Choosing The Best Treatment Plan For You
As you may know, medications are the backbone of the Parkinsons treatment plan. But because the disease affects everyone differently, and each persons response to therapy will vary, there is no hard-and-fast rule about when you should begin taking medication and what to take first. Some doctors prescribe medication upon diagnosis. Others believe that drugs, especially levodopa, should be delayed as long as possible to avoid earlier onset of medication-related side effects.
Your involvement from the very start is important because you want to be sure your doctor is addressing your individual needs. When your doctor writes a new prescription, or makes a change to an existing one, take the opportunity to ask for an explanation. If her response goes something like, I always start my Parkinsons patients on X dosage of Y, a dopamine agonist, you might want to consider switching to a movement disorders specialist, a neurologist who has had special training in Parkinsons disease and other movement disorders.
What Causes Parkinson Disease
Parkinson disease arises from decreased dopamine production in the brain. The absence of dopamine makes it hard for the brain to coordinate muscle movements. Low dopamine also contributes to mood and cognitive problems later in the course of the disease. Experts dont know what triggers the development of Parkinson disease most of the time. Early onset Parkinson disease is often inherited and is the result of certain gene defects.
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A Comprehensive Exercise Program Includes:
- Aerobic or cardiovascular activity. This can include any exercise that increases your heart rate such as walking, hiking, dancing, swimming or riding a bicycle. As always, pick something you enjoy doing. You are more likely to stick with it if you enjoy it
- Flexibility and stretching. Certain muscles feel tight and stiff with Parkinsons. These are the primary muscles that flex your arms, shoulders, hips, knees and ankles. Stretching can reduce the impact of Parkinsons-related stiffness that affects your bodys movement
- Strength training. Stronger muscles reduce the amount of energy you spend on everyday movements, resulting in less fatigue throughout the day as well as greater stamina
- Balance and fine movement control. It is important to include exercises that challenge your balance, hand-eye coordination and fine motor control with your hands
- Weight-bearing exercise. Walking, running and exercise that include foot impact can improve bone strength and lower risk of fractures due to falls
- FUN! Pick exercises you enjoy. Our Pre-Exercise Worksheet can help you start the conversation with your healthcare provider before beginning or increasing the intensity of your exercise program
Before starting or increasing the intensity of an exercise program, be sure to have a conversation with your healthcare professional about anything specific to your symptoms and health that you should be aware of as you exercise.
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.
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How Does Exercise Affect The Brain
Researchers;have studied the brains of mice that exercised under conditions similar to a human being on a treadmill. Exercise did not increase the number of neurons or amount of dopamine in mices brains. But it did prompt their brains to use dopamine more efficiently.
Dopamine is;a neurotransmitter that helps regulate movement and emotional response. Lack of it is associated with neurodegenerative diseases like Parkinsons.
Some studies have indicated that exercise reduces the chance that dopamine neurons will become damaged.
Note: Parkinsons News;Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
When To See A Physical Therapist
When someone is first diagnosed with PD, they should also have an appointment with a physical therapist to work out an exercise program tailored to them.
All people with PD should ideally have an exercise program for their individual needs. Seeing a physical therapist will help them avoid risks, get advice about their specific type of PD, and give them confidence.
As the disease progresses, a person should continue to meet with the physical therapist to maximize the benefits from their exercise program by changing it whenever necessary.
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When Should I Start Exercising
Right now!;Everyone should exercise more, whether they have PD or not.
In PD, a special kind of;neuron that produces the chemical transmitter dopamine gets damaged and lost.;However, there is a lag between the time when neuron loss begins and when PD movement symptoms start to show. By the time most people are diagnosed, as much as 40 to 60 percent of their dopamine neurons are already gone. The reason people with PD dont experience symptoms until they reach this point is that the brain can compensate for the loss of dopamine neurons by adapting. In fact, the brain reshapes itself throughout life in response to experience. Scientists call this ability to change and compensate “experience-dependent neuroplasticity.”
To find exercise classes in your area call the Parkinsons Foundation Helpline at 1-800-4PD-INFO .
Page reviewed by Dr. Bhavana Patel, Movement Disorders Fellow at the University of Florida, a Parkinsons Foundation Center of Excellence.
*Please note that not all content is available in both languages. If you are interested in receiving Spanish communications, we recommend selecting both” to stay best informed on the Foundation’s work and the latest in PD news.
Are There Any Risks Of Exercising With Parkinsons Disease
Some symptoms, like Parkinsons tremors, may seem worse during exercise. But exercise generally improves tremors and other symptoms in the long run.
