Improving Movement With Simulation
The Parkinsons disease experts at Encompass Health Rehabilitation Hospital of Jonesboro in Arkansas shared exercises for Parkinsons patients that can be done in therapy or prescribed by a clinician to complete at home. As specialized therapists, we use these exercises to improve our patients quality of life, target and reduce symptoms and increase function and mobility, Norton said.
When practicing these exercises use big, exaggerated motions. This may feel awkward at first, but with practice this method helps Parkinsons disease patients recalibrate so that big motions begin to feel more normal.
What Medications And Treatments Are Used
Medication treatments for Parkinsons disease fall into two categories: Direct treatments and symptom treatments. Direct treatments target Parkinsons itself. Symptom treatments only treat certain effects of the disease.
Medications that treat Parkinsons disease do so in multiple ways. Because of that, drugs that do one or more of the following are most likely:
Several medications treat specific symptoms of Parkinsons disease. Symptoms treated often include the following:
- Erectile and sexual dysfunction.
- Hallucinations and other psychosis symptoms.
Deep brain stimulation
In years past, surgery was an option to intentionally damage and scar a part of your brain that was malfunctioning because of Parkinsons disease. Today, that same effect is possible using deep-brain stimulation, which uses an implanted device to deliver a mild electrical current to those same areas.
The major advantage is that deep-brain stimulation is reversible, while intentional scarring damage is not. This treatment approach is almost always an option in later stages of Parkinsons disease when levodopa therapy becomes less effective, and in people who have tremor that doesnt seem to respond to the usual medications.
Researchers are exploring other possible treatments that could help with Parkinsons disease. While these arent widely available, they do offer hope to people with this condition. Some of the experimental treatment approaches include:
Q: What Types Of Improvements Can Be Reasonably Expected From A Course Of Cognitive Rehab
A: The evidence for cognitive rehab for people with PD is still emerging. It appears that restorative cognitive training can produce short-term improvements in the cognitive skills trained, but the sustainability of those improvements and whether they transfer to improved daily function are not yet known. There are clues that strategy-based approaches that target daily life activities may produce benefits for everyday function, but studies on these approaches are currently limited. Cognitive rehab can also help you figure out how to maintain participation in your existing daily activities and roles and/or find other ways to remain mentally engaged and stimulated throughout your day. A cognitively engaged lifestyle is thought to protect cognition from neurodegeneration and thus may potentially delay or slow cognitive decline associated with PD.
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Data Sources And Search Strategy
This study was carried out according to the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions . The systematic literature search was conducted using Pubmed , Excerpta Medica dataBASE , Cochrane Central Register of Controlled Trials , the Oriental Medicine Advanced Searching Integrated System , and Chinese medical databases . The articles reported until December 2016 were searched, and there was no language limitation. Various exercise terms and MeSH terms were used for searching. The search strategies used in each database are presented in Table 1.
Parkinsons Home Exercise Program
You dont need to join a gym or purchase expensive fitness equipment to stay active with Parkinsons disease. On the contrary, there are many great exercises that you can do from the comfort of your home, regardless of which stage of the disease you are in. Take a look at some great examples in the sections below.
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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.
Managing Your Symptoms With Medication
Almost all patients with Parkinsons disease eventually need to take medication to help with their motor symptoms. Several classes of medications are available and can be viewed here. Carbidopa/Levodopa remains the most effective symptomatic therapy and is available in many strengths and formulations. It also may be used in combination with other classes of medications including Dopamine Agonists, COMT Inhibitors, MAO Inhibitors, and Anticholinergic agents. Treatment is highly individualized and adjusted over time based on symptoms and side effects.
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Description Of The Included Studies
A total of 4,047 studies were retrieved by electronic search. After eliminating duplicates, the 2,795 studies left were screened by abstract. Among them, 71 studies were selected for eligibility assessment. After reviewing the full texts, 18 studies were finally selected for the meta-analysis. Fifty-three studies were excluded due to the following reasons: improper interventions such as robot therapies , inappropriate outcome measures , ineligible study design , and inappropriate control group which contained more than 2 active control groups .
PRISMA flow chart of the study selection and identification process .
