Tuesday, November 29, 2022

Strength Training For Parkinson’s

Secondary Outcomes: Physical Parameters

Parkinson’s Seated Strength & Balance Workout with Nancy Bain

The studies reviewed have analyzed a variety of outcomes to assess the effects of training in people with PD, including both physical parameters and quality of life parameters, as reported in . For the secondary outcomes, we also considered the effects tested at the peak of the medication cycle.

Seven studies assessed balance using both self-reported scales and specific physical tests. Mini-Balance Evaluation System Test, Berg Balance Scale,,, Activities-Specific Balance Confidence Scale ,,, FAB Scale, Choice Stepping Reaction Time, Single Leg Stand Time,, Maximum Balance Range, Limit of Stability Test,, Center of Mass Displacement,, and the Latency of Compensatory Postural Response to External Perturbation Test were administered. Regardless of intervention type, most of the articles reviewed reported an improvement in balance in agreement with the literature data.,, However, a statistically significant improvement highlighted by the ABC test was reported in the study of Combs et al in the group that carried out traditional exercises compared to the box training group. Shen and Mak also reported a statistically significant improvement in terms of balance/limit of stability in repetitive step group training with respect to the strength training group, although there was no statistically significant improvement between groups., It is worth noting that Volpe et al pointed out a statistically significant improvement in the hydrotherapy group with respect to physiotherapy.

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.

Calculation Of Sample Size

Based on literature findings and our expertise, we considered an improvement in the dysphagia severity score of 30% to be of clinical relevance. In a sample size calculation, n = 21 patients would yield a power of 80% to detect a statistically significant difference of 30% between the active and sham groups. Numbers were rounded up to 25 patients per study arm.

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Mst Pd And Neural Plasticity

After 4 wk of MST, the PD patients exhibited a V/M ratio level that was even higher than what is typically observed in healthy old individuals . Notably, this training-induced increase in efferent drive accounted for 26% of the increase in leg press 1RM and 46% of the increase in chest press 1RM . These results are in accordance with a recent study revealing that PD patients have the potential to improve efferent neural drive in response to strength training . Albeit, that study showed that improvements in V/M ratio were only evident if the training was performed while standing on an unstable device. Surprisingly, the Silva-Batista et al. study showed that the direct motor response during rest and during MVC improved following the unstable strength training in PD. This finding contrasts the current study and previous literature , documenting the Mmax and Msup to remain unaltered following strength training. Increases in efferent neural drive, as observed in the present study, may be attributed to both enhanced firing frequency and/or motor unit recruitment . In support of this notion, David et al. showed that high-intensity strength training improved voluntary muscle activation in PD patients. Collectively, the present data and previous observations demonstrate the effectiveness of strength training performed with high intensity to induce significant neural adaptations in PD patients.

How To Exercise With Parkinsons

Strength training with Parkinson

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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Details Of The Included Articles

The details of the reviewed articles are reported in . The range of disease severity assessed by the Hoehn and Yahr scale is 1.53 the lowest mean age considered is 58.6±5.6 years old and the maximum is 75.7±7.2 years old, and the number of subjects per study ranged from 22 to 60. The lowest intervention per week considered is reported in the study of Mateos-Toset et al, in which they highlighted the effects of a brief exercise session of hand training with therapeutic putty. The longest intervention is reported in the study of Corcos et al, in which they assessed the effects of 2 years of progressive resistance training. As regards the length of the training session, the shortest was the single 15-minute hand exercise reported by Mateos-Toset et al and the longest was the double 30-minute session of specific training plus one additional 60-minute session of common exercises, reported by Arcolin et al. Most of the reviewed articles assessed the post-treatment effects, and only three reported the long-term effects.,,,

Brian Grant Foundation Exercise Videos

Cost: Free

Cost: Free for 9 videos $29/month or $290/year for online 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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Strengths And Limits Of This Review

The strengths of this review are the selective eligibility criteria and high methodological quality of the articles included. However, we could not answer the question of whether strength training improves motor symptoms and quality of life of PD patients, as we were not able to perform a meta-analysis because data included studies with different designs and different primary and secondary outcomes.

Strength Training For Parkinsons It Helps

Parkinsons Disease Exercises: Arm Strength

As a whole, strength training improves muscle strength, muscle tissue, endurance, walking ability, balance, and the effort needed to perform daily activities for those with Parkinsons.

