Exercise And The Brain
In Parkinsons, neurons in a brain area called the substantia nigra that are responsible for producing a neurotransmitter called dopamine gradually die off, leading to motor symptoms such as tremor and bradykinesia .
Levodopa which works to increase dopamine levels in the brain but cannot rescue damaged neurons is currently the front-line treatment for the disease.
Some evidence suggests that, like levodopa, exercise may exert some of its effects by increasing dopamine. A recent study of 17 Parkinsons patients used positron emission tomography scans of the brain before and after stationary cycling. Results showed that habitual exercisers in this group eight patients who exercised more than three hours a week had higher dopamine levels in the dorsal striatum after stationary cycling than the nine others who were sedentary.
The eight exercisers also performed better on functional tests assessing motor symptoms, including the Unified Parkinsons Disease Rating Scale part 3 which measures items such as gait and time to stand and in tests of non-motor symptoms such as apathy and depression.
Exercise might also go a step further than levodopa by increasing brain-derived-neurotrophic-factor , which promotes the survival of neurons that make dopamine the same neurons that degenerate in Parkinsons patients.
An analysis of 12 studies of BDNF levels in Parkinsons patients found lower levels of BDNF in patients serum than in healthy individuals .
For Some Parkinsons Patients Boxing Can Be Therapy
No-contact boxing is a great full-body workout for anyone, but some experts say people with neurological disorders just might benefit most.
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For Cheryl Karian, a 72-year-old retired physician assistant, boxing is medicine. Ms. Karian, whose Parkinsons disease was diagnosed in 2020, doesnt compete or spar, but every Tuesday and Thursday, she trains for an hour at Main Street Boxing and Muay Thai in downtown Houston.
Before her diagnosis, Ms. Karian ran, played tennis and worked a demanding job caring for patients at MD Anderson Cancer Center. This all changed in the years leading up to her diagnosis in 2020, as she started experiencing cognitive difficulties and frequent falls. I cant do what I used to do, Ms. Karian said one day after a boxing class.
Along with two other class participants, Ms. Karian was shadowboxing, or punching into thin air, under the direction of the professional boxer Austin Trout, known as No Doubt Trout. It was part of a program called Rock Steady Boxing, which specializes in no-contact boxing training for Parkinsons patients.
As Mr. Trout called out instructions One, two! One, two, slip! Ms. Karian threw different punches, dodging and rolling her head, all while maintaining a boxers wide-legged stance.
Could A Mediterranean Diet Reduce Symptom Severity In Parkinsons Disease
There are numerous reported benefits to following Mediterranean and MediterraneanDASH Intervention for Neurodegenerative Delay diets. Though slightly different, both diets involve eating plenty of fruit, vegetables and legumes while limiting the consumption of other foods, such as dairy. A new US study suggests that these diets may even reduce the severity of Parkinsons symptoms. The findings were published in the scientific journal Nutrients. The researchers conducted a survey which contained questions about MEDI and MIND diets among participants enrolled in an ongoing study. They then used a cross-sectional analysis to investigate the link between the survey results and Parkinsons symptoms. Results showed that both diets were associated with fewer reported symptoms of Parkinsons over time with MIND being twice as strong in reducing symptom severity. The researchers wrote based on these findings, Future dietary intervention trials should consider the MIND diet as a therapeutic strategy for improving
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Is The Rate Of Parkinsons Disease Diagnosis Higher In The Us Than First Thought
Previous figures have suggested that between 40,000 and 60,000 people are diagnosed with Parkinsons every year in North America. Now, a new study has indicated that this figure could be higher. Research published in the journal npj Parkinsons disease suggests that almost 90,000 people aged 65 and over are diagnosed with the condition in the US each year. Researchers analysed five healthcare datasets one from Canada and four from the US and found that the number of people diagnosed with Parkinsons in the US could now be around 50% higher than previously thought. Study co-author Dr James Beck said: These updated estimates of incidence are necessary for understanding disease risk, planning healthcare delivery and addressing care disparities. The research was supported by the Parkinsons Foundation, The Michael J Fox Foundation and the Institute for Clinical Evaluative Sciences.
