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 the full 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 aquarobics. 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.
Reviewed by the doctors at The Cleveland Clinic Neuroscience
WebMD Medical Reference provided in collaboration with the Cleveland Clinic
Saturday, December 27, 2008
Friday, December 12, 2008
Gaming your way to better health
Interactive games seek to get people moving, help them manage disease
By Kristen Gerencher, MarketWatch
Last update: 7:12 p.m. EST Dec. 11, 2008
SAN FRANCISCO (MarketWatch) -- Video games aren't just for kids and couch potatoes anymore. They're increasingly being used to motivate people of all ages to move their bodies and manage their chronic health conditions more effectively.
Health electronic games represent 16% of the overall video gaming industry, amounting to a $6.6 billion worldwide market this year, according to a report from IConecto, the sponsor of Gaming4Health.com, a company that designs and distributes custom e-games for insurers and employers.
The bulk of that figure comes from the two largest subcategories known as exergames and brain fitness. Exergames such as the popular Nintendo Wii Sports and Wii Fit systems pair digital interactive technology with the player's physical motion, while brain fitness focuses on cognitive training aimed at improving or maintaining mental function.
"Exergaming is just one part of the solution to reduce health-care costs and improve health status," said Doug Goldstein, chief executive of Gaming4Health in Alexandria, Va. "We have to get people moving. If this is an engaging way to get people moving then let's do it."
Smaller health e-game categories cited in the report include healthy eating, which involves weight management and obesity-related interventions, and condition management, targeted to people with chronic ailments such as diabetes, asthma, cancer or pain.
Some health insurers are getting in on the action. Humana developed a competitive game for school children called the Horsepower Challenge. Cigna distributes a game called ReMission to teens and young adults with cancer. In a study published in the journal Pediatrics last August, ReMission, which features a sassy nanobot named Roxxi who blasts cancer cells in a fictional cancer patient, was shown to increase players' adherence to oral chemotherapy and antibiotics regimens, which can prevent cancer recurrence.
Video: Gaming For Health
Interactive video games are bringing fresh therapy and fitness approaches to players of all ages. MarketWatch's Kristen Gerencher looks at a program designed to help young cancer patients and one aimed at people with Parkinson's disease. (Dec. 11)
Health-oriented games are targeted to older adults as well. Sixty-one percent of more than 350 senior-living and older-adult centers surveyed intend to purchase some form of computer-generated or Wii-type game in the next two years, according to a November poll from the International Council on Active Aging, a trade group representing senior-living communities and centers. Another 38% were considering buying brain fitness software.
"Over the last 10 years there's been virtually zero increase in the level of activity in individuals 55-plus," said Colin Milner, the council's chief executive. "People are beginning to come in with these products transferring movements online and trying to make it fun."
Debunking stereotypes
The market's shifted in the last decade as game publishers, health plans, academics and policymakers became more enthusiastic about the potential for game applications in health care, said Debra Lieberman, director of the Health Games Research national program at the University of California-Santa Barbara, which is overseeing the disbursement of $4 million in health-gaming research grants from the Robert Wood Johnson Foundation.
"People understand that good games can be made that don't have violence or hateful portrayals of racial and ethnic groups and aren't even sedentary anymore because you're up and off the couch," she said.
"It's not seen as such a radical thing to do in your health-care organization," Lieberman said. "It's now really feasible to think about health games that could be a moneymaker."
Still, much more needs to be learned, she added. "We're still trying to discover what quality is and what games can and cannot do."
Such research is likely to speed the convergence of traditional gaming and health care, said Steve Cole, vice president for research at HopeLab, a nonprofit in Redwood City, Calif., that developed ReMission as part of its charter to support the health of teenagers with chronic disease.
"The market that we want to catalyze has the health-care industry as the consumer of these games and the commercial games industry as the producer of these games," he said. "But the commercial games industry has been quite slow to take it up because they don't really feel they know how to change health behavior. That's not what they've done in the past."
Not everyone believes gaming will improve health measures on a broad scale. It may make a mark in senior fitness or in the fight against childhood obesity, but health e-games likely will remain a niche market, said Carl Doty, a principal analyst at Forrester Research in Boston.
"I don't see it as a pragmatic way to get people engaged in fitness. I think there are some isolated examples where it can have beneficial outcomes," Doty said. "The root problem goes much deeper than getting people to have a little bit of fun. It's more about culture, diet and it's tough to get that level of behavior change with gaming."
Exergaming
Humana, the Louisville, Ky.-based health insurer, is pleased with the performance of its online game to get school children moving, said Joanna Darst, product manager for the Humana Innovation Center.
The Horsepower Challenge gives each student a pedometer, which tracks their movement and sends wireless updates to the HumanaGames.com Web site. Students also receive animated horses that represent them online, where they can see their progress. Teams of school systems compete against each other, and kids who accumulate activity earn rewards they can use to accessorize their horses.
"Our mission is basically to help people play their way to better health," Darst said. "We want to make it fun for people to get healthy."
Though Humana gives most of its games away for free, its motives aren't entirely altruistic. The company is factoring in relatively high turnover in its business.
"If they aren't a Humana member today they might be in a couple years, and if they come to us healthier because of the games then we're better for that," Darst said.
Humana also has sold a few units of a senior-focused game called Dancetown, a game similar to Dance Dance Revolution but with a safety rail that surrounds the dance pad, she said. "You can set different levels of difficulty on the pads so a grandmother can play a grandchild but it's challenging for both."
At Inland Empire Health Plan, which serves low-income beneficiaries of the state's public programs in two large counties in Southern California, doctor-referred overweight kids can work out with interactive games as part of a weight-loss program that takes place at a site called XRtainment Zone in Loma Linda, said Gary Melton, director of health administration in San Bernardino.
"It's pretty exciting, especially when you see the facility," he said. "It appeals to those children that don't typically get involved in soccer and sports and all of that stuff."
The downside is that many families live and work too far away from the site to make it a viable fitness alternative, Melton said.
But the 100 kids who do participate can exercise with a variety of games, one of which allows the rider of a stationery bicycle to do so in front of a screen where a character rides through the streets of Tokyo on a motorcycle, said Dr. Sue Gengler, Inland's health education manager.
