chi
Tai chi is an ancient Chinese form of martial arts, which today is practiced as a style of exercise combining flowing movements, breathing techniques and meditative practices. Tai chi is low impact and is suitable for all ages and levels of fitness. It does not require any special equipment.
There has been research focused on the general health benefits of tai chi, and these may include reduction of stress, anxiety and depression, as well as improved flexibility, balance, agility, strength and stamina.
Yoga
Dance
These are just three types of exercise that show promise and benefit for people with PD. So go ahead and try an online dance, yoga or tai chi class at home . Or you can try another exercise type that piques your interest and start moving!
Tips and takeaways
Data Extraction And Quality Assessment
The data were extracted by two independent reviewers , who assessed all the studies based on the predesigned standards. Data were checked by a third investigator . Extracted data from the included studies contained the following information: author name, year of publication, sample size, mean age, interventions , and main outcome measures. We assessed the included studies’ quality on the basis of Cochrane Collaboration’s risk of bias tool. There were three scores for each item according to the following criteria: random sequence generation, allocation concealment, blinding of participants and personnel, incomplete outcome data, selective reporting, and other biases.
Patients’ Response Towards Tai Chi And Routine Exercises
All the enrolled participants showed interest and enjoyed physical therapy. Participants of both groups reported satisfaction. Participants of both groups felt more balanced with better stability in their gait. The results of the study were consistent with a previous study . The program was safe and successful in terms of achieving the objective of making elderly PD patients familiar with Tai Chi and other exercises.
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Tai Chi Improves Balance And Motor Control In Parkinsons Disease
Parkinsons is a severe neurodegenerative disease that can affect the neurons adversely resulting in complications like the inability to maintain body balance and to regulate movements.
An article published by professors from Harvard Medical School describes how new safe therapies are sprouting up every now and then for the effective treatment and prevention of Parkinsons disease.
The article was written in support of the study performed by a group of researchers from the Oregon Research Institute.
They investigated the positive effects of Tai chi therapy on patients with disabled balance and motor control.
A twice weekly therapy of Tai chi strengthened the muscles and improved balance significantly reducing their risk of falls. It prevented a decline in motor control functions.
Although resistance training and stretching are other alternative exercises often recommended to Parkinsons patients, studies have proven that Tai chi produces better results.
In 2012 Li et al. compared the effects of Tai chi with resistance training and stretching on Parkinsons disease.
Participants in the Tai chi group showed better balance and motor control as compared to the resistance training and stretching exercise groups. They had a greater functional capacity and reduced risk to accidental falls.
Parkinsons patients experience backaches as a result of poor posture.
Tai chi comprises of exercises that focus on maintaining the right posture and help manage back and neck aches.
Parkinson’s Disease And Taoist Tai Chi Arts
If you have been recently diagnosed or have been suffering for years, you know that Parkinsons disease can cause problems with movement, posture, balance and cognition. Research into Tai Chi and Parkinsons disease shows that Tai chi is very effective in helping people who have Parkinsons. With Taoist Tai Chi® practice you can move more freely, maintain flexibility, find better alignment, posture and balance, and improve cognition. In addition, people practicing Taoist Tai Chi® arts have found a sense of lightness and well-being.
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How Does Taoist Tai Chi Practice Help
Taoist Tai Chi® arts involve a full range of motion with deep stretching and continuous turning of the spine. They exercise the whole physiology including muscular, skeletal, and circulatory systems, as well as tendons, joints, connective tissue and organs. This whole body approach has a profound effect on our health, increasing strength, flexibility and resilience, whatever our condition.
Taoist Tai Chi® arts are also a form of moving meditation that has a deep effect on the brain, calming and clearing the mind.
Move More Confidently Be Active Be Social
Exercise & Parkinsons Research
Exercise is good for the heart and the muscles, but exercise can actually change the brain. Establishing early exercise habits is an essential part of overall disease management, which is why neurologists now recommend exercise as part of most PD treatment plans.
