Wednesday, June 13, 2012

Parkinson’s disease patients turn to dance

Phyllis Valentine never trained as a dancer, but she fondly remembers whirling around the room doing the polka with her father as a young girl.

She also remembers watching her father’s steady deterioration after he was found to have Parkinson’s disease, a debilitating neuromuscular condition that eventually robs patients of the ability to perform even the most basic movements without great difficulty. So when, at the age of 75, Valentine received a similar diagnosis, she figured any dancing was solidly in her past.

“The doctor told me I was in the early stages,” says the former New Yorker, a petite woman with an irreverent sense of humor who lacks the tremor that is the most recognizable sign of a Parkinson’s patient. “But I was scared to death.”

Parkinson’s, which results from the dying of brain cells that produce dopamine, a chemical messenger critical to movement, can result in tremors, stiffness, difficulty with speech and general movement impairment.

About 1 million American have the disease and approximately 60,000 new cases are diagnosed annually.

Paradoxical as it may seem to pair movement-restricted patients with artists who make a living from their flexible and athletic bodies, David Levanthal — the MMDG dancer who has become the unofficial authority on Dance for PD — says both bring “a superconsciousness to movement.” The physical and mental discipline a dancer requires to execute challenging steps travel along the same brain pathways that a Parkinson’s patient must exercise to retain even the most pedestrian movement

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Sunday, September 12, 2010

The Benefits of Exercise for People Who Suffer From Parkinson’s Disease

Many sufferers of Parkinson’s disease quickly find that various aspects of their life are no longer controllable in the way that they used to be however by exercising regularly Parkinson sufferers can continue to control their gross movements i.e. walking, holding objects etc. for longer which adds a mental and emotional boost to their wellbeing. Research has shown that exercise may also improve the synthesis of dopamine in the brain and increase the levels of neurotrophic factors which are beneficial compounds.

Exercise for people diagnosed with Parkinson’s disease incorporates muscle strengthening, flexibility and toning activities so that muscles and joints stay flexible and strong. It is normal for a physiotherapist to implement an exercise schedule for the patient that includes a range of activities to work all muscles of the body over a two or three day period. So for example, day one of the cycle may include walking and strengthening exercises for the arms and hands whereas day two might be a yoga class where flexibility of the joints is the main focus.

It is essential to monitor the patient’s progress, not only so that any improvements and decreases in function are recorded but also as a stimulus for the patient; when people see improvement and can visualise the effort that they put in they are much more positive about continuing the regime.

In general exercise should test the entire body and not just the limbs so that posture and movement is maintained for as long as possible. Good posture is essential in the later stages of Parkinson’s disease because stooping can hamper breathing and swallowing. Exercises for posture include callisthenics, yoga, Pilates, tai chi, and swimming however not every sufferer will enjoy these types of activities. Simply sitting upright while reading a book or watching TV and walking with a straight back will also help though, thus walking the dog or playing with the children or grandchildren are great ways to work the body muscles and to enjoy daily exercising.

Regular exercise for the Parkinson’s sufferer will reduce the incidence of muscle cramps, rigidity of the joints and the aches and pains associated with staying still for long periods of time. Also, because exercise helps the sufferer to maintain control over many of their gross movements (although maybe not the tremors) it gives them a heightened sense of achievement and so stress and anxiety levels remain low. Keeping a positive mental attitude is incredibly important in conditions like Parkinson’s disease where sufferer can very easily become frustrated and discouraged with their predicament.

As with all exercise routines, the patient should start with a good warm up followed by the exercise activity of their choice or which has been scheduled for that day, and then they should finish with a positive cool down so that the chances of developing muscle cramps and injuries are greatly reduced. An exercise session should ideally last around 15-20 minutes and should not by any means exhaust the patient. Overexertion can be equally as damaging to a Parkinson’s sufferer as no exercise at all.

In order to make daily exercise more appealing and less of a chore it may be worth trying to find a friend or relative that is willing to exercise with the patient. Also, a bit of variety in the type of exercise will not only mean that the exercise stays interesting but it will also ensure that all muscles and joints of the body are used to a satisfactory level.

Sunday, September 5, 2010

Parkinson's disease patients find benefits in martial arts exercise

Many people have seen martial arts performed in movies and on television, most likely as a means of defense against opposing forces in battle scenes. However, in Winter Haven, a form of martial arts - tai chi - is being used as a means of defense against an internal opponent - Parkinson's disease.

Parkinsons patients Bob Harmon, left, and Laura Williams perform Tai Chi with instructor Michael Carey and assistant Kate Gilbert at the Main Street Dojo's, Inc. on Central Avenue in Winter Haven.

Bob Harmon, left, follows the precise movements of instructor Michael Carey during Tai Chi.

Funded as part of a grant by the University of South Florida neurology department, Dr. Michael Carey has been offering free tai chi classes in Lakeland to Parkinson's disease patients for two years. This summer, he started offering the classes in Winter Haven.

