Physiotherapy And Parkinsons Disease: Learn How Stretching Can Improve Your Symptoms
Parkinsons disease is the most common neurodegenerative motor disorder, with motor symptoms such as tremors, muscle stiffness, inertia or freezing.
Muscle strength can be reduced in people with Parkinson’s disease, not because the muscle itself is damaged, but because the brains control on the muscle is reduced, and partly because the muscles are used less intensively . Such motor symptoms can be painful, and there is medication that can successfully reduce them. Paired with medication, an exercise routine that includes stretching can improve motor symptoms.
In general, stretching is an important part of the exercise routine. Daily stretches keep and improve flexibility, prevent stiffness, lead to improved balance and posture, and daily activities such as walking and writing become much easier to do. As the experiences of people with Parkinsons disease are different from one another, so is the stretching routine. Make sure to discuss with your physiotherapist to find a program specific to your needs.
How To Start Exercising If Youre Living With Parkinsons
Safety is key. The first thing you need to do is talk with your neurologist and primary care doctor to make sure that the exercise regimen that you embark upon is safe for you.
Next, ask for a referral for physical therapy. A physical therapist will be able to figure out what movement challenges you may have and design a program to help you improve. There are certain physical therapists with additional training in Parkinsons. Your physical therapist will work with you for your allotted sessions, and then can help you plan your ongoing exercise regimen that is tailored to you. You can contact the APDA National Rehabilitation Resource Center for Parkinsons Disease for help finding resources in your area.
Additionally, physical therapy can help counteract the tendency for people with PD to reduce the size of their movements. The Lee Silverman Voice Technique has designed a program called LSVT-BIG which trains participants to make big movements. You can search for an LSVT-trained professional near you.
Anyone starting out on an exercise program could benefit from APDAs Be Active & Beyond exercise guide which includes clear photos with simple instructions that are easy to follow, with exercises that address all levels of fitness.
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 .
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Tips For Exercising Safely
Before starting an exercise program, consult with your neurologist and primary care doctor about any health concerns and ask for recommendations, the Parkinsons Foundation advises.
Ask your doctor to refer you to a physical therapist who knows about Parkinsons together, the two of you can identify any concerns and physical limitations you may have. Your exercise regimen should be targeted to address your symptoms and physical limitations.
You should stop any exercise or stretch that causes pain, and take steps to prevent falls while exercising, such as:
- If indoors, remove area or throw rugs
- Work out in well-lit areas
- Dont use rolling chairs
- Work out with friends or buddies, particularly when performing outdoor activities
- Stay hydrated
- Avoid overexertion
Walking Hiking Or Jogging
Walking, hiking and jogging helps get your body moving, and dont worry you can perform at your exact desired pace. Raising the heart rate through cardiovascular exercise holds many benefits, and this is one of the best ways to do so.
Aerobic exercise is one of the best forms of exercise for those with Parkinsons, and it can be achieved in the great outdoors or on a treadmill. The choice is yours.
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Balance Exercises For People With Parkinsons Disease
Parkinson is a progressive disorder of the central nervous system, affects an individuals motor system and results in shaking, tremors, difficulty in walking, etc. While there are medications like Levodopa and Amantadine which are often prescribed to Parkinsons disease. Exercising could be one of the best ways to stay healthy in Parkinson. So, maintaining balance can be a challenge for people who are suffering from Parkinsons disease. Today, we will share top 12 balancing exercise for people with Parkinsons disease.
Guidance From An Accredited Exercise Physiologist
Its important to contact a health professional before commencing exercise to ensure your safety. An Accredited Exercise Physiologist can assess and tailor an exercise program specific to your individual needs. They will supervise your exercises and ensure you start at a light intensity, gradually increasing your prescription based on your progress. Sometimes individuals with Parkinsons may need to be cautious during hot temperatures, around trip hazards and if they are fatigued or unwell. Your Accredited Exercise Physiologist will adapt your program and always be there to guide you.
to find an exercise physiologist near you.
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What Type Of Exercise Should I Do If I Have Parkinson’s Disease
Exercise is a planned, structured, repetitive activity that is intended to improve physical fitness. There is no right exercise for people with Parkinsons. Everyones regimen will differ, depending on overall health, symptoms and previous level of activity. Any exercise helps, and a variety of exercise types may provide well-rounded benefits.
