Saturday, August 13, 2022

Cognitive Exercises For Parkinson’s

Move Well With These Exercises For Early

Parkinson’s Brain & Body Workout with Polly Caprio

Parkinsons disease can lead to a wide range of symptoms, but some people with the condition are so early in the PD journey that they dont have strong symptoms in any one specific area. Understanding and developing strong habits early can help a person move well with Parkinsons.

MyParkinsonsTeam has partnered with PD Warrior an organization that specializes in providing rehabilitative exercise programs to people with Parkinsons disease to help spark your exercise journey.

During previous weeks in this six-part series, you learned how to warm up, tackle tremor, overcome bradykinesia , and boost agility. This weeks videos cover the steps required to perform low-impact, neuroprotective exercises that are helpful for anyone with PD, particularly those early on in the diagnosis journey. Theyll also boost your heart rate.

Consider the following guidance before you work through the video:

  • If you arent accustomed to exercising, check with your physician first.
  • If your doctor gives you clearance, it is suggested that you warm up prior to exercising and stretch after you complete your session.
  • Try to engage in exercise three times per week.
  • Feeling some muscle soreness following exercise is normal.
  • Warming up, stretching, and staying hydrated can help combat muscle soreness.

Below are the written steps of the video exercises. You can write them down or print them for reference:

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Fun Games For Boosting Brain Health In Seniors With Parkinsons

By 9 am on June 17, 2019

In addition to tremors, slowness, stiffness, and balance issues, its also common for seniors with Parkinsons to experience cognitive problems, which could include difficulty with solving problems, processing information, doing specific tasks, or paying attention. Playing the following five brain games may help aging adults with Parkinsons manage the cognitive issues theyre experiencing.

Cognitive Training Exercises For Stroke Patients

The following cognitive training exercises can help stroke patients improve their critical thinking skills.

Choose the activities that resonate with you and practice them on a regular basis. Consistency is key to rewiring the brain to recover cognitive skills needed for daily life.

Here are some great cognitive training exercises:

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What Happens To The Brain During Exercise

What is happening in the brain during exercise? A Neuro Cycle Class, a Pedaling for Parkinsons class, an RSB class, and a DTD class are designed to help the brain rewire for change. During aerobic exercise at higher intensity levels, muscles contract and release a hormone called Irisin. Irisin is called the exercise hormone , releasing into the brain a protein called Brain-Derived Neurotrophic Factor . The presence of this protein is key to maintaining neurons and creating new ones . And what this means for those living with Parkinsons is life-changing results.

Exercises For Cognitive Impairment

Gait Training

Even a moderate amount of physical exercise can benefit us all, including those with neurological diseases like PD. Harvard Health Publishing notes that, Exercise boosts your memory and thinking skills both directly and indirectly. It acts directly on the body by stimulating physiological changes, along with encouraging production of growth factors chemicals that affect the growth of new blood vessels in the brain, and even the abundance, survival, and overall health of new brain cells. One way Bev practices movement therapy is by dancing, which I wrote about in June.

Nutrition can also play an important role in promoting better brain function. A study published in the Journal of the American Geriatrics Society found that adhering to a Mediterranean diet, which emphasizes whole grains, fruits, vegetables, fish, and other items, is associated with improved cognitive function.

In terms of brain exercises for people with PD, one option is doing games and puzzles such as word searches. Bev has a booklet of word searches that she keeps on her end table next to the couch. At times, instead of turning on the television, she will turn to the puzzles to work her brain. Just dont ask either of us to play sudoku!

Another brain workout that helps my sister is adding or subtracting manually without a calculator. She sometimes asks me to double-check her totals, but I jokingly tell her, I did not get the math gene, so I am using a calculator.

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Weekly Regimens Of Physical Cognitive Exercises Shown To Slightly Improve Symptoms Of Parkinson Disease

The motor and non-motor symptoms of patients with Parkinson Disease were shown to slightly improve with a weekly exercise regimen of physical and cognitive exercises, according to research presented at Future Physiology 2019.