Rock Steady Boxing Is Everywhere
Rock Steady Boxing is a non-contact fitness program designed specifically for people with Parkinsons. Founded in 2006, by a young onset patient who wanted to challenge his disease, its origin comes from his personal regimen designed by a boxing trainer.2
Working with a coach on a modified boxing regimen to gain strength and agility, he noticed improvements in his health and a reduction in Parkinsons symptoms. He achieved such individual improvement that he formed a nonprofit to help bring the program to others. Today there are over 450 RSB programs around the world.3
According to RSB, boxers condition for optimal agility, speed, muscular endurance, accuracy, hand-eye coordination, footwork and overall strength to defend against and overcome opponents. At RSB, Parkinsons disease is the opponent. Exercises vary in purpose and form but share one common trait: they are rigorous and intended to empower people with PD to fight back.”
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We Are Meant To Be Active
A 2018 study looked at the reduction of movement in neurological diseases. Commenting on the research, one of its authors, Dr. Raffaella Adami, told the journal Frontiers that we are meant to walk, run, crouch to sit, and use our leg muscles to lift things.
According to the article, Cutting back on exercise makes it difficult for the body to produce new nerve cells some of the very building blocks that allow us to handle stress and adapt to challenge in our lives.
Live Large With Parkinson’s At The Countryside Y
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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Moving For Better Balance
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.
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.
The Basic Elements Of Exercising With Parkinsons
There are four core elements of exercise that are important for people with PD:
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.
Cognitive challenges in exercise
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Exercising With Parkinsons Disease: Try It And See The Benefits
I began taking Rock Steady Boxing classes about nine months ago. The exercise program is tailored for those with Parkinsons disease, and if youre like me, youve dragged your feet and refused to go for any number of reasons or excuses. Maybe there isnt a class near you. Or perhaps you feel too tired and dont think youll have enough energy to do whats required. Maybe money or time is the issue.
Do me a favor.
What Are The Benefits Of Rock Steady Boxing
- Enables people to fight Parkinsons symptoms through a non-contact, boxing-style fitness program
- Improves quality of life and sense of self-worth
- Moves your body in a number of motions while continuously changing the routine as you progress through the workout
- Provides a social outlet to meet people and make friends within the community
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Parkinsons Patients Fight Back In Rock Steady Boxing Program
Three times a week, Susan Vittone, a 5-foot-4 former kindergarten teacher, makes the 45-mile trek from her home in Mexico, Mo., to Columbia for a workout class. Unlike most women her age, Susans workout includes lacing up a pair of gloves and whacking a heavy bag suspended from the ceiling in MU Health Cares Human Performance Institute .
I never thought I would ever be boxing, she said with a laugh. I am not sure if my mother would approve.
But Vittone knows her mother would be in her corner knowing the critical link between boxing and her good health.
Vittone was diagnosed with Parkinsons disease in December 2015. She described her initial reaction as devastation. A friend suggested that she watch a video about a specialized workout called Rock Steady Boxing. Her neurologist said she should give it a try.
The benefits have been invaluable for Vittone, who credits the program for keeping her symptoms at bay.
The class begins like any other workout for a mature group, with warmups that focus on balance and agility. Then, its time to box. The participants dont hit each other. They pound heavy bags and the smaller speed bags.
1, 2, 3 2, 3, 4.
The trainer yells numbers that correlate to punches a jab, hook or uppercut, thrown with the right or left hand. Then, with loud voices, the group repeats the numbers. Its an effort to keep the brain active while making large movements. The yelling is therapy, too.
The Rock Steady Boxing Solution
Various studies in the 1980s and 1990s supported the notion that rigorous exercise, emphasizing gross motor movement, balance, core strength, and rhythm, could favorably impact range of motion, flexibility, posture, gait, and activities of daily living. More recent studies, most notably at Cleveland Clinic, focus on the concept of intense forced exercise, and have begun to suggest that certain kinds of exercise may be neuro-protective, i.e., actually slowing disease progression. Our clients attest, and academic institutions, such as University of Indianapolis and Butler University, are reporting and documenting the improved quality of life among our boxers. Discovery of a cure may be many years away but in the last seven years, there is evidence that progress is made in all stages of the disease by those participating in the RSB program.