Managing cancer, Parkinson's disease
Games such as ReMission can help young-adult cancer patients, who are prone to skipping chemotherapy doses, stay on track, Cole said. "It's not because they don't understand they should take their chemo. After months and months and months of treatment, they start to feel confident of being cured and a desire to get back to the life they led."
Getting the benefits doesn't require spending lots of time parked in front of the computer, he said. "We found that kids who played the game as little as one to two hours showed the same positive effect as kids who played for more than 20 hours."
At the University of California-San Francisco, researchers are adapting the Wii gaming platform to help patients with Parkinson's disease improve their gait and balance.
With a grant from the National Institutes of Health, researchers will test whether the custom program works to help Parkinson's patients overcome their functional impairments better than traditional methods like physical therapy, said Glenna Dowling, chair of the physiological nursing department at UCSF.
"People with Parkinson's tend to take these small stutter steps, which are very unstable," she said. "This gets them to pick up their feet and have a more normal gait. [It] has the potential to reduce falls."
Patients often don't get much physical therapy, and having a home-based game protocol would make treatment more accessible, Dowling said. The first phase of research among 20 patients, half of whom worked with the game in a lab setting, proved promising.
"We saw positive benefits by three months and even more positive benefits by six months," Dowling said.
Kristen Gerencher is a reporter for MarketWatch in San Francisco.
By Kristen Gerencher, MarketWatch
Last update: 7:12 p.m. EST Dec. 11, 2008
SAN FRANCISCO (MarketWatch) -- Video games aren't just for kids and couch potatoes anymore. They're increasingly being used to motivate people of all ages to move their bodies and manage their chronic health conditions more effectively.
Health electronic games represent 16% of the overall video gaming industry, amounting to a $6.6 billion worldwide market this year, according to a report from IConecto, the sponsor of Gaming4Health.com, a company that designs and distributes custom e-games for insurers and employers.
The bulk of that figure comes from the two largest subcategories known as exergames and brain fitness. Exergames such as the popular Nintendo Wii Sports and Wii Fit systems pair digital interactive technology with the player's physical motion, while brain fitness focuses on cognitive training aimed at improving or maintaining mental function.
"Exergaming is just one part of the solution to reduce health-care costs and improve health status," said Doug Goldstein, chief executive of Gaming4Health in Alexandria, Va. "We have to get people moving. If this is an engaging way to get people moving then let's do it."
Smaller health e-game categories cited in the report include healthy eating, which involves weight management and obesity-related interventions, and condition management, targeted to people with chronic ailments such as diabetes, asthma, cancer or pain.
Some health insurers are getting in on the action. Humana developed a competitive game for school children called the Horsepower Challenge. Cigna distributes a game called ReMission to teens and young adults with cancer. In a study published in the journal Pediatrics last August, ReMission, which features a sassy nanobot named Roxxi who blasts cancer cells in a fictional cancer patient, was shown to increase players' adherence to oral chemotherapy and antibiotics regimens, which can prevent cancer recurrence.
Video: Gaming For Health
Interactive video games are bringing fresh therapy and fitness approaches to players of all ages. MarketWatch's Kristen Gerencher looks at a program designed to help young cancer patients and one aimed at people with Parkinson's disease. (Dec. 11)
Health-oriented games are targeted to older adults as well. Sixty-one percent of more than 350 senior-living and older-adult centers surveyed intend to purchase some form of computer-generated or Wii-type game in the next two years, according to a November poll from the International Council on Active Aging, a trade group representing senior-living communities and centers. Another 38% were considering buying brain fitness software.
"Over the last 10 years there's been virtually zero increase in the level of activity in individuals 55-plus," said Colin Milner, the council's chief executive. "People are beginning to come in with these products transferring movements online and trying to make it fun."
Debunking stereotypes
The market's shifted in the last decade as game publishers, health plans, academics and policymakers became more enthusiastic about the potential for game applications in health care, said Debra Lieberman, director of the Health Games Research national program at the University of California-Santa Barbara, which is overseeing the disbursement of $4 million in health-gaming research grants from the Robert Wood Johnson Foundation.
"People understand that good games can be made that don't have violence or hateful portrayals of racial and ethnic groups and aren't even sedentary anymore because you're up and off the couch," she said.
"It's not seen as such a radical thing to do in your health-care organization," Lieberman said. "It's now really feasible to think about health games that could be a moneymaker."
Still, much more needs to be learned, she added. "We're still trying to discover what quality is and what games can and cannot do."
Such research is likely to speed the convergence of traditional gaming and health care, said Steve Cole, vice president for research at HopeLab, a nonprofit in Redwood City, Calif., that developed ReMission as part of its charter to support the health of teenagers with chronic disease.
"The market that we want to catalyze has the health-care industry as the consumer of these games and the commercial games industry as the producer of these games," he said. "But the commercial games industry has been quite slow to take it up because they don't really feel they know how to change health behavior. That's not what they've done in the past."
Not everyone believes gaming will improve health measures on a broad scale. It may make a mark in senior fitness or in the fight against childhood obesity, but health e-games likely will remain a niche market, said Carl Doty, a principal analyst at Forrester Research in Boston.
"I don't see it as a pragmatic way to get people engaged in fitness. I think there are some isolated examples where it can have beneficial outcomes," Doty said. "The root problem goes much deeper than getting people to have a little bit of fun. It's more about culture, diet and it's tough to get that level of behavior change with gaming."
Exergaming
Humana, the Louisville, Ky.-based health insurer, is pleased with the performance of its online game to get school children moving, said Joanna Darst, product manager for the Humana Innovation Center.
The Horsepower Challenge gives each student a pedometer, which tracks their movement and sends wireless updates to the HumanaGames.com Web site. Students also receive animated horses that represent them online, where they can see their progress. Teams of school systems compete against each other, and kids who accumulate activity earn rewards they can use to accessorize their horses.
"Our mission is basically to help people play their way to better health," Darst said. "We want to make it fun for people to get healthy."
Though Humana gives most of its games away for free, its motives aren't entirely altruistic. The company is factoring in relatively high turnover in its business.
"If they aren't a Humana member today they might be in a couple years, and if they come to us healthier because of the games then we're better for that," Darst said.
