Thursday, September 22, 2022

Parkinson’s Disease Physical Therapy Exercises

Meaningful Physical Activity For Those Impacted By Parkinson’s Disease

Parkinson’s Disease Exercises: LSVT BIG Movements

On the Day 2 video of the Upper Midwest Parkinson’s Symposium, at timestamp 1:31, you will find a one-hour talk by Dr. Kristin Pickett, PhD. She explains the difference between occupational therapy and physical therapy . She believes those diagnosed with Parkinson’s disease should have PT, OT and speech therapy as part of their care team early on. Especially if you hate “exercise,” you can incorporate physical activity/movement into your everyday tasks. This is what she means by “meaningful physical activity.”

Voting On The Recommendations

GDG members agreed on the strength of every recommendation. Recommendations were approved and adopted when a majority of 60% of the GDG voted to approve. All recommendations received 100% agreement among the quorum of the voting GDG. No disagreements were recorded during recommendation voting. When changes were made to the strength of a recommendation based on the magnitude of benefit or potential risk, harm, or cost, the GDG voted and provided an explanation in the rationale.

Spotlight On Parkinson’s Disease: Staying Healthy Keeping Fit

In this 45-minute webinar Terry Ellis, PhD, PT, shares which Parkinson’s symptoms are reduced by what types of exercise, the intensity of exercise required to have an impact on PD symptoms, how to overcome resistance to exercising, and tips for implementing an effective exercise routine. In the last 15 minutes of the webinar Dr. Ellis answers listener questions.

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Establish A Regular Exercise Routine

Outside of seeking physician approval, its important to understand that the best exercise for Parkinsons disease is the kind that patients enjoy and will stick with. Forming a new habit can be daunting, but long-lasting physical fitness regimens are the most effective against PD symptoms regardless of their intensity. Activities that raise your heart rate and promote deep breathing are ideal, but every little bit helps. If an activity isnt clicking after giving it a fair try, then move on to something else that might be more promising.

Assessment Of Gait Parameters

Pin on Fibro/MS

Stride time , percentage of double stance time , stride length and the coefficient of stride length were assessed at different walking speeds on a motorized medical treadmill ergometer. There is sufficient evidence that gait variability is increased in basal ganglia disorders . Furthermore, increased stride-to-stride variability might reflect a failure of automatic stepping mechanisms . Increased gait variability can be seen throughout the course of Parkinsons disease and has been found to be one aspect of walking, closely associated with risk of falls in the elderly .

For better comparison of the training effects patients walked at 6 different walking speeds prior and after the training period. The treadmill was equipped with force platforms, that allowed an accurate determination of foot-ground contact. Patients were not allowed to use the handrails of the treadmill for support.

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Try Seated Exercises If You Have Limited Mobility

Performing strength and flexibility exercises while sitting can help you stay fit and improve your range of motion all with minimal stress and wear and tear on your muscles and joints.

An example of a seated stretching routine recommended by the Parkinsons Foundation is the hamstring stretch. To do this stretch:

  • Sit tall in a chair and place one leg straight out on another chair.
  • Keep your toes pointed upward, your knee flat, and your back straight.
  • Gently reach for your toes with both arms.
  • Only reach as far forward as you can without bending your knee and without feeling strain.
  • Switch legs and repeat.
  • An example of a strength exercise you can perform while sitting down is the shoulder blade squeeze. To perform this exercise:

  • Sit with your back straight and your buttocks forward on the edge of a chair.
  • Open your arms out to the sides, with your fingers spread.
  • Pull your arms back and squeeze shoulder blades together.
  • Your physical therapist can recommend additional seated exercises.

    Flexibility / Stretching Exercises

    1. Body TwistSit on the edge of a seat. Sit tall. Turn your shoulders to the right. Place your right hand behind you. Twist your body and head to the right as far as you can go without any pain, only a stretched feeling. Hold. Try to relax and breathe.

    2. Wall HangFace a wall and stand with your feet about 30cm from the wall. Lift your hands straight above your head and place palms on wall, as high as possible. Lean forward without arching your back. The stretch should be felt under the arms and in your chest. If this is too easy, take the feet further back from the wall.

    If you can reach, rest your hands on the frame at the top of the door. Keeping your arms straight, slowly lean forward until you feel a gentle stretch. Hold. Do not over-stretch.

    3. Doorway Bend

    Stand near a doorway. Lift your arm to the side, up to shoulder height. Bend your elbow to 90 degrees and place the entire forearm on the door frame. Gently turn your body away from the arm and feel a stretch in the shoulder and chest. Hold. Repeat on the other arm.

    4. Side Bend

    Sit tall in a chair that doesnt have arms.Lift one arm over your head and curve your body to the side.Keep your buttock firmly on the seat so you dont tip the body.A stretch should be felt on the side of the body. Hold. Repeat for the other side. Do not lean forward or backwards.