Reduce challenges by stretching before and after exercise. Use good form to prevent injury. And avoid slippery floors, poor lighting and tripping hazards. If you have pain, stop and rest.
Pushing yourself too hard during exercise can lead to injury. Start slowly and increase intensity and duration over time. Keep a log to track your exercise choices and how you feel. Eventually, youll learn what works best for you.
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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.
In Summary Reduce Your Stress
The most important thing we can do for our long-term health, both physical and cognitive, is to reduce the stress in our bodies. All stress physical, emotional and chemical causes inflammation and long-term damage throughout the body.
Whether youre seeking Parkinsons prevention techniques or ways to alleviate symptoms, any of the above dietary and lifestyle practices can have long-term health benefits. Drinking green tea, eating organic, local vegetables, and regular aerobic exercise all significantly reduce the long-term cumulative damage done by stress.
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The Modag Anle138b Clinical Trial
Another neuroprotective approach involves enhancing cellular function, and significant preclinical research has shown that boosting the function of mitochondria can help cells survive. Mitochondria are the power stations of cells providing all of the energy requirements. Cure Parkinsons has several clinical trial programs dedicated to mitochondria-targeted approaches. An example of this is the UDCA in Parkinsons UP study. UDCA is a treatment that is used for dissolving gall stones, but recently researchers have found that it also has neuroprotective properties in models of Parkinsons. Cure Parkinsons is co-funding the UP study to determine if UDCA could be a useful neuroprotective treatment for Parkinsons.
Possible Risk Reduction Factors
While age, genetics, and being a man make it more likely youll develop Parkinsons disease, some factors make it less likely. It is generally believed that;Asian-Americans and African-Americans seem to have a lower risk of developing Parkinsons as compared to Caucasians. Drinking coffee may lower risk, as a 30-year study of Japanese-American men found the greater amount of coffee they drank, the lower their risk of Parkinsons disease became.;
How Does Exercise Help
There is increasing evidence that exercise may have a neuroprotective effect, meaning that it can slow the progression of your condition. Researchers think that exercise can delay the onset of Parkinsons as well as slow progression if introduced early on.
There are also psychological benefits to exercise. It wont take Parkinsons away but it can give you a sense of control over it and make you feel better about living with the condition. This, together with a good medication regime, can really enhance quality of life and help you maintain independence. You can tailor your regime to suit your own individual abilities and requirements, whether you want to maintain the strength and fitness you already have or get yourself fitter and healthier. Remember, its never too late to start and the benefits can be enormous.
Some of the benefits of regular exercise include:
- improved balance and fewer falls
- improved posture and flexibility
- improved brain function and health
- fewer muscle and joint injuries
- preventing/reducing;gait, sleep, speech and swallowing problems
- preventing/reducing bone wasting .
You should tell your physiotherapist or occupational therapist if you plan to use a Wii to exercise. Ask your doctor for advice if you have any concerns about using this tool.
Dance, for example;Irish set dancing, tango, waltz and foxtrot, has also been shown to improve symptoms. For more information on dance and its benefits in Parkinson’s see;Dance therapy.
What Types Of Exercise Can Help Manage Parkinsons Disease
There are several types of exercises you can do to manage Parkinsons disease. You can create a varied routine based on your specific concerns, fitness level, and overall health.
Aim to do at least a few minutes of movement each day. Include exercises that improve cardiovascular health, flexibility, and strength. If you change up your exercises every week. your body can learn new ways to move.
There are a few different types of exercise that may be especially helpful to those with Parkinsons, including:
- physical and occupational therapy
Can Progression Of Parkinson Disease Be Slowed
Deep brain stimulation implanted in early-stage Parkinson disease was found to decrease the risk of disease progression. If findings are replicated in a larger trial recently approved by the FDA, DBS would be the first therapy proven to slow the progression of any element in PD.
Deep brain stimulation implanted in early stage Parkinson disease was found to decrease the risk of disease progression and lessen the need for multiple, simultaneous prescription drugs, according to study findings published in Neurology.
PD serves as the fastest growing neurological disorder worldwide, with as many as 60,000 US cases diagnosed each year. Innovations within the treatment of PD have led to better, noninvasive outcomes for common symptoms such as tremor and OFF periods. However, as the disease progresses, these therapies may not prove as effective and can contribute to significant economic burden for both patients and caregivers.
When it comes to managing PD, senior author David Charles, MD, professor and vice chair of neurology at Vanderbilt University Medical Center , noted the relentless nature of the disease, which currently has no therapies approved to slow its progression.