The motor and non-motor symptoms of patients with Parkinson Disease were shown to improve with a weekly exercise regimen of physical and cognitive exercises, according to research presented this month at The Physiological Society early career conference, Future Physiology 2019: Translating Cellular Mechanisms into Lifelong Health Strategies.

Over time, symptom recurrence of PD has been shown to affect nearly 90% of patients, causing a significant impact on quality of life and financial stability. Previous research exhibited that either physical or cognitive exercises are effective at improving and sustaining cognitive/physical function in patients with PD , however the distinct benefit of different types of exercise on motor and non-motor symptoms has yet to be examined.

Researchers at the University of Kent sought to analyze the long-term effects of multi-modal exercises in PD, as well as compare results to non-exercise-attendees with PD and healthy older adults. The study authors developed a weekly community-based MM exercise session for PD to evaluate its effects on function, cognition, and well-being outcomes across a 3-year period:

Reference

Exercise Is Both Treatment And Prevention

There is growing evidence that exercise, particularly vigorous exercise, may provide neuroprotective effects that can improve motor function, cognition, and quality of life in patients with PD. Exercise is now considered a treatment of PD with multiple benefits and few adverse effects.3,4

Animal and prospective cohort studies provide evidence that vigorous exercise may exert neuroprotective effects and decrease the risk of developing PD. There have been several cohort studies suggesting that regular exercise during the midlife period reduces the risk for PD years later. Meta-analysis of prospective studies affirms the diminished risk of developing PD following moderate to vigorous physical activities in preceding years.5-7 An analysis of 2 prospective cohort studies that included 48,574 men and 77,254 women showed a 60% reduced risk of PD in men who performed at least 10 months of strenuous exercise per year compared to those who regularly exercised less than 2 months per year.5 Similarly, the results of the prospective Cancer Prevention Study II Nutrition Cohort, which followed over 140,000 participants from 1992 and 2001, showed that those who underwent moderate to vigorous activity had 40% lower risk of PD than those who did not.6

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Impact Of Exercise On The Brain

Exercise not only helps the physical aspects of PD but the mental ones as well. It has been shown to help relieve symptoms of fatigue, mood, sleep problems, and mental health.

Dopamine is a neurotransmitter that controls the brains reward and pleasure centers, as well as regulating movement and emotional responses. In PD, there is a dopamine deficiency.

While exercise has not been shown to increase the amount of dopamine in the brain, research does show that it helps it to be used more efficiently.

The exercises that someone with PD should undertake will depend on how limiting their symptoms are. In all cases, the exercise should focus on three areas:

  • flexibility and stretching
  • aerobic, also known as cardio
  • resistance or using the muscles against opposing force

There are many different types of exercise that involve all three of these areas. These exercises include:

  • tai chi
  • Pilates
  • dancing

The exercise type known as random practice has been shown to benefit people with PD particularly. This is an aerobic exercise that challenges the individual to change speed, activity, or direction.

It is also essential for someone with PD to vary activities. This is because people with the condition may have trouble changing activity and doing two activities at the same time. As a result, random practice and variation will help to challenge those symptoms.

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Impact Of Exercise On Cognition

Parkinson’s Brain & Body Exercises to Improve Memory and Movement

Currently, there are no approved pharmacologic therapies that alter disease outcomes for patients with PD and mild cognitive impairment or PD dementia . The prevalence of cognitive impairment in PD varies, but some estimate that up to 30% of patients with PD have cognitive impairment at initial presentation.23 Exercise has been shown to have beneficial effects on cognition in the general population. Aging is associated with progressive reduction of gray matter volume, whereas exercise and cardiovascular fitness are associated with greater cortical gray matter and hippocampal volume.3 Prospective studies have shown increased cortical gray matter or hippocampal volumes in seniors randomized to 6 to 12 months of exercise compared to less active controls.3 Likewise, blood volume of the hippocampal dentate gyrus was increased at the end of a 3-month exercise program, which correlated with aerobic fitness defined by peak VO2.3 In addition, there is less brain atrophy in patients with AD who are cardiovascularly fit.3 These studies suggest that improved cardiovascular fitness preserves brain tissue in regions vital for memory and cognition.