Humana also has sold a few units of a senior-focused game called Dancetown, a game similar to Dance Dance Revolution but with a safety rail that surrounds the dance pad, she said. "You can set different levels of difficulty on the pads so a grandmother can play a grandchild but it's challenging for both."
At Inland Empire Health Plan, which serves low-income beneficiaries of the state's public programs in two large counties in Southern California, doctor-referred overweight kids can work out with interactive games as part of a weight-loss program that takes place at a site called XRtainment Zone in Loma Linda, said Gary Melton, director of health administration in San Bernardino.
"It's pretty exciting, especially when you see the facility," he said. "It appeals to those children that don't typically get involved in soccer and sports and all of that stuff."
The downside is that many families live and work too far away from the site to make it a viable fitness alternative, Melton said.
But the 100 kids who do participate can exercise with a variety of games, one of which allows the rider of a stationery bicycle to do so in front of a screen where a character rides through the streets of Tokyo on a motorcycle, said Dr. Sue Gengler, Inland's health education manager.
Managing cancer, Parkinson's disease
Games such as ReMission can help young-adult cancer patients, who are prone to skipping chemotherapy doses, stay on track, Cole said. "It's not because they don't understand they should take their chemo. After months and months and months of treatment, they start to feel confident of being cured and a desire to get back to the life they led."
Getting the benefits doesn't require spending lots of time parked in front of the computer, he said. "We found that kids who played the game as little as one to two hours showed the same positive effect as kids who played for more than 20 hours."
At the University of California-San Francisco, researchers are adapting the Wii gaming platform to help patients with Parkinson's disease improve their gait and balance.
With a grant from the National Institutes of Health, researchers will test whether the custom program works to help Parkinson's patients overcome their functional impairments better than traditional methods like physical therapy, said Glenna Dowling, chair of the physiological nursing department at UCSF.
"People with Parkinson's tend to take these small stutter steps, which are very unstable," she said. "This gets them to pick up their feet and have a more normal gait. [It] has the potential to reduce falls."
Patients often don't get much physical therapy, and having a home-based game protocol would make treatment more accessible, Dowling said. The first phase of research among 20 patients, half of whom worked with the game in a lab setting, proved promising.
"We saw positive benefits by three months and even more positive benefits by six months," Dowling said.
Kristen Gerencher is a reporter for MarketWatch in San Francisco.
Sunday, December 7, 2008
Pacquiao's Trainer Fighting Different Battle
Updated: Dec 4, 2008 04:55 PM
Millions of fight fans will cheer for Manny Pacquiao or Oscar De La Hoya this weekend in the year's biggest fight. But Michael Berk has the story of a boxer turned trainer whose fight began long ago.
"Freddie Roach was a great fighter. He thought it was a great insult to duck a punch," said Bob Arum, President of Top Rank Inc.
That was a badge of courage Roach wore during his career inside the ring. Now on the apron as Manny Pacquiao's trainer, he wears the scars. One big scar really -- Parkinson's disease.
"I'm on a new medication and it's working pretty well. I drool a little bit sometimes, but that's a characteristic of it," he said.
Research supports that side effect, but Roach believes there's another. One which the medical establishment would never support, "One time I had Muhammad Ali -- he has very violent tremors -- he asked me if he could work out in my gym about five years ago. Once he started hitting the bag, his tremors went away. I'm very similar to him."
Parkinson's can and will rob Freddie of his coordination, balance and ability to stand tall, that's what science tells us. The disease, however, has no chance against the sweet science.
"It's like home. I'm comfortable -- it's my comfort zone. I'm sore sometimes, that's natural, but it's what I live for," he said.
Ultimately, the punches may be what he dies for, "You can't prove it, but it's related, of course. I chose the sport, nobody forced me to do it."
And Parkinson's disease won't force him away.
Millions of fight fans will cheer for Manny Pacquiao or Oscar De La Hoya this weekend in the year's biggest fight. But Michael Berk has the story of a boxer turned trainer whose fight began long ago.
"Freddie Roach was a great fighter. He thought it was a great insult to duck a punch," said Bob Arum, President of Top Rank Inc.
That was a badge of courage Roach wore during his career inside the ring. Now on the apron as Manny Pacquiao's trainer, he wears the scars. One big scar really -- Parkinson's disease.
"I'm on a new medication and it's working pretty well. I drool a little bit sometimes, but that's a characteristic of it," he said.
Research supports that side effect, but Roach believes there's another. One which the medical establishment would never support, "One time I had Muhammad Ali -- he has very violent tremors -- he asked me if he could work out in my gym about five years ago. Once he started hitting the bag, his tremors went away. I'm very similar to him."
Parkinson's can and will rob Freddie of his coordination, balance and ability to stand tall, that's what science tells us. The disease, however, has no chance against the sweet science.
"It's like home. I'm comfortable -- it's my comfort zone. I'm sore sometimes, that's natural, but it's what I live for," he said.
Ultimately, the punches may be what he dies for, "You can't prove it, but it's related, of course. I chose the sport, nobody forced me to do it."
And Parkinson's disease won't force him away.
Tuesday, December 2, 2008
Just the right moves
Dance aids those with Parkinson's
Johnny Diaz
WALTHAM - "Wiggle your fingers at the ceiling," Naomi Goodman told her dance students as she stretched her arms skyward. "Shake your body loose like a wet noodle. Take off that shirt, and stretch that spine. Extend your arms like beautiful wings."
The dancers followed her every move, though it didn't come fast or easy at first. These students live with tremors in their arms, weakness in their legs, and lack of muscle control in their everyday lives. But for two hours every Monday they groove to the blues, shimmy to jazz, and glide to the tango at the Jewish Family & Children's Service center. Here, they temporarily forget they are Parkinson's patients as they tap into their inner dancers.
They are pioneers in an unconventional but promising approach to helping people with Parkinson's, a progressive degenerative disease. Goodman, a dance and yoga instructor, incorporates movements from those disciplines to help people with Parkinson's improve their coordination and flexibility as their disease gradually robs them of both.
The students say the class, one of two in the Bay State, eases their symptoms and gives them a sense of control over a disease that often renders them powerless over their own bodies. The combination of music and dance instills a certain grace to their movements and makes them feel good. It is a way to take on this relentless disease.