People with Parkinsons who engaged in at least 2.5 hours of exercise a week had a better quality of life than those who didn’t exercise at all or started exercising later.
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Dance For Pd Instructional Dvds/streaming
Cost: vol. 1 DVD $29.99, vol. 2 DVD $59.98, vol. 3 $29.99 DVD, vol. 4 $24.99 stream or download , vol. 1, 2 or 3 streaming $23.99 each, full media bundle $120 .
Each volume is a complete class with movements that draw from ballet, modern dance, tap, jazz and improvisation to create accessible, stimulating dances for all.
Volumes 1 and 3 feature seated and standing dances, and a teacher is always on screen to demonstrate both seated and standing versions. Volume 2 is designed to be done seated. Volume 4 is the first all standing class, but can be equally enjoyed from a chair.
Cost: $20/month
Access a growing playlist of dance classes designed to bring joy to anyone living with a movement concern. Sample class video
Visit Empowered By Movement for live streaming dance exercise classes.
Cost: Free
In early 2019, trained and licensed Dance for PD affiliate, Pamela Lappen, posted a series of twelve 30-minute videos on YouTube using the Dance for PD exercise model. Between March and September 2020, she posted five more exercise videos .
Cost: $39.95 for book/DVD set
This exercise program includes categories such as wake up call, walking and balance, cardiovascular, strength, facial and vocal, and night-time stretching. Suitable for any disease stage, with many levels of difficulty. Designed by certified trainer and orthopedic surgeon with PD.
Cost: $39.95 for book/DVD set
Cost: Free
Cost: Free
Cost: $50/month
How Can It Help In Parkinsons
To date there is limited research into the benefits of Tai Chi for Parkinsons but because it enhances balance and body awareness, it is believed by many to reduce the risk of falls, improve balance and confidence when walking and also improve gait and posture. Some people with Parkinsons have reported improvements in sleep too.
Unlike most sports or exercises, Tai Chi does not rely on strength, force or speed, which makes it possible for a range of abilities, ages and strengths. Even a small amount of practice can bring benefits in health and fitness, enabling the mind and body to relax. This in turn may improve emotional wellbeing and overall quality of life.
As with all physical therapies, you may find some of the activities challenging, but techniques may be adapted to suit individuals your teacher should be able to advise on this. Special care may be needed if you have severe osteoporosis, a hernia or are pregnant
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Inclusion And Exclusion Criteria
All patients aged 18 years and above with confirmed PD ), severity level I to III , that could move independently, had no other severe neurological disorder, had not participated in any kind of physical therapy program in the previous 2 months, and did not have other severe orthopedic disorders were included in the analysis.
Patients with PD disease severity level IV and patients who had received any physical therapy exercise in the previous 2 months were excluded from the analysis.
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Live Large With Parkinson’s At The Countryside Y
Cost: Free
These two 25-minute exercise classes are designed for people with Parkinson’s. The exercises may be done seated or standing, supported by a chair. These videos were created in March/April 2020.
Purchase Info: www.lsvtglobal.com or email
Cost: $28 for DVD or download $15/year streaming
Videos are designed for people with PD to use as an adjunct to LSVT BIG treatment delivered by an LSVT BIG certified clinician. The videos can also be used during the month of therapy and after therapy as a motivation to practice and keep moving. Volume 1 contains standard exercises while standing. Volume 2 contains exercises adapted to seated and supine positions, plus a chapter for caregivers. Available in English, German and Japanese.
Purchase Info: Ohana Pacific Rehab Services, 808-262-1118, online
Cost: $24.50 for DVD $19.50 for book $40 for DVD and book
This program focuses on exercises, flexibility, and pragmatic solutions for walking, moving, falling, and getting up off the floor. Adaptive equipment is reviewed. Demonstrators have PD. Three levels of exercise shown. Designed by a physical therapist.