Parkinson's disease patient Laura Williams began taking the classes in Lakeland and switched to the Winter Haven classes when they became available.

"I knew what tai chi was, but I didn't know how it could help people with Parkinson's disease," said Williams of her decision to start the class two years ago. "I heard about the class through my doctor, and I decided to go. It has helped so much with my balance, because my balance wasn't that good because of Parkinson's. The class has been good for that."

Williams said that because of tai chi's slow, deliberate movements, the exercise is one she can practice at home to supplement the once-a-week class.


Thursday, August 12, 2010

Comparing exercise in Parkinson’s disease-The Berlin BIG Study.

Ebersbach G, Ebersbach A, Edler D, Kaufhold O, Kusch M, Kupsch A, Wissel J

Physiotherapy widely used Parkinson’s disease (PD), bυt tr r few controlled studies comparing active interventions. Recently, a technique named “Training BIG” b introduced. Training BIG derived frοm t Lee Silverman Voice Treatment focuses ο intensive exercising οf high-amplitude movements. I t present comparative study, 60 patients wt mild tο moderate PD wr randomly assigned tο receive tr one-tο-one training οf BIG, group training οf Nordic Walking (WALK), οr domestic nonsupervised exercises (HOME). Patients BIG WALK received 16 hours οf supervised training within 4 (BIG) οr 8 (WALK) weeks. T primary efficacy measure w ffr change Unified Parkinson’s Disease Rating Scale (UPDRS) motor score frοm baseline tο follow-up t 16 weeks between groups. UPDRS scores wr obtained b blinded video rating. ANCOVA οw significant group differences fοr UPDRS-motor score t final assessment (P < 0.001). Mean improvement οf UPDRS BIG w -5.05 (SD 3.91) whereas tr w a mild deterioration οf 0.58 (SD 3.17) WALK οf 1.68 (SD 5.95) HOME. BIG w ο superior tο WALK HOME timed-up--ο timed 10 m walking. Tr wr ο significant group differences fοr quality οf life (PDQ39). T results provide evidence tt BIG effective technique tο improve motor performance patients wt PD. (c) 2010 Movement Disorder Society.

Saturday, July 24, 2010

Exercise and Parkinson's Disease

Reviewed by Jon Glass, MD

Because Parkinson's disease affects your ability to move, exercise helps to keep muscles strong and improve flexibility and mobility. Exercise will not stop Parkinson's disease from progressing;but, it will improve your balance and it can prevent joint stiffening.

You should check with your doctor before beginning any exercise program. Your doctor may make recommendations about:

* The types of exercise best suited to you and those which you should avoid
* The intensity of the workout (how hard you should be working)
* The duration of your workout and any physical limitations
* Referrals to other professionals, such as a physical therapist who can help you create your own personal exercise program

The type of exercise that works best for you depends on your symptoms, fitness level, and overall health. Generally, exercises that stretch the limbs through thefull range of motion are encouraged.

Here are some tips to keep in mind when exercising.

* Always warm-up before beginning your exercise routine and cool down at the end.
* If you plan to workout for 30 minutes, start with 10-minute sessions and work your way up.
* Exercise your facial muscles, jaw, and voice when possible: Sing or read aloud, exaggerating your lip movements. Make faces in the mirror. Chew food vigorously.
* Try water exercise, such as water aerobics or swimming laps. These are often easier on the joints and require less balance.
* Work out in a safe environment; avoid slippery floors, poor lighting, throw rugs, and other potential dangers.
* If you have difficulty balancing, exercise within reach of a grab bar or rail. If you have trouble standing or getting up, try exercising in bed rather than on the floor or an exercise mat.
* If at any time you feel sick or you begin to hurt, stop.
* Select a hobby or activity you enjoy and stick with it. Some suggestions include: gardening; walking; swimming; water aerobics; yoga; tai chi.

Saturday, July 17, 2010

Why Exercise is So Important

Daily exercise therapy is one of the best things that you can do for yourself to counteract the negative effects of PD & other neurological & muscular disorders. A lack of physical activity reduces the amount of oxygen to the brain, contributes to further cell damage, loss of cognitive skills and muscle control.

Exercise brings additional oxygen & glucose to the brain, both of which are crucial to brain function. The body responds by forming new capillaries to bring the additional blood to nerve cells and by boosting brain chemicals that protect neurons and strengthen new neuronal connections. We have learned from stroke victims that the human brain has the ability to create new connections and bypass damaged areas to regain lost motor skills & muscle control. Remarkable results have been achieved, over time, with daily mental & physical exercise therapy. Mental concentration on repetitive physical movements can provide benefits to our muscles as well as our mental ability to control them.

