Parkinsons Disease: Treatment Via Other Dopamine Type Drugs
Drugs that mimic dopamine, called dopamine agonists, may be used to delay the movement-related symptoms of Parkinsons. They include Apokyn, Mirapex, Parlodel, the skin patch Neupro, and Requip. Apokyn, an injectable, may be used when the effects of levodopa begin to wear off. Side effects include nausea and vomiting, drowsiness, fluid retention, and psychosis.
How To Avoid Losing Height
If a medical condition is to blame for your height loss or stopped posture, it needs to be specifically treated. However, height loss as a result of getting older or weaker bones can be prevented with a few lifestyle changes on your part.
These changes can also improve bone density, which can prevent the onset of several diseases like osteoporosis, which contribute to height loss.
Start doing weight-bearing exercises to strengthen muscles and bones Ensure you get enough calcium and vitamin D through your diet or supplements Avoid excessive alcohol consumption and smoking Get regular bone density testing to stay ahead of any degenerative diseases like osteoporosis Do exercises that work against gravity such as jogging, walking, and aerobics
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Parkinson’s Posture
Friday March 21, 2014
How does posture change with Parkinson’s?
Postural Change with Aging
Not all changes are caused by Parkinson’s disease. Degenerative changes from arthritis increase with aging. Osteoporosis can also also cause changes such as compression or fracture of the vertebral bones causing both pain and flexed posture.
- DEXA or bone density scan – Ask your doctor about ordering this test to see if you have osteoporosis or osteopenia.
- Calcium and vitamin D keep your bones strong. Be sure your get the calcium you need in your diet. Ask your doctor if a vitamin D level is appropriate.
- Weight bearing exercise weight lifting helps you keep your bone mass
How does postural change affect mobility?
With normal posture our weight is well centered over the middle of our feet making it much easier to balance. When our spine is bent forward, the head also comes forward and our center of mass shifts ahead of the feet. To keep from falling, the forward flexed person tends to bend his or her knees and hips. This leads to difficulty in taking big steps and requires more energy to walk. Falls are more likely to happen due to the reduced foot clearance or shuffling that occurs while walking with knees bent. Also forward slouching limits arm swing, can cause shoulder and neck problems, reduces the lung volume which can lead to shortness of breath and or softness of speech.
What are the treatments?
- Swimming
- Dancing
How can I get started?
Monique L. Giroux, MD
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What Is Parkinsons Disease
Parkinsons disease is a nervous system disease that affects your ability to control movement. The disease usually starts out slowly and worsens over time. If you have Parkinsons disease, you may shake, have muscle stiffness, and have trouble walking and maintaining your balance and coordination. As the disease worsens, you may have trouble talking, sleeping, have mental and memory problems, experience behavioral changes and have other symptoms.
A Stooped Or Hunched Posture Can Be An Early Sign Of Parkinson’s Disease
Experts say that a stooped or bent posture can be an early sign of Parkinson’s disease. Pharmacist Seamus Flynn and his wife, oncologist Dearbhaile Collins, PhD, explain that, “Parkinson’s affects the autonomic nervous system, which leads to a loss of control of automatic activities A stooped or hunched posture would normally cause a response from the brain to correct the posture and stand up straight, but this response is missing in Parkinson’s due to under-activation of the autonomic nervous system.”
According to the Parkinson’s Foundation, these changes in posture can include stooped or rounded shoulders, decreased lower back curve, or a forward lean of the head or whole body that makes you look hunched over.
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Loss Of Height & Stooped Posture
As we age we get shorter, but its likely that we wont notice. If you do notice, it could be a result of a health condition. Its important to know the causes in order to find a treatment to prevent loss of height and its associated pain. Learn more here.
10 minute read
It is not uncommon for older people to think they are taller than they actually are. Shrinking height inevitably comes along with aging, and many people forget or ignore this fact.
As you get older, you will get shorter, but it will likely not be by any largely noticeable amount. The loss in height from aging is one thing, but you can also lose height as a result of stooped posture, which is linked to several health conditions.
It is important to know the potential causes of losing height and what you can do about them.
There Are A Few Factors That Can Contribute To A Shift In Posture
In addition to the changes to your autonomic nervous system, there are a few other reasons people with Parkinson’s experience stooped or hunched posture. According to the Parkinson’s Foundation, possible contributing factors include being in one position for too long, concentrating on another activity, and muscle stiffness or rigidity
“Since people affected by Parkinson’s disease lose control over their muscles to a certain degree, they experience uncontrolled stiffening of limbs,” explains family physicianWaqas Ahmad, MBBS. This stiffening can contribute to a hunched posture.
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What Medications Are Used To Treat Parkinsons Disease
Medications are the main treatment method for patients with Parkinsons disease. Your doctor will work closely with you to develop a treatment plan best suited for you based on the severity of your disease at the time of diagnosis, side effects of the drug class and success or failure of symptom control of the medications you try.
