Benefits Of Exercise And Medication In Parkinson’s
In the last few years, the importance of exercise has become even more significant for people with Parkinsons. Research is showing that a tailored Parkinsons specific exercise programme is important for your health. This means that alongside medication, the right kind of exercise may improve your overall physical ability, your symptoms and the quality of your life. Exercise helps to slow symptom progression as well as to maintain general health and ward off concurrent cardiovascular risk factors, metabolic conditions, frailty and falls.
Exercise can provide the vehicle to teach you how to achieve that functional and efficient movement again, even if you have to work harder through the movement to achieve it. Parkinsons medication, among other things primarily is used to enhance, replace or simulate the missing dopamine in your system. This can have very good effects on your movement, and to some extent your mood, overall. It is important that your medication is optimised for your needs as well. This often requires regular updates with your doctor to ensure you are functioning at your best.
The best approach to managing your Parkinsons with exercise is to target your symptoms appropriately and to be optimally medicated.
Should I Talk To My Healthcare Provider Before I Start Exercising If I Have Parksinson’s 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.
Which Exercise Is Best For Parkinsons
The exercise you enjoy and will do regularly is the best exercise for Parkinsons.
Walking and balancing exercises, boxing, dancing, treadmill, bike, Tai Chi, yoga, Nordic or pole walking, and swimming are just a few of your options.
Before starting any exercise program, seek assessment by a neurological physiotherapist or exercise physiologist to recommend what levels you need to work at.
For more information regarding the benefits of exercise, types of exercise and exercise opportunities near you, contact the Parkinsons NSW InfoLine team: 1800 644 189.
Parkinsons NSW does not advocate that you use exercise alone without prescribed Parkinsons medication.
For maximum effectiveness, you should combine exercise with an appropriate medication regime. Contact your specialist for advice appropriate to your symptoms and stage of Parkinsons.
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Static Standing Balance Exercises For Parkinsons
You can start by doing a static standing balance exercise. To start, stand with both feet flat on the floor, with your head and belly button level. Lift your left leg off the floor and hold it there for 30 seconds. Then slowly place it back on the ground and repeat with the opposite leg. You can also add other objects to the exercise, such as a chair or table. Try starting out with 5 repetitions on each side and gradually increasing the number of repetitions.
Voice Choral Singing Therapy
Voice Choral Singing Therapy uses music therapy to help patients increase their respiratory volume and reduce vocal fatigue. Research studying VCST has shown it can improve vocal intensity and intelligibility however, it does not provide significant improvements in functional measures of vocal quality.2
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How Can It Help In Parkinson’s
Nordic walking can improve fitness in the same way that running does, but it is much kinder to the ankles, knees and hips as it has a much lower impact on the joints. This can be particularly attractive if you experience joint pain.
Perhaps the most important advantage of Nordic walking if you have Parkinsons is that is allows you to maintain and develop your ability to walk well by:
- enhancing balance and coordination
- reducing slowness of movement
- reducing freezingand gait problems
- improving mobility and creating more fluid movements
- correcting posture, particularly the stooped position associated with Parkinsons
- reinforcing the alternating movements of the arms and legs which can be lost in Parkinsons and so improving stability
- boosting independence and quality of life.
Various studies 1,2 have shown that people with Parkinsons who participate in Nordic walking programmes have improved functional independence and quality of life. It seems that mood also improves.
Once the basic steps have been learnt you can tailor your programme to suit how you feel at any particular time. Walking in a group also has social and psychological benefits.
Carers and family members who walk with you may find that they too feel fitter and have fewer aches and pains.
References
Dr Marina Clements Dpt
Exercise is the best medicine. We know this, but lets admit it sometimes it can be challenging to get motivated to exercise and even more difficult to establish consistency, which is key in making lasting improvements in your health and fitness. That is why I make it my personal mission to make exercise something you want to do. Exercise is a celebration of movement and what your body can do. It should be fun, make you feel good, and it should be something you look forward to doing.
Through my own health and fitness journey, I found that the only exercise regime I could stick to was attending group exercise classes. I fell in love with Zumba, kickboxing, strength, and cardio classes and have continued doing them ever since! There was a community of people who supported each other and held each other accountable for showing up to class each week. I would always leave happy that I showed up to class. Exercise suddenly became a scheduled priority on my calendar. Group exercise became one of my passions, and I knew that I wanted to lead and provide environments for others to improve their health and wellness by becoming an exercise class instructor.
I absolutely adore teaching, and it is my hope that everyone finds their mode of exercise that inspires them! Maybe group exercise will be your passion, too! Outside of teaching for the APDA, I enjoy swing dancing, attending live music events, spending time outside, thrifting, and trying new plant-based recipes.