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We Asked Our Experts About The Effects Rock Steady Boxing Has On Parkinsons
Despite limited clinical evidence, this program is tremendously popular and we get asked about it often. We aimed to find out more about Rock Steady Boxing by talking with two experts on this subject from the APDA community, Dr. Adena Leder and Dr. Terry Ellis. While the two have somewhat different outlooks, there is valuable insight to be gleaned from their unique perspectives.
Dr. Adena Leder is the Medical Director of the Adele Smithers Parkinsons Center, and Associate Professor, New York Institute of Technology College of Osteopathic Medicine. She is the Medical Director of the Nassau County APDA Information and Referral Center, based at NYIT. Dr. Leder is also a trained Rock Steady Boxing instructor.
Dr. Terry Ellis is an Associate Professor at Boston University, College of Health and Rehabilitation Sciences, and Chair of the Department of Physical Therapy & Athletic Training. Dr. Ellis is also the Director of the Center for Neurorehabilitation at Boston University and the Director of the APDA National Rehabilitation Resource Center housed at Boston University.
We asked Dr. Leder and Dr. Ellis their thoughts on Rock Steady Boxing.
Boxing And Parkinsons Disease
We know without a doubt that exercise is important for people with Parkinsons disease . Various types of exercise and movement can help people improve their balance, strength, mobility, flexibility, endurance and walking ability. Studies also reveal that exercise can help improve cognition, depression, fatigue, and sleep. We have discussed exercise in previous blogs and go into great detail in our Be Active & Beyond exercise guide. Weve also shared tips for exercising safely while at home during the pandemic. We often get questions about boxing as exercise for people with PD especially about Rock Steady Boxing, a specific type of boxing class for people with PD that is offered around the country. For todays blog well share a bit more info about Rock Steady Boxing and get input from two experts on the topic so you can decide if this type of class is right for you. Note: Not every boxing-style class designed for people with PD is a Rock Steady Boxing class. There are some independently-run classes that are not affiliated with Rock Steady. For the purpose of this blog, we are specifically discussing the Rock Steady Boxing program.
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Q: Are All Rock Steady Boxing Courses The Same Do You Have Advice For People Looking For Classes On How To Find A Good One
Dr. Leder: All programs are not the same. The instructors and the class format can vary quite a bit. Most often, people will simply go to the one that is closest to where they live, but they might want to trial a class before they sign up to make sure they like the instructor and it feels safe for them.
Dr. Ellis: In my experience, there is a lot of variability in the quality of the classes. In order to become an instructor in the program training is required, which is great, but the variability in instructors still remains. Some instructors come from the world of boxing and fitness others, from the medical world.
It is important for anyone who teaches these classes to have some expertise in PD. Understanding elements of PD such as freezing of gait, postural control deficits, fall risk and on/off periods, that are unique to PD can make the class safe and more effective for people with PD. Invariably, a program overseen by movement disorders specialist like Dr. Leder will be enhanced by her PD expertise.
Rock Steady Boxing For Parkinsons Patients
Parkinson’s Disease causes a loss of function within the motor systems of our bodies. This can cause movements to be smaller, slower, less accurate, and less coordinated. It can also cause a shuffling gait pattern and often, a resting tremor.
These physical challenges are what boxers condition to improve. Boxing conditions individuals for optimal agility, speed, endurance, accuracy, balance, coordination and overall strength – key elements that are necessary to develop in order to fight back against the progression of Parkinsons disease.
Focused research shows that forced, intense exercise can improve Parkinson’s symptoms, thus the Rock Steady Boxing Method was born.
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Could Living Near Nature Help To Slow Parkinsons Disease Progression
There are numerous reported benefits to spending time outdoors from boosting your mood to improving your physical health. Now, new research from the US has found that living near natural environments like forests, parks and rivers could be linked to a slower progression of Parkinsons. The study, published in JAMA Network Open, focused on people aged 65 and over, living in mainland US, who had health insurance between 2000 and 2016. Researchers analysed hospital admissions data associated with both Alzheimers and Parkinsons. They also observed patients postal codes and geological data, to investigate whether increased exposure to nature could be linked to the rate at which the conditions advanced. The results suggested that those with Parkinsons who lived in greener environments were at a lower risk of hospitalisation. The study authors added that policy makers should consider interventions of natural environments to prevent Parkinsons.