The class serves another function: It provides a social outlet for Parkinson's patients, who often isolate themselves because they feel self-conscious about their disease.
"Parkinson's stiffens you up and makes you fearful of doing very much," said Rosamond Rosenmeier, 80, who has been dancing in these classes since they began last summer. In 1998, when she complained to her doctor of a persistent trembling in her left hand, he diagnosed her with Parkinson's. The disease has weakened her balance; she finds walking difficult. Her speech often fades in mid-sentence, another symptom. The class has changed her attitude, though. "I feel stretched and happy," she said. "It's fun. It's a good group of people to be with. I don't usually gather with a group of Parkinsonians."
There's no cure for Parkinson's, which afflicts more than 1.5 million Americans. Patients take a daily mix of pills to slow the progress of the disease, which occurs when brain cells that produce dopamine die off. Dopamine is a naturally produced chemical that transmits signals that control muscle movement. When those cells are destroyed, people begin to lose their balance, coordination, and muscle control.
Recent studies have found that music and dance can be effective as a supplement to the medical treatments. One study, released this year by the Washington University School of Medicine in St. Louis, reported that patients who took tango classes improved their balance and mobility substantially. Similar dance classes for Parkinson's patients have started in New York, Chicago, and San Francisco.
Patients report, and neurologists believe, that the musical rhythms help trigger coordinate movement, thus alleviating, temporarily, some of the symptoms. The music also helps people remember how to move their bodies.
"Music facilitates movement in Parkinson's disease," said Linda Tickle-Degnen, chairwoman of the department of occupational therapy at Tufts University. Two years ago she and a colleague conducted a research trial at Boston University to examine how social interaction and music affected people with Parkinson's. Among the findings: Many participants improved mobility and coordination after they had more social interaction and exercise in their lives.
"Dance gives them that practice and exercise. Dancing would not just facilitate how well you are moving your legs but your arms and your face too," she said. "Then there's this added piece that it's fun. When people are having fun, they move better."
That's one of the reasons Ed Rudman helped bring the dance class to Waltham. Rudman was diagnosed with Parkinson's 12 years ago. For the first few years, he told only his immediate family and co-workers that he had the disease.
"I didn't want people to look at me differently," said Rudman, former chairman of Beth Israel Deaconess Medical Center. Although his symptoms have slowly surfaced, he remains active. He began to notice that he felt better after exercising and dancing at the Kripalu Center for Yoga & Health in the Berkshires.
"I thought, 'Wouldn't it be great to start a dance group for Parkinson's but to slow it down?' " said Rudman, 71. He broached the idea with Megha Nancy Buttenheim, his yoga and dance instructor, who had been training Goodman as an instructor. They worked with dance instructors at the Mark Morris Dance Group in Brooklyn, who have been using ballet, the waltz, and other dance styles to help people with Parkinson's. The collaboration, along with input from neurologists at Boston University, resulted in the launch of a dance class last June at the Jewish Family & Children's Service. Another series of classes begins Dec. 15.
"My intent is to help people laugh and smile. Parkinson's is a disease that can be cruel," said Rudman, who takes 20 pills a day plus protein shakes to build muscle. To further research, he initially invested $150,000 of his own money and helped raised $5 million three years ago to launch Link Medicine Corp., a Cambridge start-up drug developer that is searching for a cure for Parkinson's.
"There is no cure," Rudman said. "There is plenty of medications available to mask the symptoms. You get stiff and you can't move." As he danced in class recently, he added, "Here you laugh, you kick, you stomp, and you dance."
At that recent class, 20 students, who included spouses, adult children, and caregivers, sat in a circle of chairs as Goodman led them into stretching drills. The class is open to anyone with Parkinson's.
Students chanted "Pa, pa, pa . . . Ta, ta, ta . . . Ca, ca, ca," to flex their facial muscles.
After they warmed up, the class stepped forward, scooted and shuffled at their own pace to the various dance styles. They did the twist, shimmied, and performed Argentina's national dance, the tango.
"Twist to the left, twist to the right," Goodman, urged them. Upbeat songs from Dion and the Pussycat Dolls got everyone's groove on. "If you want to turn up the spice a little, put some hip into it." Everyone seemed to float to the music.
At the end of the class, the dancers regrouped in a circle and revealed their frustrations with the disease. Among them: They can't take off their shirts unassisted, iron clothes, or open bottles.
"My legs and arms now follow a choreography I did not choose," Rosenmeier wrote in a poem she titled "Harboring P," which was discussed in the session.
As the students swapped stories, they also celebrated the joys of the class and the hope it provides on and off the dance floor.
"It is altogether a remarkable experience to be part of," Rosenmeier said. "It moves you to do better."
Johnny Diaz
WALTHAM - "Wiggle your fingers at the ceiling," Naomi Goodman told her dance students as she stretched her arms skyward. "Shake your body loose like a wet noodle. Take off that shirt, and stretch that spine. Extend your arms like beautiful wings."
The dancers followed her every move, though it didn't come fast or easy at first. These students live with tremors in their arms, weakness in their legs, and lack of muscle control in their everyday lives. But for two hours every Monday they groove to the blues, shimmy to jazz, and glide to the tango at the Jewish Family & Children's Service center. Here, they temporarily forget they are Parkinson's patients as they tap into their inner dancers.
They are pioneers in an unconventional but promising approach to helping people with Parkinson's, a progressive degenerative disease. Goodman, a dance and yoga instructor, incorporates movements from those disciplines to help people with Parkinson's improve their coordination and flexibility as their disease gradually robs them of both.
The students say the class, one of two in the Bay State, eases their symptoms and gives them a sense of control over a disease that often renders them powerless over their own bodies. The combination of music and dance instills a certain grace to their movements and makes them feel good. It is a way to take on this relentless disease.
The class serves another function: It provides a social outlet for Parkinson's patients, who often isolate themselves because they feel self-conscious about their disease.
"Parkinson's stiffens you up and makes you fearful of doing very much," said Rosamond Rosenmeier, 80, who has been dancing in these classes since they began last summer. In 1998, when she complained to her doctor of a persistent trembling in her left hand, he diagnosed her with Parkinson's. The disease has weakened her balance; she finds walking difficult. Her speech often fades in mid-sentence, another symptom. The class has changed her attitude, though. "I feel stretched and happy," she said. "It's fun. It's a good group of people to be with. I don't usually gather with a group of Parkinsonians."