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Activities From The Cognitive Stimulation Therapy Program

Activity 1: Differences and Similarities

How can you group each of the images down below in each set. Think about the differences and similarities. Can you find more than one association between them? Write down your categories or print out the images and create physical groups!

Activity 2: Sports

1) Do you like to watch sports? Why or why not?2) How do you think sports have changed throughout the years?3) Did you play any sports in your childhood?a. What is a memory of playing a sport in your past?Answers: 1) Basketball, 2) Soccer, 3) Tennis, 4) Boxing, 5) Baseball, 6) Football, 7) Hockey, 8) Golf, 9) Bowling

Activity 3: Synonyms

1. What strategies did you use to complete this activity?2. Which terms were easier for you to think of words with the same meaning?a. Why do you think that?3. Set a timer for 60 seconds and try this activity with new words. Did you think of more or less words?

Activity 4: Music MemoryMay 22, 1965 BeatlesTicket To Ride single hits #1!

Listen to the song and discuss the questions below:1. Did you enjoy listening to the Beatles? If so, what did you like about them?2. What are your favorite songs from the Beatles?3. Do these songs bring back any specific memories?4. Why do you think the Beatles were so famous?

Activity 5: Fashion Trends

Activity 6: Toys

Physical Exercise For Parkinsons Disease: Clinical And Experimental Evidence

1Institute of Psichiatry, Federal University of Rio de Janeiro , Rio de Janeiro, Brazil

2Castelo Branco University, Rio de Janeiro, Brazil

1Institute of Psichiatry, Federal University of Rio de Janeiro , Rio de Janeiro, Brazil

3Physical Activity Neuroscience, Physical Activity Sciences Postgraduate Program Salgado de Oliveira University, Niterói, Brazil

4Physical Education Department, Faculty of Unidas de Campinas , Goiânia, GO, Brazil

5Politechnique Institute of Porto, Healthy School, Porto, Portugal

8Intercontinental Neuroscience Research Group, Yucatán, Mexico

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Data Extraction And Quality Assessment

Two investigators independently extracted the relevant data and information from the eligible studies. Basic information about the study characteristics , population, interventions and comparisons , and measurement outcomes was extracted. Another two reviewers evaluated the quality of the included studies based on the standard criteria of the Cochrane Risk of Bias Tool . Any disagreements that existed were resolved through discussion. If necessary, a senior investigator was consulted to achieve a consensus.

Effects Of Physical Exercise On The Treatment Of Parkinsons Disease

Parkinson

Other therapeutic strategies have been evaluated clinically and scientifically in recent years in the search for an action to reduce clinical problems of PD, such as, non-pharmacological interventions like physiotherapy and physical exercise . Rehabilitation through physical therapy has a variety of goals and methods that generally promote benefits in parkinsonian mobility, posture, and balance. However, some limitations have been observed in a consensual way by some researchers in two topics: in relation to the benefits that seem to be more immediate , and the variety and low methodological quality of the studies . Other nonpharmacological approaches to rehabilitation in Parkinson’s disease are the practice of different modalities of physical exercises such as walking, running, strength training, whole body vibration and functional exercises, which are related to the reduction in the risk of falls, decreased motor symptoms, motor performance improvements, balance and gait improvements, positive repercussions in quality of life and executive functions .

Kurtais et al. investigated the effects of six weeks of supervised treadmill walking, three times a week for 40 minutes in patients with mild to moderate PD, and observed significant improvements in lower limb functional parameters such as walking, balance, and agility, and in related parameters, the adaptations promoted by aerobic exercise as increase of peak VO2 and caloric expenditure in METs .

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Should I Talk To My Healthcare Provider Before I Start Exercising If I Have Parksinsons Disease

Talk to your neurologist and your primary care provider before starting a new exercise regimen. They can:

  • Counsel you on how intense your exercises can be.
  • Recommend exercises appropriate for your individual health.
  • Refer you to a physical therapist to create a personal exercise program.
  • Warn about exercises to avoid based on your particular challenges or limitations.