When nerve cells are deprived of stimuli they atrophy, suggesting that stimulation of the central nervous system by physical activity may retard the loss of nerve cells in the brain and elsewhere. Exercise has been shown to enhance blood flow to various parts of the brain as well as to increase the speed with which nerve messages travel through the brain.

In addition to the effects of Parkinsons, most people diagnosed with this disease are over the age of 50 and therefore are also experiencing the normal effects of aging.

According to the American Academy of Orthopaedic Surgeons:

* As muscles age, they begin to shrink and take longer to respond
* Tendons become stiffer & less able to tolerate stress
* Handgrip strength decreases, making routine tasks more difficult
* The heart muscle becomes less capable, making us tire more quickly
* Joint motion becomes more restricted & flexibility decreases
* Joints become inflamed and arthritic as the cushioning cartilage begins to breakdown

However the good news is, that we now know that most of the changes in our musculoskeletal system that were attributed to normal aging are in fact the result of inactivity and or insufficient physical exercise. The less physical activity and exercise we do the less capable we become.
According to the Mayo Clinic, "Exercise has important benefits for everyone regardless of age or physical condition... When your condition threatens to immobilize you, Exercise keeps you moving... to retain your mobility & function, use it or lose it".

Saturday, July 10, 2010

Gameworld: Motion games broaden uses beyond exercise

By John Gaudiosi
RALEIGH, North Carolina (Reuters Life!) – Ever since Nintendo launched the Wii, gamers have been interacting with characters and working out with virtual trainers in titles like Electronic Arts’ “EA Sports Active” or Ubisoft’s “Your Shape.”
Nintendo is even encouraging families to exercise together with “Wii Games: Summer 2010,” a national tour that kicks off in Jersey City, New Jersey on July 16 with Olympic gymnast Shawn Johnson serving as an ambassador for the competition.

Now researchers, scientists and game developers are using Nintendo’s console for many other health-oriented applications, and in some cases are getting millions of dollars in grants to dream up new technologies.

A recent gathering of over 400 top minds at the sixth annual Games for Health Conference in Boston found innovative new ways that video games with motion-sensor controllers are being used to help doctors and patients.

Through a grant from the National Institute of Health, Red Hill Games and the School of Nursing at the University of California San Francisco are using Wii technology to create games that help people with Parkinson’s disease improve their balance. One called “Rail Runner” requires patients to stand up and sit down to operate an old-fashioned railroad hand cart.

“Most of these patients are in their 70s and 80s, and they really love these games,” said Bob Hone, creative director at Red Hill Studios. “They really want something that’s going to address their disease, and what’s different is these games are designed specifically for them.”

Red Hill is incorporating similar Wii technology into games to help improve gait and balance in kids with Cerebral Palsy.

“These kids sometimes have physical challenges, so we’ve taken that into account to make games where they feel like they’re walking and they get to the finish line successfully,” said Hone.

This fall, Sony Computer Entertainment America will launch PlayStation Move for PlayStation 3 and Microsoft will introduce Kinect for Xbox 360. These new devices are expected to not only open up gaming to a new mainstream audience, but also offer pioneers in the burgeoning Games for Health arena the ability to dream up new technology.

“The impact of these new technologies is going to be as seismic as Nintendo was when it originally came out with the Wii and the Wii balance board, because it’s going to extend across more platforms,” said Stephen Yang, a researcher and assistant professor at New York’s College of Courtland.

“There are a lot of great game designers out there who will be able to tap into these new physical interactions with games and bring new experiences that will be both fun and beneficial for patients,” Yang said.

John Lumpkin, MD, senior vice president of the Robert Wood Johnson Foundation, has seen first-hand the advances that motion-sensor controllers and physical games have had on both his patients and his own children.

“These games promote motion, which increases the heart rate and burns more calories,” said Lumpkin. “Even a game with the simplest motion like playing drums on ‘Rock Band’ can have a gamer burning twice as many calories per hour as he or she would just sitting around, while a more vigorous game like ‘Dance Dance Revolution’ can burn as many as six times the amount of calories,” said Lumpkin.
Lumpkin said what really excites him, and many in his field, is that fact that today researchers are using a Wii balance board game to help stroke victims regain their balance just as effectively as an $18,000 piece of equipment.

That’s one reason why the Games for Health sector has been growing exponentially over the past six years with no slowdown in sight.

“When you look at the economic activity associated with Health Care in the U.S. it’s approximately 16 percent of gross domestic product, even in countries that spend less on health care, it’s still double-digit GDPs,” said Ben Sawyer, co-founder, Games for Health.

“Small games for health developers are receiving grants in the tens of millions to the low hundreds of millions” of dollars, said Sawyer. “When you combine those numbers with game sales of titles like Konami’s ‘Dance Dance Revolution,’ Ubisoft’s ‘Your Shape,’ Nintendo’s ‘Wii Fit’ and Electronic Arts’ ‘EA Sports Active,’ the Games for Health sector is well over $1 billion annually.”