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    Peer Review And Public Commentary

    Following the formation of a final draft, the CPG draft was subjected to a 3-week peer review for additional input from external content experts and stakeholders. More than 250 comments from 12 societies were collected via an electronic structured review form. All peer reviewers were required to disclose any potential conflicts of interest, which were recorded and, as necessary, addressed.

    After modifying the draft in response to peer review, the CPG was subjected to a 2-week public comment period. Commenters consisted of the APTA Board of Directors , the APTA Scientific and Practice Affairs Committee, all relevant APTA sections and academies, stakeholder organizations, and the physical therapy community at large. More than 47 public comments were received. Revisions to the draft were made in response to relevant comments.

    Physical Therapy Exercises For Patients With Parkinson’s Disease

    Parkinson’s Disease Exercises: Strengthening and Balance

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    What Types Of Exercise Are Best For People With Parkinsons Disease

    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.

    Study Design And Participants

    We retrospectively identified PD patients, hospitalized at the Department of Parkinsons disease and Movement Disorder Rehabilitation of Moriggia-Pelascini Hospital in Gravedona ed Uniti , from January 2015 to June 2018, to undergo a 4-week Multidisciplinary Intensive Rehabilitation Treatment .

    • Eligibility criteria were as follows: diagnosis of idiopathic PD according to the UK Brain Bank criteria Hoehn and Yahr stage 2 to 4 ability to perform both the OConnor finger dexterity test and the Minnesota manual dexterity test .

    • Exclusion criteria were as follows: diagnosis of atypical parkinsonisms, psychosis, auditory and visual dysfunctions, and comorbidities impairing autonomy in ADL.

    The study design and protocol were approved by the local Ethics Committee and were in accordance with the code of Ethics of the World Medical Association . All patients signed an informed written consent form for the use of their clinical data for scientific purposes. This trial was registered on ClinicalTrials.gov website }NCT03763955.

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    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.

    Assessment Of Technical Skills

    LSVT for Parkinson

    The technique of the Nordic walking training appeared to be very challenging for the patients. Patients had difficulties in opening the hands during the push-off phase. Furthermore, patients tended to carry the pole without weight loading with the more affected hand. However, the group managed to learn the Nordic walking technique, but the level of performance differed between the patients. 17 of the patients mastered the NW technique very well, 10 patients showed a good technical performance and 3 patients performed poorly. Both the NW group and the walking group had difficulties in employing a diagonal sequence and an interlimb coordination. Patients did not notice the technical deficits and depended on the coaching of the instructors.

    Seated Option: Calf Stretch with Strap

  • Start seated on the edge of the chair with a yoga strap in hand.
  • Extend your right leg and loop the strap under the ball of your foot. Keep your heel on the floor, knee slightly bent.
  • Using the strap, gently pull your toes towards you until you feel a stretch through your calf. Hold 1-3 seconds and release. Repeat 10 times.
  • TAKE IT DEEPER:
  • Use the strap to pull your toes toward you, leading with the big toe and turning your ankle slightly inward. Hold 1-3 seconds and release.
  • Use the strap to pull your toes toward you, leading with your pinky toe and turning your ankle slightly outward. Hold 1-3 seconds and release.
  • Repeat 5 times each side.
  • Switch legs and repeat on the left side.
  • Repeat 20 times.
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    Comparison Of Exercisers And Nonexercisers

    Exercisers had significantly lower UPDRS motor scores than nonexercisers, indicating a lower severity of motor impairments . Exercisers were significantly less depressed, had significantly fewer restrictions in participation, had higher self-efficacy, and were more highly educated compared with nonexercisers. However, the 2 groups did not differ significantly on number of comorbidities, distance walked, number of falls, or other personal or environmental characteristics.

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    If I Exercise Will I Still Need My Parkinsons Medications

    Some people find that exercise helps them reduce the doses of Parkinsons medications over time. But exercise is not a replacement for your medications. In fact, some people need more medications so they can stay active. Dont make changes to your medications without talking to your healthcare providers.

    How To Exercise With Parkinsons

    Exercise Strategies for Stability, Stamina & Strength for Parkinson’s from a Physical Therapist

    Whether you’re a first-time exerciser or a lifelong athlete, the key to working out with Parkinsons is to safely and regularly move your body in a variety of ways. Your fitness regimen should include these four main categories of exercise:

    • Aerobic activity
    • Balance, agility, and multi-task exercises
    • Stretching

    People with Parkinsons should strive to perform aerobic activity at least three times weekly and to complete exercises from the other categories two to three times each week.

    In total, the Parkinsons Foundation suggests performing 150 minutes of moderate tovigorous exercise weekly.