Medications combat Parkinsons disease by:
- Helping nerve cells in the brain make dopamine.
- Mimicking the effects of dopamine in the brain.
- Blocking an enzyme that breaks down dopamine in the brain.
- Reducing some specific symptoms of Parkinsons disease.
Levodopa: Levodopa is a main treatment for the slowness of movement, tremor, and stiffness symptoms of Parkinsons disease. Nerve cells use levodopa to make dopamine, which replenishes the low amount found in the brain of persons with Parkinsons disease. Levodopa is usually taken with carbidopa to allow more levodopa to reach the brain and to prevent or reduce the nausea and vomiting, low blood pressure and other side effects of levodopa. Sinemet® is available in an immediate release formula and a long-acting, controlled release formula. Rytary® is a newer version of levodopa/carbidopa that is a longer-acting capsule. The newest addition is Inbrija®, which is inhaled levodopa. It is used by people already taking regular carbidopa/levodopa for when they have off episodes .
Living Well With Parkinson’s Disease Good Posture Is Possible
Good posture is important for everyone. In the general population, many back and neck problems stem from poor posture. In addition to this, poor posture decreases a person’s ability to weight shift appropriately to maintain balance. Patients with Parkinson’s disease are often already set forward due to poor posture and have minimal ability get to neutral let alone shift weight backward without falling. Therefore it is even more important that these patients be diligent about fighting bad posture. So how do you do that?
First, by stretching tight muscles: Pectoral muscles Ilipsoas muscle Hamstrings Gastrocnemius and Soleus
Second, by strengthening the muscles that tend to get weak: Gluteus maximus- buttocks Erector spinae- on either side of the vertebrae of the back Posterior scapular retractors-between the shoulder blades Cervical extensors- in the neck and keep the head from falling forward.
Thirdly, correct positioning at all times: Get rid of extra pillows, only use one pillow to support the small of the neck when you sleep. Sit back against the chair and pull head back- “chin tucks”. Walk tall- always think shoulders back, head up, chest out and lead with your heels.
Michelle Elmo is a Physical Therapist, graduate of Grand Valley State with a Masters in the Science of Physical Therapy. She currently works at Gentiva Home Health in Jackson. This article is a portion of her presentation to the Jackson Parkinson Support Group.
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Micrographia: Having Small Handwriting
Having small handwriting may seem like an unexpected aspect of Parkinsons, but it is quite common. Many people actually experience this symptom as one of their first signs of PD, years before other movement symptoms arrive. It is literally what the name describes: When you hold a pen or pencil and write on a sheet of paper, your numbers and letters are very small and cramped-looking. It is caused by a lack of dopamine in the part of your brain called the basal ganglia, which helps start and control your movements.25 Without dopamine, the neurons in the basal ganglia cannot communicate with each other to produce smooth, controlled movement.
What Causes Parkinsons Movement Symptoms
Dopamine is a chemical messenger that is primarily responsible for controlling movement, emotional responses and the ability to feel pleasure and pain. In people with Parkinsons, the cells that make dopamine are impaired. As Parkinsons progresses, more dopamine-producing brain cells die. Your brain eventually reaches a point where it stops producing dopamine in any significant amount. This causes increasing problems with movement.
Page reviewed by Dr. Chauncey Spears, Movement Disorders Fellow at the University of Florida, a Parkinsons Foundation Center of Excellence.
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How Do I Maintain Good Posture
Use a mirror to check posture throughout the day. Be aware of posture changes. Try to catch yourself stooping or leaning and take action to make corrections. Ask people to tell you if they notice you stooping. Change position often. Take movement breaks! Get back or neck rolls or cushions for better postural alignment when sitting. Consider yoga or tai chi classes. Seek a physical therapy referral for specific posture recommendations and treatment. Perform simple posture exercises/ stretches throughout the day.
Losing Height As You Age
On average, people lose between a 1/4 to a 1/2 inch in height each decade after your forties or fifties. Women tend to lose more height than men, but the reason is not yet known.
People lose height as a result of the discs between their vertebrae dehydrating and compressing, which leads to a loss of vertebral height. The vertebrae can also collapse because of bone loss density associated with some diseases or loss of muscle, which contributes to a stooped posture.
While height loss is an inevitable part of aging, it can also be an indicator of an underlying health condition. Stooped posture, as well as a loss of vertebral height and loss of disc height, are symptoms of some serious health conditions.
Height loss is serious if it is the result of spinal compression and can cause severe pain and disrupted mobility. It is important to have your height measured as part of your annual exam, to ensure that the inches lost are within the normal ranges of age-related height loss.
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Many People Experience Changes In Their Posture During The Course Of Parkinsons For Some Changes May Be Subtle Such As Developing A Slight Stoop But For Others They Become Pronounced Forcing Them Into Extremely Painful Positions
Even subtle changes in posture can cause discomfort, make it harder to walk, and affect balance. For those who develop more severe postural problems, the impact on everyday life can be profound, causing breathing difficulties, pain that most commonly affects the arms, legs, joints and back, falls and severe difficulties with walking and mobility.