Aerobic exercise involves activities that challenge your cardiorespiratory system such as walking, biking, running, and activities in the pool. Participating in aerobic exercise at least three days a week for 30-40 minutes may slow Parkinsons decline.
Strength training involves using your body weight or other tools to build muscle mass and strength. Strength training two days per week, starting with low repetition and weight, may be beneficial in Parkinsons disease. A focus on extensor muscles, or muscles in the back of the body, can help with posture.
Stretching two or more days per week can be beneficial to maintain range of motion and posture. Holding each stretch of major muscle groups for 30 to 60 seconds can improve muscle length.
Balance and agility training
This type of training often combines aerobic exercise, strength training, and flexibility training. Examples include:
- Tai chi, yoga or Pilates.
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.
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Parkinsons Disease Stretching Exercises
Here is a selection of some functional Parkinsons disease stretches notice that you should follow our general stretching guide when performing the Parkinson Exercises described below :
In general, you should have in mind that, since stiffness is a major enemy which can potentially result in Parkinsons disease, it is vital to keep as many of your body areas stimulated as possible for instance, try using your hands, palms and fingers for daily tasks, squeezing a small ball in your palm, marching in place with your knees high and many more!
Watch the photos below for a better understanding of the stretches described above! Its crucial to perform the exercises as accurately as possible in order to grab the usual Stretching Benefits
The pics and the video below make it easier for our visitors to find how each stretche described above can be executed! So have a careful look on them:
Other Parkinsons Disease Treatment Options
Apart from the above described stretches, additional Parkinsons disease treatments may include:
- Medications, which aim at supplementing or substituting dopamine, the neurotransmitter which, as mentioned previously, Parkinsons disease sufferers have deficiency in
- Supportive therapies, which are designed for making the sufferers routine easier help you cope with everyday life
Aerobic Exercise Helps You Maintain A Healthy Weight
Aerobic exercise helps keep your heart healthy while helping your body burn calories and maintain a healthy weight. Examples of aerobic exercises include walking, jogging, running, swimming, dancing, water aerobics, chair aerobics, and biking.
The Parkinsons Foundation recommends doing 30 minutes of aerobic exercise a day, five times a week. Your routines are up to you, and you can design them around any physical limitations.
I really encourage my patients to get out into nature, go for a walk in the park with a friend or spend time in the garden, Subramanian notes. Being outside in the sunshine is healthy, as long as you dont get too much sun, and walking or hiking can get your heart rate up. Doing these activities with friends or caregivers is also fun and helps avoid the isolation some people with Parkinsons experience.
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How Often Should I Exercise
Science has clearly shown that the benefits of exercise can be felt after just a few weeks of practice, as long as the frequency, duration and intensity are sufficient, regardless of the starting health condition. And to maintain the gains, the practice simply needs to be maintained over the long term sometimes over a period of several months and with the right support.
Even in an advanced stage of Parkinsons, the simple act of adding 30 minutes of physical activity per week can help reduce loss of mobility and decline in quality of life. People with Parkinsons disease are recommended to get 2.5 hours of moderate-intensity physical activity per week, which corresponds with the World Health Organization guidelines for adults.
Regardless of the type of physical activity performed, you can expect positive effects. What matters most is attendance, the level of effort, and a sense of security and self-efficacy. Physical activity is a great treatment that can help all people living with Parkinsons disease.
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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.
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Stretching And Flexibility Exercises Help Keep You Limber
The Parkinsons Foundation says that stretching and flexibility exercises should be the first step in your exercise program. These exercises help offset the muscle rigidity that comes with Parkinsons disease, and people who are more flexible tend to have an easier time with everyday movements like walking, the Parkinsons Foundation adds.
Although theres no standard stretching regimen for people with Parkinsons, the Foundation suggests:
- Performing stretching routines lasting at least 10 minutes at a time
- Stretching at least three to four times per week
- Holding stretches for 10 to 30 seconds and performing three to four repetitions of each stretch
- Breathing evenly in and out during each stretch
- Not stretching to the point of pain instead, each stretch should feel like a gentle pull
In addition, a flexibility program should focus on areas of the body most affected by symptoms, including the chest wall, shoulders, elbows, back of the thighs and knees, calves, wrists and palms, lower back, and neck.