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Results Of A Conventional Meta
In terms of UPDRSIII, thirteen direct comparisons were constructed using a random effect model. Each pair of comparisons consisted of a control group and a specific type of Tai Chi group. As for the outcome, the 24-form was statistically more efficient than the control group. TCEP , 8-form YS , and 8-form CS did not show a significant difference between TC and control, with P> 0.05 reported.
In a classic pair-wise meta-analysis, fourteen direct comparisons including BBS scores were constructed. All interventions, except for the 24-form, used a random effect model while synthesizing RCTs with the same pair of interventions. For BBS outcome, 24-form and 8-form CS were better than the control group. TCEP did not show a significant difference between TC and control, with P> 0.05 reported. The detailed results of the conventional meta-analysis are presented in Supplementary Datasheet 2.
Instructions To The Class And Monitoring
The investigators coached and supervised the training session for 2 months. Both investigators had more than 5 years of experience in physical therapy, cardiopulmonary resuscitation, and first aid. Participants were asked whether any discomfort was faced and their responses were recorded after the end of the training session. Changes were made on an individual basis in the program.
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Tai Chi May Improve Balance In Parkinsons Disease
S. Andrew Josephson, M.D.
AccessMedicine from McGraw-Hill
Postural instability in patients with Parkinsons disease can lead to frequent falls and progressive difficulty with activities of daily living. Most clinicians encourage these patients to participate in exercise programs in order to improve balance, but evidence for this approach is scant. A recent trial of tai chi, an exercise program that focuses on balance, therefore stands as a potentially important advance for these patients .
The authors randomized patients with idiopathic Parkinsons disease to one of three exercise classes that met for 60 min twice weekly for 24 weeks. One groups class focused on maintaining balance through postural control with tai chi training. A second group was assigned to resistance training using weighted vests and ankle weights, with the goal of strengthening muscles that are key for posture and balance. A third group was randomized to a control condition of low-intensity stretching. Outcome measures assessed at baseline, 3 months, 6 months, and then 3 months after the intervention was complete included two indicators of postural stability as measured by computerized posturographymaximum excursion and directional control.
Tables
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Can The Brain Change
We know that in PD, neurons that produce the chemical transmitter dopamine are damaged and lost. There is a period of time between when the loss of neurons begins and when PD movement symptoms start to show. By the time most people are diagnosed, nearly 80 percent of their dopamine neurons are already gone.
During this period, the brain changes, compensating for the loss of dopamine neurons which occurs during the process of neurodegeneration. Scientists call this ability to change and compensate exercise-dependent neuroplasticity . This same process occurs throughout life in response to experience. As children learn motor skills, for example, their brain cells make new connections. This process continues through adulthood.
Exercise may affect the brain by driving this compensation, or plasticity. People with PD who exercise regularly can move more normally than those who do not. We believe that exercise may be contributing to neuroplasticity helping the brain maintain old connections, form new ones and restore lost ones. This may outweigh the effects of neurodegeneration.
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How To Stay Moving In A Virtual World
The COVID-19 pandemic has been such a significant fixture in our lives over the past year and upended many aspects of our regular routines. Thankfully now that vaccination is becoming more prevalent, people are slowly resuming some of their pre-pandemic activities.
One silver lining of the pandemic is it introduced us to new ways of doing things. For example, we can now access all sorts of activities online, including exercise! APDA has a multitude of online exercise options that guide you safely through exercises designed specifically for people with PD. We even created a special Virtual Events Calendar so you can see all of the online programs available to you just click the Health and Wellness Class filter to find exercise and movement classes that you can participate in from anywhere.
Examples of FREE online exercise classes and resources for you to try:
And if online classes are not your thing, you can download APDAs free exercise guide Be Active & Beyond: A Guide to Exercise and Wellness for People with Parkinsons Disease which shows an assortment of easy-to-follow exercises for people of all abilities.
So clear an area in your living room and get moving!
Brian Grant Foundation Exercise Videos
Cost: Free
Cost: Free for 9 videos $29/month or $290/year for unlimited video streaming.