Natural Treatments For Stooped Posture
A stooped posture can result from a health condition, from poor posture, and from injury. Weakened bones that naturally occur with aging also contribute to lost height.
In many cases of stooped posture, there is pain associated with movements, especially when spinal degeneration has occurred. There are a few natural treatments you can try that will alleviate pain in the spine and restore health to the spinal joints.
Collagen: Collagen is a significant component of bone structure. Bone mass loss associated with aging can contribute to and complicate stooped posture. Collagen supplements restore lost collagen and enhance bone strength. Collagen prevents bone loss and supports degenerated spinal joints.Hyaluronic acid: Another natural substance in the body that supports joints is hyaluronic acid. This gel-like substance cushions joints and spinal discs. This prevents shrinkage as a result of slipped discs and provides support for degenerative joints. Hyaluronic acid can repair areas of the spine that have weakened and are contributing to lost height.
Astaxanthin: Astaxanthin is an anti-inflammatory compound that reduces pain and inflammation associated with stooped posture. Height loss and stooped posture force spinal bones to come into contact with one another. This causes inflammation and pain, which astaxanthin can reduce.
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Parkinsons Disease: Levodopa Treatment
Levodopa is a drug that the brain converts into dopamine. Its been used since the 1970s and is still the most effective Parkinsons medication. Eventually, levodopa can wear off quickly. It should not be taken with a high-protein diet. Levodopa is most commonly combined with carbidopa to prevent nausea and vomiting, allowing more levodopa to get to the brain. Other side effects include drowsiness. Hallucinations, paranoia, and involuntary movements may happen with long-term use.
What Is The Outlook For Persons With Parkinsons Disease
Although there is no cure or absolute evidence of ways to prevent Parkinsons disease, scientists are working hard to learn more about the disease and find innovative ways to better manage it, prevent it from progressing and ultimately curing it.
Currently, you and your healthcare teams efforts are focused on medical management of your symptoms along with general health and lifestyle improvement recommendations . By identifying individual symptoms and adjusting the course of action based on changes in symptoms, most people with Parkinsons disease can live fulfilling lives.
The future is hopeful. Some of the research underway includes:
- Using stem cells to produce new neurons, which would produce dopamine.
- Producing a dopamine-producing enzyme that is delivered to a gene in the brain that controls movement.
- Using a naturally occurring human protein glial cell-line derived neurotrophic factor, GDNF to protect dopamine-releasing nerve cells.
Many other investigations are underway too. Much has been learned, much progress has been made and additional discoveries are likely to come.
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Signs Of Parkinsons Disease
Parkinsons symptoms can be divided into two categories: motor symptoms and non-motor symptoms. Motor symptoms involve changes in how you move your body, and non-motor symptoms are other symptoms not related to movement. Both types of symptoms can be equally difficult to deal with. Until recently, doctors primarily focused on treating motor symptoms. Symptoms can vary in how severe they are from day to day you might feel better one day and worse the next, or even better in the morning and worse later in the day. Severity also depends on how effective your medications are.
What Lifestyle Changes Can I Make To Ease Parkinsons Symptoms
Exercise: Exercise helps improve muscle strength, balance, coordination, flexibility, and tremor. It is also strongly believed to improve memory, thinking and reduce the risk of falls and decrease anxiety and depression. One study in persons with Parkinsons disease showed that 2.5 hours of exercise per week resulted in improved ability to move and a slower decline in quality of life compared to those who didnt exercise or didnt start until later in the course of their disease. Some exercises to consider include strengthening or resistance training, stretching exercises or aerobics . All types of exercise are helpful.
Eat a healthy, balanced diet: This is not only good for your general health but can ease some of the non-movement related symptoms of Parkinsons, such as constipation. Eating foods high in fiber in particular can relieve constipation. The Mediterranean diet is one example of a healthy diet.
Preventing falls and maintaining balance: Falls are a frequent complication of Parkinson’s. While you can do many things to reduce your risk of falling, the two most important are: 1) to work with your doctor to ensure that your treatments whether medicines or deep brain stimulation are optimal and 2) to consult with a physical therapist who can assess your walking and balance. The physical therapist is the expert when it comes to recommending assistive devices or exercise to improve safety and preventing falls.
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The Power Of Consistency
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Become A Campaigning Politician Waving To The Cheering Throngs
The next step is to move while maintaining your verticality. Walk with attention to keeping your torso lifted. I like to use another image to encourage this in my students: imagine yourself as a beloved politician, standing tall, proudly striding through a sea of your roaring fans. Working on good posture can involve a bit of fun too.
In this video you can see everything strung together: the reset button, extending like a growing tree, and walking like a politician in a packed arena.
If you want to take your walking technique a step further, check out PDM Lab’s post on gait stability and avoiding festination.
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