Practical Exercises for Parkinson’s

Parkinson’s disease is a neurodegenerative disorder that predominately affects the dopamine-producing neurons of an area of the brain called substantia nigra. Symptoms generally develop slowly over years. The symptoms and their progression vary from person to person. Making every experience slightly different. Some of the more common symptoms people with Parkinson’s disease may experience are:

• Tremor, mainly at rest with the most common being described as a pill rolling tremor in the hands. However other forms of tremor are possible.
• Bradykinesia (slowness of movement)
• Limb rigidity
• Gait and balance problems

 

Parkinson’s disease can affect the body in ways that are seen and unseen. These are generally categorized into movement related symptoms and non- movement related symptoms. In addition to the most common symptoms listed above people may also experience:

 

Movement Symptoms:

• Dizziness or fainting
• Drooling
• Dyskinesia
• Dystonia
• Facial masking
• Trouble with balance and falls
• Rigidity
• Stooped posture
• Trouble moving or walking
• Tremor
• Bradykinesia (slowness of movement)
• Limb rigidity
• Gait and balance problems

 

Non-movement related symptoms:

• Anxiety
• Depression
• Apathy
• Difficulty breathing
• Cognitive changes
• Dementia
• Constipation and nausea
• Urinary incontinence
• Fatigue
• Weight management issues
• Trouble sleeping
• Small handwriting
• Speech and swallowing problems
• Pain
• Hallucinations/delusions
• Loss of smell
• Skin changes
• Speech and swallowing problems
• Vertigo and dizziness
• Vision changes

 

What causes Parkinson’s disease:

The cause of Parkinson’s disease is still not well understood however, it is believed that Parkinson’s is caused by a combination of genetics and environmental factors, with lifestyle also playing a role. Parkinson’s is extremely diverse and does not affect any two people in the same way. There are some commonalities with how it affects people. With the main finding being loss of dopaminergic neurons in an area of the brain known as the substantia nigra.

It is believed that genetics are responsible for 10-15% of all Parkinson’s cases. For the rest it is believed to be a combination of genetic and environmental factors. The interaction between the environment and our genes is quite complex. Some environmental exposures may lead to a lower risk of Parkinson’s disease, while others may increase it. Some environmental factors have been associated with an increased risk of Parkinson’s disease. These include head injuries, area of residence, exposure to pesticides and others.

Parkinson’s is caused by a combination of genetics, environmental and lifestyle factors. It is the interaction between all three of these factors that determines if someone will develop Parkinson’s.

 

 

Diagnosis of Parkinson’s

There is not “one way” to diagnose Parkinson’s disease. Making an accurate diagnosis especially in the early stages is difficult. However, a skilled practitioner is able to use a combination of various diagnostic tests and symptoms to make an accurate diagnosis. In order for a neurologist to consider a Parkinson’s diagnosis at least two of the four main symptoms must be present over a period of time.

• Slowness of movement (bradykinesia)
• Shaking or tremor
• Trouble with balance and possible falls (postural instability)
• Rigidity or stiffness in the arms, legs, or trunk

Here in BC the diagnosis of Parkinson’s is made by a neurologist. However, often people with Parkinson’s are first diagnosed by their family physician and later referred to a neurologist.

There are neurologists located throughout BC, although those living in small towns and rural communities may need to travel some distance for consultation. With many neurologists being generalists treating a variety of neurological disorders including Parkinson’s. Instead of specializing in one specific disorder.

 

Living with Parkinson’s

As there is no standard treatment for Parkinson’s disease the approach is individual for each person living with Parkinson’s based on his or her symptoms. Treatment most often includes medication. As well as lifestyle modifications like getting more rest and exercise. There are many medications to treat Parkinson’s symptoms, however none yet that are able to reverse the effect of the disease. It is common for people living with Parkinson’s disease to take several different medications at different times and dosages to manage their symptoms.

While tracking your medications and understanding how each one affects you can be a challenging task, this can be one of the best ways to avoid unpleasant “off” periods due to missed or incorrect doses.

 

Exercise and Parkinson’s

Research suggests that regular exercise including resistance training as well as gait and balance training may help improve or hold the symptoms of Parkinson’s disease at bay. According to Parkinson’s foundation increasing physical activity to at least 2.5 hours a week can slow the decline of quality of life. Early referral to physiotherapy and encouraging exercise as a part of treatment are associated with better outcomes. Exercise is an important component for healthy living for everyone. However, for those with Parkinson’s disease exercise is a vital component to maintain balance, mobility, and activities of daily living. Exercise and physical activity can improve many of the symptoms of Parkinson’s disease. With Parkinson’s establishing early exercise habits are essential for overall disease management.

It is never too late to start exercising weather you have just been diagnosed or have been navigating the disease for a while now. Many people ask what type of exercise is best for Parkinson’s? The answer is it depends. Research has shown that both non-contact boxing and dance can be helpful. If you enjoy these activities that is wonderful. If not or you do not have access to these activities any exercise or physical activity that you enjoy and will participate in on a regular basis is good for Parkinson’s.

 

Parkinson’s supports

A diagnosis of Parkinson’s disease can be scary and lonely. I often hear from people they feel like they were not giving all the information they need and are not sure where to find it. You are not alone, and I encourage you to reach out and ask questions, join a local group for people with Parkinson’s an exercise class or a support group can be helpful. If you live in BC the BC Parkinson’s foundation is an amazing resource

( https://www.parkinson.bc.ca/ ). In the USA (https://www.parkinson.org/) is a wonderful resource for information and can help to connect you with professionals in your area.

 

Practical exercises for Parkinson’s

Parkinson’s can affect the brain and as such adding exercises to your routine that not only challenge you physically but also mentally can help you to stay healthy. Try the exercise below

 

Arms Exercise :

Start standing tall feet hip width apart.

Reach both hands over head palms facing each other.

Move right arm clockwise and the left counter clockwise until they both meet again in the starting position.

Switch moving the left arm clockwise and the right counter clockwise.

Parkinson’s can lead to one’s gait being severely altered. To counter act that it is important to work on the proper mechanics of walking. Below is an exercise to help with toe lift during walking.

 

Balance Exercise :

Start standing tall with feet hip width apart.

Without bending at the hips rock back onto your heels.

Next again without bending at the hips shift your weight forward coming up onto your toes.

Repeat.

 

 Always remember Physiotherapist and Kinesiologist’s are here to help and can provide you with a specific plan to address your concerns when it comes to Parkinson’s and exercise.

Written By:

Katie Anderson

Registered Kinesiologist

Clinical Exercise Physiologist