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Moving For Better Balance
Cost: Free
These two instructional videos — part I is 10 minutes and part II is 5 minutes — are taught by a Jamestown New York YMCA staff member using the “Moving for Better Balance” approach, an evidence-based fall prevention program.
Cost: Free
This 30-minute video is a personal account by Michael Weiss, a person with Parkinson’s. In it he shares stretches, breathing, and physical exercises he has compiled for himself. Exercise demonstration begins 8-minutes into the video and include toe lifts, leg swing, leg lift, knee circles, hip circles, squats, arm stretches, arm twists, shoulder stretches, chair push-ups, bicycle legs, toe touches, chopping wood, conducting, dancing, and facial exercises.
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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Lee Silverman Voice Treatment
The Lee Silverman Voice Treatment is a series of exercises for people with PD. Named for Mrs. Lee Silverman who developed the technique in 1987, LSVT has been scientifically studied for 20 years. Also called LSVT LOUD, the technique focuses on simple tasks that are designed to maximize vocal and respiratory functioning. LSVT LOUD exercises have been shown to have several benefits, including:
- Improving voice quality and loudness,
- Improving the articulation of speech,
- Increasing the inflection ,
- Improving the intelligibility of speech .2-4
Research studies have found that people with PD who are treated using LSVT are likely to maintain improvement in their vocal function for up to two years following therapy.3 LSVT LOUD exercises are administered in 16 sessions over a month and include techniques such as:
- Warm-up: While sitting up straight, the patient says ah in a loud, clear voice for as long as possible, stopping if the voice becomes scratchy.
- Vocal stretches: After taking a deep breath, the patient starts at a low pitch and glides up as high as possible saying an Ah or Ee sound.5
Patients are trained to monitor the loudness of their voice and the effort it takes to produce it. The treatment does not train people with PD to shout or yell, but it uses loudness training to bring the voice to a healthy, improved vocal level without strain. Look for a speech therapist who is certified in the LSVT technique or search for a clinician at the LSVT Global website.4
Re+active Pt Videos For Home Exercising
Cost: Free
re+active has posted to its YouTube channel a few exercise videos, including a seated re+move class , Parkinson’s exercise class , and pole walking .
Cost: Free
This is a series of 66 short videos. There are stretches, warm ups, workouts, fitness challenges, tai chi, and tips & tricks videos. The idea is by the time you’ve followed along with one video in each category, you’ve done a whole body workout.
Cost: Free
Three short videos include quick chair exercises, exercises for stronger legs and glutes, and exercises for better balance.
Cost: $14.95/month or $135/year after a free one week trial
A growing library of workouts for those with Parkinson’s, including: 5-minute workouts, Undefeated Boxing, Rise & Shine morning blast, exercise ball, Brain & Body Bar, and Parkinsons’ workout with towel and ball.
Cost: Free
This collection of pre-recorded exercise videos includes three 20-minute warm up/stretching videos, four 20-minute seated workouts, one 20-minute upper body boxing video, a 9 minute boxing basics video, two one-hour Rock Steady Boxing Winnipeg workouts, two advanced RSBW workouts, and two yoga Parkinson’s workouts.
Cost: Free
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Pathophysiology Of Parkinsons Disease
The progressive death of dopaminergic neurons in the Substantia Nigra pars compacta located in the midbrain, more precisely in the Basal Ganglia , promotes a significant decrease in the levels of the neurotransmitter dopamine, and as a consequence the functional impairment of the neural circuits . The chronic reduction in dopamine levels gives rise to the manifestation of the motor symptoms that characterize this disease. However, the pathophysiology of PD is not limited to the dopaminergic system, that is, neuronal degeneration of other areas of the brain such as the brainstem and cortex competes and even precedes neuronal death in BG. Thus, other neurotransmitter systems are compromised, thus making PD a multisystemic pathology manifested by a series of motor and non-motor symptoms .
Examples of experimental tests showing a high and a low data dispersion.
The cardinal motor signs of PD are: resting tremor, plastic-type muscular rigidity, bradykinesia , and postural instability. This set of symptoms associated or not, forges characteristic clinical signs in patients with the disease such as gait and balance disorders, mask facies and dysarthria. In addition to these symptoms, a set of sensory autonomic and cognitive-behavioral symptoms may manifest during the course of the disease .
Exercise Tips For Parkinsons
Exercise is a vital part of the daily routine for anyone living with Parkinsons.