    To help you achieve this goal, try these helpful tips:

    • Invest in a treadmill, elliptical, or exercise bike. This will make it convenient to perform aerobic exercise from your home, regardless of the weather.
    • Obtain a set of light hand weights from a local exercise shop or thrift store. These can be used for a wide variety of strength training exercises.
    • Follow along with one of the many online exercise classes on YouTube that are tailored to people with Parkinsons disease. The Parkinsons Foundation and the Davis Phinney Foundation offer many great online exercise videos.
    • Connect with a workout buddy by finding a local Parkinsons support group associated with the American Parkinson Disease Association

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    What Type Of Physiotherapist Should I See

    Any physiotherapist you see should ideally specialise in Parkinsons.

    Like many other healthcare professionals, physiotherapists specialise in different areas of practice. Some work specifically with people with neurological conditions like Parkinsons, and some have additional qualifications in exercise and fitness training, especially those working in gym settings.

    Your physiotherapist will assess how Parkinsons affects your movement, whether youre newly diagnosed, or youve had the condition for some time. This means they can help to keep up your fitness levels, and maintain good posture and balance as your condition progresses. This will help you remain independent.

    You may feel that your mobility is very good and that you are exercising without any problems. But a physiotherapist can also help you maintain your mobility to help avoid any future issues.

    Your physiotherapist should form part of your support network, involving your family and carers, in helping you manage your Parkinsons.

    Seeing a physiotherapist can have a number of benefits for people with Parkinsons and their carers. These are outlined below.

    Which Works For Me

    After your evaluation, let your therapist decide which exercise program is best for you. It is never too early or too late to start an exercise program for Parkinsons. Research has demonstrated functional improvements at all stages of the disease. Your therapist will determine with you which treatment protocol best suits your needs. Contact us to schedule your evaluation.

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    Be Active & Beyond: A Guide To Exercise And Wellness For People With Parkinson’s Disease

    This 36-page booklet outlines the importance of exercising for those with PD, discusses barriers to exercise and how to overcome them, distills exercise guidelines from several organizations into a quick reference chart for those with PD, provides information on exercise basics and how to get started along with specific exercises to increase endurance, strength, flexibility, and balance, and an exercise log to keep track of progress.

    The Basic Elements Of Exercising With Parkinsons

    Parkinsons Patients Learning Power of Exercise

    There are four core elements of exercise that are important for people with PD:

  • Aerobic e.g. brisk walking, stationary cycling activities that get the heart pumping
  • Strengthening e.g. using weights or resistance bands to improve muscle strength
  • Balance e.g. tai chi, dance to help you be more steady on your feet
  • Stretching e.g. mat exercises, yoga to provide flexibility
  • Including all four of these elements in your exercise regimen is ideal .

    Aerobic activity or high-intensity exercise may be particularly important for Parkinsons and general health

    High-intensity exercise has been formally studied in PD with impressive results. The Study in Parkinson Disease of Exercise Phase 2 enrolled 128 people with early PD, who were not yet on dopaminergic medication into three groups:

    • a high-intensity treadmill exercise group, in which people exercised at 80-85% of their maximum heart rate
    • a moderate-intensity treadmill exercise group, in which people exercised at 60-65% of their maximum heart rate
    • a wait-list control group

    After six months, the high-intensity group had essentially no change in their motor scores, whereas the control group had a three-point worsening of their motor scores.

    Currently, the SPARX3 trial is enrolling participants and underway. This trial is similar to SPARX2, but with a goal of studying many more participants.

    Forced exercise

    Cognitive challenges in exercise

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    Balance Exercisescan Improve Your Mobility

    Balance is an important aspect of mobility, and people with Parkinsons commonly experience balance problems when standing or moving around, the APDA notes. Dance and tai chi are two activities that can help you improve balance, and the APDA recommends performing balance-related activities two to three days a week for 20 to 30 minutes each time.

    Balance training can help you prevent falls, Subramanian notes.

    Posted By C-Care

    Parkinsons disease is a common neurodegenerative condition, which mainly affects the motor system and can make simple physical tasks difficult over time. Since Parkinsons is degenerative, symptoms advance and change over time. Symptoms of Parkinsons include:

    • Tremors
    • Dementia
    • Mood alterations

    Parkinsons is a challenging disease both for those who suffer from it, and for their family members. When diagnosed early, there are many things you can do to minimize symptoms, including exercises, some of which well list here.

  • WalkingParkinsons affects your gait, often causing you to take smaller steps, as well as impeding balance. This combined with stiffness can cause falls. In order to combat these difficulties, try to walk regularly. While walking, aim to:
  • Swing your arms.
  • Take long steps.
  • Pay attention to the way your foot lifts and lands as you step.
  • Walking is also an all-around healthy way to get exercise, and should always be part of your daily routine.

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