There's no cure for Parkinson's, which afflicts more than 1.5 million Americans. Patients take a daily mix of pills to slow the progress of the disease, which occurs when brain cells that produce dopamine die off. Dopamine is a naturally produced chemical that transmits signals that control muscle movement. When those cells are destroyed, people begin to lose their balance, coordination, and muscle control.
Recent studies have found that music and dance can be effective as a supplement to the medical treatments. One study, released this year by the Washington University School of Medicine in St. Louis, reported that patients who took tango classes improved their balance and mobility substantially. Similar dance classes for Parkinson's patients have started in New York, Chicago, and San Francisco.
Patients report, and neurologists believe, that the musical rhythms help trigger coordinate movement, thus alleviating, temporarily, some of the symptoms. The music also helps people remember how to move their bodies.
"Music facilitates movement in Parkinson's disease," said Linda Tickle-Degnen, chairwoman of the department of occupational therapy at Tufts University. Two years ago she and a colleague conducted a research trial at Boston University to examine how social interaction and music affected people with Parkinson's. Among the findings: Many participants improved mobility and coordination after they had more social interaction and exercise in their lives.
"Dance gives them that practice and exercise. Dancing would not just facilitate how well you are moving your legs but your arms and your face too," she said. "Then there's this added piece that it's fun. When people are having fun, they move better."
That's one of the reasons Ed Rudman helped bring the dance class to Waltham. Rudman was diagnosed with Parkinson's 12 years ago. For the first few years, he told only his immediate family and co-workers that he had the disease.
"I didn't want people to look at me differently," said Rudman, former chairman of Beth Israel Deaconess Medical Center. Although his symptoms have slowly surfaced, he remains active. He began to notice that he felt better after exercising and dancing at the Kripalu Center for Yoga & Health in the Berkshires.
"I thought, 'Wouldn't it be great to start a dance group for Parkinson's but to slow it down?' " said Rudman, 71. He broached the idea with Megha Nancy Buttenheim, his yoga and dance instructor, who had been training Goodman as an instructor. They worked with dance instructors at the Mark Morris Dance Group in Brooklyn, who have been using ballet, the waltz, and other dance styles to help people with Parkinson's. The collaboration, along with input from neurologists at Boston University, resulted in the launch of a dance class last June at the Jewish Family & Children's Service. Another series of classes begins Dec. 15.
"My intent is to help people laugh and smile. Parkinson's is a disease that can be cruel," said Rudman, who takes 20 pills a day plus protein shakes to build muscle. To further research, he initially invested $150,000 of his own money and helped raised $5 million three years ago to launch Link Medicine Corp., a Cambridge start-up drug developer that is searching for a cure for Parkinson's.
"There is no cure," Rudman said. "There is plenty of medications available to mask the symptoms. You get stiff and you can't move." As he danced in class recently, he added, "Here you laugh, you kick, you stomp, and you dance."
At that recent class, 20 students, who included spouses, adult children, and caregivers, sat in a circle of chairs as Goodman led them into stretching drills. The class is open to anyone with Parkinson's.
Students chanted "Pa, pa, pa . . . Ta, ta, ta . . . Ca, ca, ca," to flex their facial muscles.
After they warmed up, the class stepped forward, scooted and shuffled at their own pace to the various dance styles. They did the twist, shimmied, and performed Argentina's national dance, the tango.
"Twist to the left, twist to the right," Goodman, urged them. Upbeat songs from Dion and the Pussycat Dolls got everyone's groove on. "If you want to turn up the spice a little, put some hip into it." Everyone seemed to float to the music.
At the end of the class, the dancers regrouped in a circle and revealed their frustrations with the disease. Among them: They can't take off their shirts unassisted, iron clothes, or open bottles.
"My legs and arms now follow a choreography I did not choose," Rosenmeier wrote in a poem she titled "Harboring P," which was discussed in the session.
As the students swapped stories, they also celebrated the joys of the class and the hope it provides on and off the dance floor.
"It is altogether a remarkable experience to be part of," Rosenmeier said. "It moves you to do better."
Wednesday, November 19, 2008
Exercise and Parkinson's Disease
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 the full 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 aquarobics. 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.
Reviewed by the doctors at The Cleveland Clinic Neuroscience
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 the full 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 aquarobics. 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.
Reviewed by the doctors at The Cleveland Clinic Neuroscience
Dance Lifts Bodies and Souls for Parkinson's Patients
By Sacha Pfeiffer
WALTHAM, Mass. - October 20, 2008 - Many of us know the telltale signs of Parkinson's disease -- the tremors, the stiff limbs, the unsteady walk. The disease has no cure, and medications for it tend to stop working over time.
But recent studies show that dancing can help reduce Parkinson's symptoms. So a local nonprofit has started a dance class for people with the disease.
Vicki Weiss was 64 years old when she noticed something odd about her body. Her hand seemed to have changed position slightly, keeping her from doing simple tasks.
"I couldn't unlock the doors or flip pancakes, and then I stopped being able to swing this hand when I walk -- little subtle things."
Those little subtleties led to a grim diagnosis: Parkinson's disease. Weiss immediately got treatment. She takes a drug that controls her symptoms. She walks three miles a day. And a few months ago, she tried something else.
Weiss and about 15 other people with Parkinson's are sitting in a circle as instructor Naomi Goodman tells them to lift their shoulders up and down. It's easy for some of them. But others move stiffly. One woman is locked in a stooped position. Another slumps in a wheelchair.
Hyperkyphosis is basically a humped spine. It's one of the symptoms of Parkinson's. So are rigid limbs, slow movement, and poor balance. Goodman, the instructor, tells the group to reach for the ceiling, lean toward the floor, and twist from side to side. She explains that these moves will loosen their bodies. Weiss says that's exactly what they've done for her.
"I did find that my body was, my movements were looser. I had better range of motion, and I had a great feeling of well-being."
That sense of well-being can lift the depression that sometimes comes with Parkinson's. But dancing does more than that. Studies show that it can help people with Parkinson's improve their balance and mobility. And the music can help them remember how to move their bodies.