The nine free classes include boxing fundamentals, HIIT , chair fit, tai chi, core, yoga, stretching/mobility. The free classes are 13 to 30 minutes. Classes are led by a physical therapist with Parkinsons specific certifications.
Paid classes incorporate PWR! Moves, cognitive dual task training, balance training, intensity training, and flexibility. For subscribers, new 20-25 minute videos are released weekly.
Cost: Free
Dance exercise class videos on YouTube. Each is fewer than 10 minutes long. Nearly 30 videos as of October 28, 2020.
Rachelle was featured at the Davis Phinney Foundation Victory Summit Albany in October, 2020. Watch an interview with Rachelle here, and Rachelle’s 25 minute Dance Beyond Parkinson’s Summit presentation here.
Cost: Free
Six seated dance exercise class videos on YouTube. Each is about one hour long. All are with the same instructor.
Cost: Free for 16 videos $50 for 100+ videos
Sixteen archived exercise classes are available for free viewing. Classes are designed to increase coordination, balance, flexibility, and strength through music and movement from a broad range of dance styles. 100+ archived classes and additional benefits are available for a $50 membership.
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Neuroprotective Benefits Of Exercise
Neuroprotection is when your brain works to prevent the death of neurons, or brain cells. For people with PD, exercise is not only vital to maintaining balance, mobility and daily living activities, but it has the potential to have a neuroprotective effect.
The Parkinsons Foundation studied exercise as part of our Parkinson’s Outcomes Project study. Our Center of Excellence network believes that exercise is important to good outcomes in PD, and data supports that. Exercising enhances the sense of wellbeing, even across different disease stages and severities.
Study Finds Tai Chi Exercises May Prove Effective For Patients With Parkinson Disease
In individuals with mild to moderate Parkinson disease, Tai Chi was shown to be a potentially effective meditation technique that may slow down disease progression, according to study findings.
In individuals with mild to moderate Parkinson disease , Tai Chi was shown to be a potentially effective meditation technique that may slow down disease progression, according to study findings published in the Brazilian Journal of Medical and Biological Research.
Researchers aimed to compare the effect of routine exercises to the practice of Tai Chi on physical and clinical performance of elderly people with PD. The researchers collected data from interviews, physical and clinical performance, and levodopa consumption of 500 patients with confirmed diagnoses of PD.
Tai Chi is an exercise based on balance maintenance guided by the yin-yang theory of traditional Chinese medicine originating 6000 years ago. Tai Chi is a safe and effective technique that helps the body and brain, and consists of approximately 108 intricate exercise steps, said the study authors. The National Parkinson Foundation has recommended Tai Chi for PD patients as complementary therapy but little evidence has been provided via clinical trials.
Reference
Li Q, Liu J, Dai f, et al. Tai Chi versus routine exercise in patients with early- or mild-stage Parkinsons disease: a retrospective cohort analysis . Braz J Med Biol Res. doi: 10.1590/1414-431×20199171.
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Study Selection And Characteristics
A total of 773 studies were retrieved from the seven electronic databases. After removing duplicates, 638 articles were included and 585 pieces of literature were excluded for not qualifying the inclusion criteria following a review of the titles and abstracts. A full review of the remaining 53 articles resulted in the exclusion of 33 irrelevant citations, including 4 articles for reporting inappropriate subjects, 19 articles for being not accessible, 8 articles for not reporting outcomes of UPDRSIII or BBS, 1 article for not reporting results, and 1 article for repeating publication of the same study. Ultimately, 20 studies with a combined study population of 996 patients were included in this network meta-analysis , comparing the efficiency of 24-form, TCEP, 8-form YS, 8-form CS, and control group in improving movement disorders for treating PD. The characteristics of the selected articles are shown in Table 1.
Figure 1. Schematic illustration of the literature search and study selection criteria.
Table 1. Basic characteristics of the included studies.