It doesnt have to be repetitive or boring. It can be as fun and as imaginative as you allow it to be. The keys are consistency, force and complexity. Firstly, lets have a look at how your symptoms can be improved with specific exercises.
| If you have difficulty in these areas | Focus on these exercises |
|---|
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Every Day You Should Be Aiming To:
Learn something new
That could be reading various newspapers, listening to radio shows, listening to audio books, or joining a book club. Also investigate the various memory training puzzles that are available.
Challenge yourself
Volunteer, perhaps with a Parkinsons NSW Support Group or community service organisation, or even in a knitting or sewing group. Make sure you go out each day, even if you feel a little unsteady on your feet. By using a cane or walker, you will gain greater confidence.
Practice writing by making big sweeping movements
A pen grip may help with control and make it easier to grasp your pen lightly and decrease the force required to move it across the page.
Exercise your voice
Tips Before Begin Balancing Exercise For Parkinson People
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Frequently Asked Exercise Questions
Q: If one part of my body needs more attention what should I do?
If you have noticed more symptoms in one particular arm or leg, you may wish to focus on that limb more intensively during each exercise station. Make sure that the particular limb you are focusing on is leading the exercise in effort and amplitude and that you have symmetry between both sides. You may also wish to double the repetitions on that side, especially if there is a marked difference from one side to the other.
Q: How do I avoid injuring myself?
It is really important that you warm up first and follow the instructions for each exercise to avoid injury. If you are just starting out, be gentle on yourself, especially if you are new to exercise or dont exercise regularly. As you become more confident with the exercises you can start to work towards an effort level of 80% and full range of movement weight shift and amplitude. If anything hurts while you are doing the exercises or you feel unbalanced stop immediately. All of the exercises can be modified to be made easier as well as harder so listen to your body.
Q: What about my medication. Is there a better time to do the exercises?
Q: What Clothing & Footwear Should I Wear?
Wear loose, comfortable clothing that breathes well. Layers may help if you have extremes of temperature where you train or are prone to overheating. Your footwear needs to be supportive such as trainers or walking shoes.
What Does A Parkinson’s
Its important to practice Parkinsons specific exercises rather than general exercise training to improve movement because of the type of brain stimulation each type of exercise produces.
Your brain has the ability to help you move better. It learns from all stimulation applied to it, including exercise, and has an enormous capacity to re-wire the neural connections for improved movement. You may not have noticed, but, getting off a low chair, rolling in bed and picking up a cup of water all require infinite amounts of fine-tuning as your brain prepares, conducts and evaluates the task. Your brain is receiving constant feedback about the environment so that it can move with the appropriate amount of speed, power and accuracy to be effective and efficient.
Dopamine deficiency can lead to the continuing reduction of movement, speed and power. Instead of getting up from the chair first time round, it may mean that you have to use your arms to push up, or rock back and forth a bit to get enough momentum to stand up. It is the chronic reduction in a movement that makes big movements like walking and small movements like writing so challenging.
Parkinsons specific exercise will teach you how to move with amplitude, power and speed in everyday tasks so that you can get back to doing the things you enjoy doing. By increasing your overall activity level, Parkinsons specific exercise may also slow down the symptom progression of your Parkinsons.
Exercise frequency
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Strength Training Helps Build Muscle Mass
Strength training can involve lifting weights, using machines at the gym, using your own body weight for resistance, or even using common household items like a milk jug filled with sand, the Parkinsons Foundation notes. Your strength training should focus on the following muscle groups:
- Core muscles
- Arm muscles
- Hands and wrists
In general, strength training should be done two to three times per week, but scheduled so that youre not targeting the same muscles on consecutive days, as your muscles need to rest and recover, the foundation advises.
As with stretching exercises, strength training can be performed while standing, sitting, or while on the ground.
The Wisconsin Parkinson Association recommends several exercises to help strengthen your grip and improve your reach. Tasks such as handwriting and reaching for items on higher shelves can be a challenge for people with Parkinsons disease, and hand exercises can help minimize these issues.
In general, resistance training helps build and maintain muscle mass, Subramanian says. The stronger you are, the more independent youll be.
Pushing Movements: The Push
The push-up is one the most popular exercises of all time! Mastering the “push” is a different challenge. The “push” requires core stability, upper back, and shoulder strength. Once mastered, people living with PD will notice an increase in power and strength.
*Word of caution: Parkinson’s Disease typically affects a person’s posture. Please remember that anything overhead will alter the center of gravity, which means some fighters need to perform a “push” exercise that keeps the arms closer to the body.
| Exercise- Wall Push-up | ADL- Rising from the floor |
| Push-up on Smith Machine Bar | House cleaning |
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