After the 5-year follow-up, the study found that those with early-stage PD who received early DBS with ODT had a more than 5 times lesser odds of of experiencing worsening of their rest tremor compared with those given only ODT .
How To Slow Parkinsons Disease
It begins with trembling or shaking, usually in the fingers of one hand. Over time the tremor worsens, and other symptoms such as slow movements, muscle rigidity, and difficulty walking appear. Patients with Parkinsons disease are eventually given prescriptions for l-dopa and other drugs, and they may be offered deep brain electrical stimulation, stem-cell or gene therapy somewhere down the road. But the one thing they want most, hope for improvement, they do not get.
Until now. Researchers have discovered that coenzyme Q10 and creatine, nutritional supplements that are sold in health food stores, offer something rare to those who suffer with Parkinsons disease: hope.
Parkinsons Disease and Free Radical Damage
Parkinsons disease is characterized by a sharp decline in dopamine, a key neurotransmitter that stimulates the brain and affects movement. This decline is caused by the destruction of neurons, or brain cells, that produce dopamine. As dopamine levels fall, other neurons compensate and become overactive, which further contributes to the symptoms of the disease.
Nobody knows why the dopamine-producing neurons die. A genetic predisposition has been identified, as has a link to certain environmental toxins. Another suspect, which is a factor in many degenerative diseases, is free radical damage. Levels of some free radical fighting antioxidants are known to be low in patients with Parkinsons, especially in the dopamine-generating neurons.
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Eat Plenty Of Protein But Not With Levodopa Medications
If youre taking a levodopa medication, your doctor may tell you to avoid protein when taking your meds. Both animal and plant protein can interfere with the absorption of levodopa medications.
But you should still eat plenty of protein. Just be strategic with the timing. Dont take levodopa medications with meals, Dr. Gostkowski says. Its best to take it on an empty stomach either 30 minutes before your meal or an hour after eating.
If you get nauseous from the medication, eat a small amount of starchy food with it, such as crackers. Make sure whatever you eat with your medicine doesnt have protein. Its a misunderstanding that people with Parkinsons should avoid protein, Dr. Gostkowski says. You definitely need protein in your diet. Just dont eat it when youre taking your levodopa medication.
Exercise And The Risk Of Developing Pd
Most prospective cohort studies have found an inverse relationship or trend between physical activity and the subsequent development of PD , with a pooled hazard ratio of 0.66 for developing PD when comparing the highest level of physical activity with the lowest level . The first published study linking prior physical activity to PD was by who carried out a case-control study in 50,002 male students attending the University of Pennsylvania and Harvard College between the years 1916 and 1950. Their study observed lower odds of developing PD if the student played varsity sports or underwent regular exercise in college with OR of 0.64 and 0.83, respectively. They also observed that in adulthood, those subjects who engaged in moderate exercise or heavy sports had lower odds of developing PD, although neither of these associations achieved statistical significance .
Other epidemiological studies that support the inverse relationship between physical activity and developing PD include studies from the NIH-AARP Diet and Health Study cohort , the Cancer Prevention Study II Nutrition Cohort ; the Finnish Mobile Clinic Health Examination Survey , a populated-based case-control study in California , and the Survey of Health, Aging and Retirement in Europe .
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Can Exercise Slow Down Parkinson’s Disease
Parkinson’s disease is the 2nd most common neurodegenerative disorder caused by the deterioration of motor function due to the death of brain cells that make an important chemical called dopamine. Without dopamine, voluntary movement is impossible.
People living with PD experience progressive loss of muscle control leading to tremors in the limbs and head while inactive; stiffness; slowness and impaired balance. As symptoms progress, people may find it difficult to walk, talk, and complete simple tasks. Some secondary symptoms are anxiety, depression and dementia.
Exercise is universally accepted as part of a healthy lifestyle. But people with Parkinson’s disease need to exercise to sustain balance, mobility and daily living activities, along with a likely positive neuroprotective effect. The Parkinson’s Foundation Quality Improvement Imitative studied exercise as part a Parkinson’s Outcomes Project study.
Exercise For Parkinson’s Disease
- Exercise in a regular manner. While doctors say an exercising for an hour a day, 3 or 4 times a week is sufficient, researchers think that the more you do, the more you benefit.
- All forms of exercise are beneficial. Start with short walks around your home or apartment building.
- Formal Parkinson’s exercise program addresses various facets of fitness including strength, balance, coordination, suppleness & stamina.
- Consult your physician or a physical therapist who understands Parkinson’s disease.