Art And Other Complementary Therapies For Parkinsons Disease
A growing number of people with Parkinsons disease are interested in trying to improve both their motor and non-motor symptoms with therapies that are not medications. Beyond physical, occupational and speech therapy, all of which can play a crucial role in maximizing function in PD, there are a vast array of available complementary therapies. These include:
Many of these therapies have been studied formally in PD, although usually in only small groups of people. Therefore, much is unknown about whether these therapies are truly effective and if so, how they work and how to maximize their benefit. Complementary therapy for PD is a large topic to cover and I will write more than one blog on this subject. Today, lets focus on art therapy.
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Meditation And Relaxation Techniques
Meditation and relaxation techniques can take many forms. Listening to relaxing music is the most basic form. Mindful meditation can be used to relax and focus on breathing or negative emotions and thoughts. It can also be used to help a person become more aware of their surroundings or body movements. Several studies have shown a connection between Parkinsons disease symptoms and mindful meditation.
The treatment options for Parkinsons disease include several different medications, surgical procedures, and physical therapies. Whats appropriate for you depends on the symptoms youre experiencing and how severe your disease is. You will most likely benefit from treatments for your tremors and other motor symptoms, but other options for some of the non-motor effects of Parkinsons disease may also be beneficial for you.
How Does Exercise Change The Brain
What happens in the brain to produce these benefits? A study conducted by Beth Fisher and her team at the University of Southern California found that on a day-to-day basis, people with PD who exercised moved more normally than those who did not.
The study also found that in looking at mice that had exercised under conditions parallel to a human treadmill:
Based on these findings, the research team believes exercise may help the brain maintain old connections, form new ones and restore lost ones. In certain situations, the neuroplasticity created from exercise in people with PD may outweigh the effects of neurodegeneration.
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Alternative Treatments For Parkinsons Disease
Alternative therapy may also be used to treat Parkinsons disease. The most touted in recent years has been the effect of Vitamin E on reversing the progression of the disease although, this effect is still being debated by the scientific community.
Relaxation and guided imagery have also been suggested to help with stress, depression, and anxiety. Medical studies have shown that relaxation and guided imagery may help slow the progression of symptoms as well as quicken healing time after surgeries or injuries.
Treating Parkinsons With Complementary Medicine
Complementary medicine incorporates many different practices that can be used alongside conventional medicine to try to ease PD symptoms. There is typically not as much rigorous data to support the use of complementary medicine techniques, as compared to conventional medicine, but many patients find them helpful. These include yoga and massage.
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Explore Different Types Of Exercise For Parkinsons
There are countless forms of physical activity out there, and finding one that fits a Parkinsons patients unique needs and abilities may be difficult, depending on the severity of their symptoms. In some cases, seemingly impossible activities like dancing or riding a bicycle are feasible for seniors with PD who struggle to even walk. Proceed with caution, though, and always consult a physician before starting a new exercise regimen.
The Parkinsons Foundation offers the following examples of exercises for Parkinsons disease:
- Intensive sports training
- Treadmill training with body weight support
- Resistance training
- Alternative forms of exercise
- Home-based exercise
- Practice of movement strategies
Incorporating elements of yoga, Pilates, tai chi, dancing or boxing can improve core strength and balance and facilitate rotational movement to combat rigidity. While any kind of movement is beneficial, there are specialized programs designed to address the challenges that PD patients face. One such program is the LSVT BIG Treatmentan exercise treatment program for people with PD based on the principle that the brain can learn and change .
Playing A Musical Instrument
Music is good for the mind and body. Listening to music can increase the release of dopamine in the brain. The symptoms of Parkinsons disease are caused by a decrease of dopamine, and increasing this chemical neurotransmitter can reduce symptoms. Additionally, playing a musical instrument can increase dexterity and reduce stiffness in the hands.
Caring for a loved one with Parkinsons can be extremely challenging, and a compassionate professional caregiver can be a wonderful source of support. If your elderly loved one is living with a serious medical condition and needs help managing the tasks of daily living, reach out to Home Care Assistance, a home care agency you can trust. Our caregivers are available 24/7, there are no hidden fees in our contracts, and we offer a 100% satisfaction guarantee on all of our in-home care services.
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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.
Cleaning Tips For Those With Parkinson’s
- Use long handles on sponge mops, cleaning brushes, dust pans, brooms, or window washers.
- Sit to fold laundry, wash dishes, iron clothes, use the sweeper, mop the floor, or to plug in appliances at low outlets. Adapt counters so that you can reach them from your wheelchair or from a sitting position.