Physical therapist Terry Ellis helped incorporate physical therapy exercises into dance moves for the class. She's a professor at Boston University who specializes in treating Parkinson's and other neurological problems.
"When they hear that beat, all of a sudden they sort of lock into that beat and they can move more quickly, and they can move more gracefully, and they can move quicker, and they can move with less effort."
Parkinson's is caused by the loss of brain cells that produce a chemical called dopamine. Dopamine is a neurotransmitter, which means it delivers signals between cells. One of those signals controls body motion. So when dopamine-producing cells die, a person can lose the ability to move. Some people with Parkinson's can't walk, talk, chew, or even swallow.
But Ellis, the BU professor, says research suggests that exercise, and dance in particular, may protect the cells that produce dopamine. And that may prevent or slow development of the disease.
"This needs further study, obviously, to see what happens with this, but the early studies are promising."
Those promising studies are behind this dance class and others around the country. The one at Jewish Family & Children's Services in Waltham is open to anyone with Parkinson's, Jewish or not. The dancing is gentle, and the class is a lot like a yoga session. In fact, instructor Naomi Goodman describes it as a blend of yoga, theatre games, ballet, and physical and occupational therapy. It's set to music that ranges from the Beatles to the Bangles, and from the Pussycat Dolls to Pachelbel.
Nancy Mazonson, who coordinates the Parkinson's support program at Jewish Family & Children's Services, helped design this class. She says the dancing has made a big difference to some people who've been handicapped by the disease for years.
"We had someone who said he danced at a wedding for the first time in six years. That, to us, is a huge change in somebody's life."
Mazonson also says dancing is liberating for many Parkinson's patients.
"There's something about seeing people with this very devastating disease doggedly trying to move and wanting so much for the joy of dance to sort of imbue them with an ability to break out of this shell that the disease encases them in."
"I used to dance in the corner and I had a buttoned-down personality, and now I let it all hang out."
That's Ed Rudman, who was diagnosed with Parkinson's 11 years ago. He decided he would do everything possible to slow the progression of the disease. This is the second time he's taken this class, which he helps support financially.
"When I hear music I kind of just want to move my arms and legs. It makes me feel just alive. And when you add the music to the dancing, put them together, and I could go all day."
WALTHAM, Mass. - October 20, 2008 - Many of us know the telltale signs of Parkinson's disease -- the tremors, the stiff limbs, the unsteady walk. The disease has no cure, and medications for it tend to stop working over time.
But recent studies show that dancing can help reduce Parkinson's symptoms. So a local nonprofit has started a dance class for people with the disease.
Vicki Weiss was 64 years old when she noticed something odd about her body. Her hand seemed to have changed position slightly, keeping her from doing simple tasks.
"I couldn't unlock the doors or flip pancakes, and then I stopped being able to swing this hand when I walk -- little subtle things."
Those little subtleties led to a grim diagnosis: Parkinson's disease. Weiss immediately got treatment. She takes a drug that controls her symptoms. She walks three miles a day. And a few months ago, she tried something else.
Weiss and about 15 other people with Parkinson's are sitting in a circle as instructor Naomi Goodman tells them to lift their shoulders up and down. It's easy for some of them. But others move stiffly. One woman is locked in a stooped position. Another slumps in a wheelchair.
Hyperkyphosis is basically a humped spine. It's one of the symptoms of Parkinson's. So are rigid limbs, slow movement, and poor balance. Goodman, the instructor, tells the group to reach for the ceiling, lean toward the floor, and twist from side to side. She explains that these moves will loosen their bodies. Weiss says that's exactly what they've done for her.
"I did find that my body was, my movements were looser. I had better range of motion, and I had a great feeling of well-being."
That sense of well-being can lift the depression that sometimes comes with Parkinson's. But dancing does more than that. Studies show that it can help people with Parkinson's improve their balance and mobility. And the music can help them remember how to move their bodies.
Physical therapist Terry Ellis helped incorporate physical therapy exercises into dance moves for the class. She's a professor at Boston University who specializes in treating Parkinson's and other neurological problems.
"When they hear that beat, all of a sudden they sort of lock into that beat and they can move more quickly, and they can move more gracefully, and they can move quicker, and they can move with less effort."
Parkinson's is caused by the loss of brain cells that produce a chemical called dopamine. Dopamine is a neurotransmitter, which means it delivers signals between cells. One of those signals controls body motion. So when dopamine-producing cells die, a person can lose the ability to move. Some people with Parkinson's can't walk, talk, chew, or even swallow.
But Ellis, the BU professor, says research suggests that exercise, and dance in particular, may protect the cells that produce dopamine. And that may prevent or slow development of the disease.
"This needs further study, obviously, to see what happens with this, but the early studies are promising."
Those promising studies are behind this dance class and others around the country. The one at Jewish Family & Children's Services in Waltham is open to anyone with Parkinson's, Jewish or not. The dancing is gentle, and the class is a lot like a yoga session. In fact, instructor Naomi Goodman describes it as a blend of yoga, theatre games, ballet, and physical and occupational therapy. It's set to music that ranges from the Beatles to the Bangles, and from the Pussycat Dolls to Pachelbel.
Nancy Mazonson, who coordinates the Parkinson's support program at Jewish Family & Children's Services, helped design this class. She says the dancing has made a big difference to some people who've been handicapped by the disease for years.
"We had someone who said he danced at a wedding for the first time in six years. That, to us, is a huge change in somebody's life."
Mazonson also says dancing is liberating for many Parkinson's patients.
"There's something about seeing people with this very devastating disease doggedly trying to move and wanting so much for the joy of dance to sort of imbue them with an ability to break out of this shell that the disease encases them in."
"I used to dance in the corner and I had a buttoned-down personality, and now I let it all hang out."
That's Ed Rudman, who was diagnosed with Parkinson's 11 years ago. He decided he would do everything possible to slow the progression of the disease. This is the second time he's taken this class, which he helps support financially.
"When I hear music I kind of just want to move my arms and legs. It makes me feel just alive. And when you add the music to the dancing, put them together, and I could go all day."
Q&A with Janet Hamburg: She’s been making all the right moves
By JAMES A. FUSSELL
Janet Hamburg has a lot of titles.