With this in mind, strength training is an excellent option to help stop or reverse the physical and functional effects of Parkinsons disease.

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What Are The Findings

  • Strength training performed against a resistance different from body weight is well tolerated in subjects with mild to moderate PD.

  • Strength training improves both physical parameters and quality of life parameters of PD patients.

  • To support the beneficial effects of strength training, clinical trials that include specific muscle strength evaluation are required.

Selection Criteria For Studies

Strength training was defined as an intervention in which participants exercised a muscle or group of muscles against an external resistance. For this study, we considered as external resistance cycle ergometer, weight machine, elastic band, punching bag, and water. In further analysis, we included articles in which the effect of strength training in subjects affected by PD was evaluated and the articles that matched the following inclusion criteria based on PICO principles:

  • randomized controlled trials related to both sexes

  • stages 13 on the Hoehn and Yahr scale

  • study design comparing the effects of strength training versus different exercise protocol

  • study outcomes: muscle strength, physical performance, quality of life

  • training/assessment of subjects during the on medication period

  • articles written in English.

Exclusion criteria were as follows:

  • observational studies

  • studies with healthy or non-exercise controls

  • studies employing supplementary intervention therapies in addition to strength training

  • studies with tailored exercise programs to meet individual capacity.

Two authors independently screened the articles by title and abstract against the selection criteria. Articles that were unclear from their title or abstract were reviewed against the selection criteria through the full text. Any discrepancies between authors were resolved through discussion. The second step was to screen all full-text articles that passed the first step.

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What Kind Of Exercise Can I Do If I Have Trouble Standing Or Walking

Even with advanced Parkinsons symptoms, you can still reap the benefits of some activities. If you have trouble walking or balancing, hold a bar or rail to exercise and stretch. If standing or getting up is tough, exercise and stretch in a chair or bed. Physical exercise performed in a seated position, such as biking on a recumbent bike can allow you to exert yourself in a safe manner.

Facial exercises may help combat difficulties speaking or swallowing:

  • Chew your food longer and more vigorously.
  • Exaggerate your face and lip movements when you speak.
  • Make faces in the mirror.
  • Sing or read out loud.

Mental exercises give your brain a workout and can improve memory. For example:

  • Name as many animals as you can in 1 minute.
  • Play brain games and do puzzles.
  • Solve math problems in your head.

You can also add activity in small bits throughout your day:

  • Park further away from stores so you walk longer distances.
  • Stretch or do leg exercises while watching TV.
  • Swing your arms more when you walk, and take long strides.
  • Take the stairs instead of the elevator.

The Benefits Of Yogafor Parkinsons Disease

Regular Exercise May Slow the Progression of Parkinsons Disease ...

According to the Parkinsons Foundation, yoga can help with flexibility, breathing, and posture as well as relaxation and stress reduction. Best of all, its a self-paced activity, the foundation adds, which means you dont have to perform certain exercises if your physical limitations get in the way. Bonus: Your routine can be modified depending on your needs for example, doing seated yoga in a chair.

Yoga is really my go-to, Subramanian says. Mind-body exercises are really beneficial for mental health, which is important given the risk for anxiety and depression in Parkinsons disease.

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Data Extraction And Analysis

Two authors independently extracted data from the 13 studies that met the inclusion criteria. In agreement with PICO principles, the data included the following: disease population and disease status, the study design and number of participants, strength training , outcomes, participant retention and dropouts, and adverse effects associated with strength training. Any discrepancies between reviewers were resolved through discussion with the third author .

Data Extraction And Quality Evaluation

The basic data and clinical characteristics were gathered as follows: author, country, publication year, sex ratio, age, sample size, disease stage , disease duration, frequency and intervention time, follow-up period, outcome measures, and intervention of different group. Two authors XYL and JH, independently extracted the data and cross-checked the information discrepancies were resolved through discussion or consultation with another experienced author JY until a consensus was reached. Quality of the included articles was evaluated using the bias risk assessment from the Cochrane collaboration Network, which included whether the random allocation method was correct, whether the allocation was hidden, whether blinding methods were used, whether there was loss of follow-up, the presence of selective reporting biases, or other biases.

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Strength Training As A Treatment

Currently, there is no cure for Parkinsons. With that in mind, science has focused on ways to improve the quality of life for those with the disease.

Among the proven treatment options is something we know well: strength training.

Strength training reverses some of the physical effects of Parkinsons and can possibly match the physical ability of Parkinsons sufferers to that of those without the disease.