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How Hard Should I Exercise If I Have Parkinsons Disease
A rating of perceived exertion is a good way to measure intensity. On a scale from 0 to 10, 0 would be how you feel while sitting or lying down, while 10 would be the maximum effort you can give. Building up to an effort between 5 to 8 means you are exercising at a high intensity. A good gauge is, if you can have a conversation with someone while exercising, you should probably increase your intensity.
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Art And Pd: Beyond The Physical Benefits
Art therapy may also be a tool that enhances the lives of people with PD more generally. One small study investigated clay art in people with PD and showed improvements in hand dexterity, mood, and quality of life. More studies are necessary to determine whether these effects are clinically relevant and if so, to define the optimal type and duration of the therapy.
Also, despite the visuospatial challenges of some people with PD, there is evidence that people with PD might experience an increase in creativity, or even develop a new interest in creative pursuits with their diagnosis, possibly fueled by dopaminergic medications. An increase in creativity can also accompany other neurologic disorders, unrelated to dopaminergic medication. Therefore, the possibility exists that PD alone can fuel creativity, perhaps in combination with the effects of PD meds.
An increased drive to create coupled with potential neurologic improvement from art creation may lead to an enhanced focus on art therapy for PD in upcoming years.
APDAs Connecting Through Art
Even before definitive studies are done to evaluate the benefits of art therapy in PD, people with PD find happiness, satisfaction, socialization and camaraderie in artistic pursuits.
It may take scientists more time to discover all the relationships between art, art therapy and PD. Until then, feel free to explore your inner creativity!
Tips and Takeaways
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Improving Mobility Strength And Balance
Staying mobile and self-sufficient is top of mind for people living with Parkinson disease. Stiffness is also a known problem with the disease. This rigidity can cause poor posture and pain that leads to other functional problems. A physical therapist can help with these problems. PTs guide people with Parkinson through moves and stretches to increase mobility, strength, and balance.
Working With A Physical Therapist To Create An Exercise Plan
Physical therapists are experts in getting people moving. While most people think physical therapy is just for rehabbing after an injury, its an important part of preventive care and treatment for patients with chronic conditions like Parkinsons disease.
Your experience with Parkinsons disease is unique. A physical therapist can help with Parkinsons by designing a personalized program for you. Theyll teach you specific exercises to manage your unique symptoms and keep you engaged in activity.
How often should you meet with a physical therapist? Checking in at least once or twice a year can help you develop an exercise plan that fits with your current level of mobility and the season.
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Eating Drinking And Parkinsons Disease
- Dont rush your meals. Allow the extra time you need to finish your meal. Rest your elbows on the table to provide more motion at your wrist and hand.
- Sit with your knees and hips bent at a 90-degree angle in a straight-back chair.
- Use utensils with built-up, lightweight handles, or use a spork a spoon and fork in one. Use a rocker knife for cutting food.
- Use a non-skid mat to stabilize objects on the table.
- Use a plate guard or plate with a raised lip to prevent food from spilling.
- Use a long straw with a non-spill cup or use a plastic mug with a large handle.
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.
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Build A Support System
Support comes in many different forms. Family caregivers, friends, physical therapists, fitness coaches and peers who are also living with Parkinsons can all play a vital role in keeping a PD patient motivated and active. Working out with a partner or a group provides valuable social interaction and tends to encourage consistency and commitment.
PD-specific group exercise programs like Dance for PD and Rock Steady Boxing are offered through a sizeable network of partners and affiliates to help patients stay active, socialize and manage their symptoms.
When confidence in mobility and functionality are lost, seniors with PD gradually begin moving less, avoid leaving the house or even cease caring for themselves. While this behavior is understandable, a sedentary lifestyle will lead to more severe stiffness, rigidity and depression. Being still only exacerbates symptoms, lessens quality of life and speeds up progression of the disease. There is no one best exercise or physical therapy plan for Parkinsonsonly what works best for each patient.
Physical Therapy Strategies For Parkinsons Disease
PT can improve daily functioning for people living with PD by:4
- Improving gait, or the way a person walks
- Improving transfers, like going from stillness to activity
- Improving balance
- Strengthening joints and muscles to improve physical capacity
One of the ways physical therapists help improve gait is through the use of cues. Cues are stimuli from the environment or generated by the person that they can use to facilitate repetitive movements, like walking. Cues can be:4
- Auditory, like using a metronome or music
- Visual, such as stepping over stripes on the floor
- Tactile, like tapping on the hip or leg
- Cognitive, like using a mental image of the length of a step
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