She’s a professor of dance at the University of Kansas, a registered somatic movement therapist, a certified Laban movement analyst, director of senior wellness and exercise for the Center for Movement Education and Research in Los Angeles and a senior research associate for the Laban/Bartenieff Institute of Movement Studies in New York. (Whew!)
But there’s nothing she’s more proud of than “Motivating Moves for People With Parkinson’s,” an exercise program she created to help patients deal with movement challenges. Recently she presented her research in Chicago at an international gathering of doctors, researchers and others who deal with Parkinson’s and other movement disorders. We asked her to tell us about her work.
Q. How long have you been teaching dance at KU?
A. 29 years.
What else do you do?
I’ve worked with professional and collegiate athletes and (former) NBA basketball player Albert King. I created a warm-up program for the KU men’s basketball team. I’ve also worked with musicians at the Juilliard School in New York City.
Tell us about “Motivating Moves.”
Parkinson’s disrupts the rhythm, timing and phrasing of natural coordinated movements. I designed exercises that incorporate a variety of movement and vocal dynamics to enliven people as they strengthen and stretch their muscles.
Can you describe it?
It’s a seated exercise program that takes about a half-hour. There are 24 short exercises (including) an exercise called the Big Ha! where people are shrugging their shoulders to their ears, then dropping their shoulders with a loud “Ha!” sound. Another exercise is Swivel and Slouch, which begins by swiveling the feet and legs from one side to another, and ends with allowing the torso to collapse into a twisting slouch. This prepares the body for twisting and spiraling movements that are helpful in getting out of bed. I end with silly faces and moods. Some people with Parkinson’s have difficulty speaking, swallowing and moving their faces expressively. Silly faces and moods includes a variety of exercises for the facial muscles, mouth and throat. It even includes laughing, so everybody is laughing at one point.
Do you use music?
Yes. The music supports the rhythm and dynamics of the movements while cueing and encouraging the participant to move. It was composed specifically for each exercise by the late Robert Abramson, an internationally recognized master teacher of Dalcroze Eurhythmics on the faculty of the Juilliard School.
Dalcroze … what?
It’s a method of teaching musical concepts through movement.
Of course. We were just testing you. So what do you hope your program will do for patients?
Allow people who have been robbed of their unique sense of rhythm and timing and movement dynamics in their everyday actions to feel pleasure in moving again. One thing people have told me over and over is the program is enjoyable. It’s not just like another prescription they have to take.
Do they also say it works?
One woman wrote to me and said: “Before doing Motivating Moves I was unable to dress myself. I can do everything for myself now.”
Must make them feel great.
It does. I recently completed a research study on the effects of (the program). There were statistically significant improvements in how quickly the participants could get up from a chair and walk a short distance, how much they could twist their torsos, and there were improvements in their activities of daily living.
Other success stories?
There was a woman in Kansas City who told her children that she would not be traveling anymore because of her Parkinson’s, so if they wanted to see her they’d have to visit her. After she (used the program) she made airline reservations to visit her children for both Thanksgiving and Christmas. She was just thrilled.
Why did you develop this?
My mother, Helen Hamburg, developed Parkinson’s. As I watched her movement challenges, I developed exercises to help her move more easily. Unfortunately she died before she could see the DVD. But it was done in her honor.
Janet Hamburg has a lot of titles.
She’s a professor of dance at the University of Kansas, a registered somatic movement therapist, a certified Laban movement analyst, director of senior wellness and exercise for the Center for Movement Education and Research in Los Angeles and a senior research associate for the Laban/Bartenieff Institute of Movement Studies in New York. (Whew!)
But there’s nothing she’s more proud of than “Motivating Moves for People With Parkinson’s,” an exercise program she created to help patients deal with movement challenges. Recently she presented her research in Chicago at an international gathering of doctors, researchers and others who deal with Parkinson’s and other movement disorders. We asked her to tell us about her work.
Q. How long have you been teaching dance at KU?
A. 29 years.
What else do you do?
I’ve worked with professional and collegiate athletes and (former) NBA basketball player Albert King. I created a warm-up program for the KU men’s basketball team. I’ve also worked with musicians at the Juilliard School in New York City.
Tell us about “Motivating Moves.”
Parkinson’s disrupts the rhythm, timing and phrasing of natural coordinated movements. I designed exercises that incorporate a variety of movement and vocal dynamics to enliven people as they strengthen and stretch their muscles.
Can you describe it?
It’s a seated exercise program that takes about a half-hour. There are 24 short exercises (including) an exercise called the Big Ha! where people are shrugging their shoulders to their ears, then dropping their shoulders with a loud “Ha!” sound. Another exercise is Swivel and Slouch, which begins by swiveling the feet and legs from one side to another, and ends with allowing the torso to collapse into a twisting slouch. This prepares the body for twisting and spiraling movements that are helpful in getting out of bed. I end with silly faces and moods. Some people with Parkinson’s have difficulty speaking, swallowing and moving their faces expressively. Silly faces and moods includes a variety of exercises for the facial muscles, mouth and throat. It even includes laughing, so everybody is laughing at one point.
Do you use music?
Yes. The music supports the rhythm and dynamics of the movements while cueing and encouraging the participant to move. It was composed specifically for each exercise by the late Robert Abramson, an internationally recognized master teacher of Dalcroze Eurhythmics on the faculty of the Juilliard School.
Dalcroze … what?
It’s a method of teaching musical concepts through movement.
Of course. We were just testing you. So what do you hope your program will do for patients?
Allow people who have been robbed of their unique sense of rhythm and timing and movement dynamics in their everyday actions to feel pleasure in moving again. One thing people have told me over and over is the program is enjoyable. It’s not just like another prescription they have to take.
Do they also say it works?
One woman wrote to me and said: “Before doing Motivating Moves I was unable to dress myself. I can do everything for myself now.”
Must make them feel great.
It does. I recently completed a research study on the effects of (the program). There were statistically significant improvements in how quickly the participants could get up from a chair and walk a short distance, how much they could twist their torsos, and there were improvements in their activities of daily living.
Other success stories?
There was a woman in Kansas City who told her children that she would not be traveling anymore because of her Parkinson’s, so if they wanted to see her they’d have to visit her. After she (used the program) she made airline reservations to visit her children for both Thanksgiving and Christmas. She was just thrilled.