Data Extraction And Quality Assessment

Parkinson’s Disease Exercises: Whole Body Strength

Data needed for meta-analysis were extracted from the included trials using a standardised form based on recommendations by the Cochrane Handbook for Systematic Reviews of Interventions V.5.1.0, part 7.6. If a study was reported in more than one publication, the information from multiple reports was collated by extracting data from each report separately and then combining the information of all data collection forms.

The methodological quality was assessed according to the Cochrane Collaboration’s domain-based evaluation framework. Main domains were assessed in the following sequence: selection bias performance bias detection bias attrition bias reporting bias other sources of bias. The scores for each bias domain and the final score of risk of systematic bias were graded as low, high or unclear risk.

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Parkinsons Disease And Strength Training: Benefits

Exercise is vital for improving balance, mobility and overall health in persons diagnosed with Parkinson’s Disease . PD is the second most common neurological disease in the world. It is characterized by a deficit in dopamine resulting from a progressive loss of neurons in areas of the brain responsible for movement and coordination.

Recently, literature has demonstrated that participating in strength training regularly can improve symptoms, make dopamine use more efficient and possibly even slow the progression of PD! In this article, we will look at why strength training has benefits specific to PD, and discuss ways to make it safe and fun.

Why Exercise?

Exercise is amazing because it changes the way our brain functions. Studies have shown that in people who regularly exercise, brain cells use dopamine more efficiently. This occurs because areas of the brain responsible for receiving dopamine signals the substantia nigra and basal ganglia, are modified. Exercise also increases the number of D2 receptors in the brain, meaning dopamine has more places to go. Additionally, researchers at the University of Pittsburgh were able to demonstrate that in animal models, exercise increased the amount of a neurotrophic factor called GDNF, which helps protect dopamine neurons from damage.

Choose Strength Training

Where to Start

Tips for Exercising Safely

  • Make sure you hydrate! Drink water before, after and during your exercise to feel better and stay safe.
  • References

    Strength Training For Parkinsons

    27 January 2014

    Researchers at the University of Alabama at Birmingham say that high-intensity strength training produced significant improvements in quality of life, mood and motor function in older patients with Parkinsons disease. The findings were published Jan. 9 online in the Journal of Applied Physiology.

    Study participants showed significant improvement of six points on average on a measure called the Unified Parkinsons Disease Rating Scale. On another measure, a seven-point fatigue scale, the group improved from a score above the clinical threshold for undue fatigue to a score below this threshold.

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    Maximal Strength Training In Patients With Parkinsons Disease: Impact On Efferent Neural Drive Force

    Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway

    Myworkout, Medical Rehabilitation Clinic, Trondheim, Norway

    Myworkout, Medical Rehabilitation Clinic, Trondheim, Norway

    Department of Physical Medicine and Rehabilitation, St. Olavs University Hospital, Trondheim, Norway

    Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway

    Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway

    Department of Internal Medicine, University of Utah, Salt Lake City, Utah

    Department of Rehabilitation, Rga Stradi University, Riga, Latvia

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  • Tai Chi Vs Weight Training

    Strength Training for People With Parkinson

    Itâs not so much what you do, but that you do something if you have Parkinsonâs disease, says Stuart Isaacson, MD. He is the director of the Parkinsonâs Disease and Movement Disorders Center of Boca Raton and an associate professor of neurology at Florida International Universityâs Herbert Wertheim College of Medicine in Miami.

    âParkinsonâs disease affects mobility, and any type of exercise that helps people move may improve overall mobility, so we always recommend exercise,â he says. âEveryone with Parkinsonâs should exercise. A little is better than none.â

    Recent studies have suggested that tai chi, a form of martial arts marked by slow, gentle movements and deep breathing, may improve some symptoms of Parkinsonâs disease, such as balance.

    Is tai chi better than weight training? It depends. âIf balance is the issue, tai chi may be best, but if a person is concerned mainly with mobility, stiffness, and slowness, weight training may offer more benefits,â Isaacson tells WebMD.

    Some evidence suggests that exercise may do even more than boost strength and balance it may protect brain cells from degeneration and make Parkinsonâs medications work better.

    Many people with Parkinsonâs disease are also depressed and may not be willing to exercise. It is not a choice, Isaacson says: âIt has to be a part of everyday routine, much like taking medications, showering, or eating.â

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    Daniel Corcos, PhD, the University of Illinois, Chicago.

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