Pharmacological Treatment Of Parkinsons Disease

Pharmacological treatment of PD is based on the replacement of dopamine levels in the brain, which generally promotes the temporary improvement of physical disability and control of some of the symptoms. The medication considered gold standard in the treatment of PD motor symptoms is Levodopa , a metabolic precursor of dopamine that crosses the blood-brain barrier easily. Once in the Central Nervous System, L-Dopa is metabolized basally by DOPA decarboxylase, leading to dopamine. L-Dopa is marketed in association with a decarboxylase inhibitor drug , preventing the peripheral synthesis of dopamine and ensuring the drug’s arrival in the brain . Other drugs are available, in most cases in association with L-dopa, and are divided according to the mechanism of action in order to increase the concentration of dopamine levels such as Monoamine Oxidase-B , Catechol-O-Methyl Transferase inhibitors, or dopaminergic agonists such as Pramipexole . However, pharmacological treatment for PD has limitations ranging from possible drug interactions and side effects , to decrease in its efficacy with years of use and the appearance of secondary symptoms such as dyskinesias and fluctuations , due to the lack of effectiveness of the treatment of non-motor symptoms of the disease . The choice of drug or association that will be administered to the patient depends on factors such as age, stage of the disease, type of activity performed by the patient, and their mental state.

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Information Sources And Study Selection

We systematically searched Medline , Embase, PsycInfo, CINAHL, and CENTRAL for the term Parkinson’s in combination with widely used terms describing cognition-based intervention from inception to November 6, 2014. There was no limit on publication language. Reference and citation lists of relevant studies were manually scanned for potential eligible articles. One reviewer performed initial eligibility screening by assessing titles and abstracts of all results. Following initial screening, 2 independent reviewers assessed full-text versions of potentially eligible articles.

How Does Exercise Change The Brain

Brain & Body Parkinson’s Exercises with Polly

Exercise affects how efficiently dopamine is used in the brain it does not produce more of the hormone dopamine. According to the Parkinsons Foundation, exercise improves this efficiency by modifying the areas of the brain where dopamine signals are received.

When dopamine travels through the brain, it connects to two brain cells through a space called the synapse. For one cell to close off the signal of dopamine to send it to the next cell, a protein complex known as the dopamine transporter has to pick it up. Studies have shown that people who exercise more have less of the dopamine transporter, allowing the dopamine to stay in the synapse longer and send a longer signal.

Dr. Joseph Jankovic, neurologist at Baylor St. Lukes Medical Center, has been a principal investigator in over 100 clinical trials for treatments of Parkinsons disease. He is also the founder and director of the Parkinsons Disease Center and Movement Disorders Clinic, which has been recognized as a Center of Excellence by the National Parkinsons Foundation.

People who exercise also have increased connectivity within the brain, and they have less age-related degeneration of the brain. All of these factors support a notion that the brain benefits from long-term exercise, and this has been specifically shown in patients with Parkinsons disease.

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Cognitive Training In Parkinsons Disease: A Review Of Studies From 2000 To 2014

Daniel Glizer

1MacDonald Lab, Brain and Mind Institute, University of Western Ontario, London, ON, Canada

2Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada

Abstract

Cognitive deficits are prevalent among patients with Parkinsons disease , in both early and late stages of the disease. These deficits are associated with lower quality of life, loss of independence, and institutionalization. To date, there is no effective pharmacological treatment for the range of cognitive impairments presented in PD. Cognitive training has been explored as an alternative approach to remediating cognition in PD. In this review we present a detailed summary of 13 studies of CT that have been conducted between 2000 and 2014 and a critical examination of the evidence for the effectiveness and applicability of CT in PD. Although the evidence shows that CT leads to short-term, moderate improvements in some cognitive functions, methodological inconsistencies weaken these results. We discuss several key limitations of the literature to date, propose methods of addressing these questions, and outline the future directions that studies of CT in PD should pursue. Studies need to provide more detail about the cognitive profile of participants, include larger sample sizes, be hypothesis driven, and be clearer about the training interventions and the outcome measures.

1. Introduction

2. Results

2.2. Waitlist-Controlled Studies

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