Stretches and flexibility exercises can be performed while seated or lying down, to avoid strain on your muscles and fatigue.
When Should Someone With Parkinsons Start Exercising
After youve been diagnosed with Parkinsons, try to start an exercise regimen as soon as possible, says the Parkinsons Foundation. The foundation calls this the pre-habilitation stage, and warns against waiting until you start to have pain or problems with your movements to begin an exercise regimen.
Still, its never too late to start. People who have advanced Parkinsons and exercise have better health-related quality of life than people who dont exercise, so its important to stay active and even try new routines as your condition progresses.
There are so many benefits to exercise with Parkinsons disease, Subramanian says. In addition to all the positive effects on symptoms and progression, there are other benefits as well, including social ones, if you work out as part of a group. Exercising will also likely help you to sleep better, which is important for overall health.
Really, she continues, the more physical activity the better, as long as youre safe. And if youre worried about staying motivated, a general rule is that any exercise that you love is something youre going to keep doing.
Dont hesitate to try different things, too, which will challenge your brain and your body. Youll see the positives right away, she says.
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They Can Host Virtual Training Sessions
If the COVID-19 pandemic has taught us anything, its that participating in virtual events can be just as effective as being there in person. Training sessions with kinesiologists are no different. Some kinesiologists can host a training session through videoconference, so you dont even have to leave the comfort of your home.
Virtual training sessions still allow group participation for those who are more motivated to exercise as a social activity. And, of course, here in Canada, its important to support both Anglophone and Francophone groups.
Virtual group training session for neuro balance.Virtual group training session for neuro flexibility.Virtual group training session for chair exercises.Virtual group training session for neuro intensity.Virtual group training session for neuro strength.
New Types Of Exercise For Parkinsons
Researchers are continually studying different types of exercise for PD and APDA works to keep you informed about these new findings.
- Karate People who participated in a study involving a 10-week karate class program noticed improvements in gait, quality of life and self-reported impression of change. We highlighted this research study at the 2019 American Academy of Neurology Annual Meeting.
- Golf A preliminary study was done to determine if golf is a beneficial mode of exercise for people with PD We highlighted this research at the 2021 American Academy of Neurology Annual Meeting.
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Which Types Of Exercise Are Best For Parkinsons
It is important to state upfront that there is no one best type of exercise for people with PD. It is most important to choose an exercise regimen that you enjoy, and will continue to do.
However, beyond doing exercise that you will stick with, there are some additional concepts to consider when designing an exercise program for someone with PD.
So What Type Of Exercise Is Best
There are many different forms of exercise, but what type is right for you? Every individual is different! Its important to remember that although a combination of aerobic, resistance and balance exercises have the best overall effect, you may need to modify each element to your suit your unique circumstance.
Aerobic exercise is described as continual movement to assist in the improvement of cardiorespiratory function. This includes walking, cycling, swimming and even dancing! Exercising to music specifically has seen some fantastic results in managing Parkinsons symptoms. Dance for Parkinsons Australia run specialised dance classes across Australia, providing a social environment so share stimulating activity.
Maintaining strength is not only important to keep our muscles healthy, it also helps with daily activities like getting off the toilet and getting out of the car. Resistance exercises can be performed using your body weight, light hand weights, resistance bands, various machines found in a gym setting or even using common household items like cans of food. Moving your muscle under a greater resistance promotes an increase in muscle mass. You may like to participate in group setting, a home program, or a combination of both.
Exercise for Neuroplasticity
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Apda In Your Community
In last weeks blog, we addressed the reasons why it is vital for people with Parkinsons disease to exercise, including improving particular motor and non-motor symptoms such as impaired balance, gait disorders, depression, and cognition.
Today, we will tackle another important question what types of exercise are most beneficial to help people with Parkinsons disease improve their quality of life? Well also address several specific types of exercise designed for people with PD and some tips on how to get started with an exercise program.