Why did you develop this?
My mother, Helen Hamburg, developed Parkinson’s. As I watched her movement challenges, I developed exercises to help her move more easily. Unfortunately she died before she could see the DVD. But it was done in her honor.
Workout helps ease the pain of Parkinson's
by Joe Fitzgibbon, Special to The Oregonian
Thursday October 09, 2008, 3:00 AM
SHERWOOD -- Muhammad Ali, Michael J. Fox and former U.S. Attorney General Janet Reno
Brent Wojahn/The OregonianKelly Johnson (left) helps Vera Darling of Beaverton with individualized exercise on a stationary bike during the Sherwood YMCA's Parkinson's Exercise class.
are the high-profile names. Kathy Grunwald, Greg South and Ron Beamer are less well known.
All are seeking relief from the muscle- and nerve-crippling effects of Parkinson's disease, with no known cure.
Nancy Nelson and Kelly Johnson of the Sherwood Regional Family YMCA want to help.
Two years ago, Nelson, director of Health and Wellness, and Johnson, a personal trainer, began offering a gentle workout called Parkinson's Exercise.
Four people showed up at the first session. Within weeks, a dozen men and women with the neurological disease joined them. Today, the number has nearly doubled.
Those with Parkinson's say they come because their joints ache or their hands shake uncontrollably. They've lost the rhythm in their step or the fluency of their speech. They need to talk with others who understand their anxieties.
"You spend time exercising with the people here, and you're bound to leave with a smile," said Grunwald, 63, of Tualatin. "If you're having a bad day -- and we have lots of them -- someone here will pick you up."
The group meets three times a week at the Sherwood YMCA.
After about 15 minutes of socializing, blood pressure checks and warmup exercises, participants pick up the pace on stationary bicycles and treadmills or the indoor track.
"I'm not much of a self-starter and really enjoy the enthusiasm of exercising with others," laughed Beamer, 61, of Beaverton, a former avid bicyclist. "We all know the meaning of 'use it or lose it.' "
Nelson and Johnson circulate, assisting class members with the equipment -- improving techniques and bad posture here, offering encouragement there.
"As the disease progresses, some of them find that it becomes harder and harder to maintain their balance or struggle to keep their heads up and bodies straight," Nelson said. "With even a little encouragement, they'll push themselves as much as they can. It is really quite inspiring."
For the last 30 minutes of each session, the men and women gather in a small, mirrored dance studio for a series of low-impact voice- and facial-expression exercises and yoga-like stretching.
A year ago, South, 64, of Portland refused to admit to himself that he needed help. "I had some minor tremors and was in denial," he said.
After checking out the Y class, "I couldn't believe how hard everyone was working and how courageous they were," he said. "I thought I'd give it a try, and I've been coming ever since."
An estimated 25,000 men and women in Oregon -- most in their 50s, 60s and 70s -- have been diagnosed with Parkinson's. The slowly debilitating disease often causes side effects such as tremors, muscle stiffness, speech impediments and balance problems. These, in turn, can lead to depression and anxiety.
Drugs help control the symptoms but research shows a strong relationship between gentle exercise and improved flexibility, endurance and mood.
"It was trial and error for us at first, but then we started attending seminars and talking with experts in the field," Johnson said. "One of the best parts of each class is watching the way everyone works together."
Nelson, who calls the 90-minute workouts the highlight of her day, said she loves the positive energy that comes from the group. Still, she'd like to do more.
"We know there are people out there who would benefit from the classes but aren't sure it's for them," Nelson said. "So we're saying to come in and give it a try. If a few more join us, we'd like to offer a second or third tier to address a wider range of abilities."
-- Joe Fitzgibbon;
If you go
What: Parkinson's Exercise
When: 1 to 2:30 p.m. Mondays, Wednesdays and Fridays
Where: Sherwood Regional Family YMCA, 23000 S.W.Pacific Hwy.
How it works: After medical release from health care provider, ambulatory men and women with Parkinson's disease work on individual and group exercises to improve alance, flexibility and muscular control. Participants enjoy social events and support groups to manage mood swings.
Thursday October 09, 2008, 3:00 AM
SHERWOOD -- Muhammad Ali, Michael J. Fox and former U.S. Attorney General Janet Reno
Brent Wojahn/The OregonianKelly Johnson (left) helps Vera Darling of Beaverton with individualized exercise on a stationary bike during the Sherwood YMCA's Parkinson's Exercise class.
are the high-profile names. Kathy Grunwald, Greg South and Ron Beamer are less well known.
All are seeking relief from the muscle- and nerve-crippling effects of Parkinson's disease, with no known cure.
Nancy Nelson and Kelly Johnson of the Sherwood Regional Family YMCA want to help.
Two years ago, Nelson, director of Health and Wellness, and Johnson, a personal trainer, began offering a gentle workout called Parkinson's Exercise.
Four people showed up at the first session. Within weeks, a dozen men and women with the neurological disease joined them. Today, the number has nearly doubled.
Those with Parkinson's say they come because their joints ache or their hands shake uncontrollably. They've lost the rhythm in their step or the fluency of their speech. They need to talk with others who understand their anxieties.
"You spend time exercising with the people here, and you're bound to leave with a smile," said Grunwald, 63, of Tualatin. "If you're having a bad day -- and we have lots of them -- someone here will pick you up."
The group meets three times a week at the Sherwood YMCA.
After about 15 minutes of socializing, blood pressure checks and warmup exercises, participants pick up the pace on stationary bicycles and treadmills or the indoor track.
"I'm not much of a self-starter and really enjoy the enthusiasm of exercising with others," laughed Beamer, 61, of Beaverton, a former avid bicyclist. "We all know the meaning of 'use it or lose it.' "
Nelson and Johnson circulate, assisting class members with the equipment -- improving techniques and bad posture here, offering encouragement there.
"As the disease progresses, some of them find that it becomes harder and harder to maintain their balance or struggle to keep their heads up and bodies straight," Nelson said. "With even a little encouragement, they'll push themselves as much as they can. It is really quite inspiring."
For the last 30 minutes of each session, the men and women gather in a small, mirrored dance studio for a series of low-impact voice- and facial-expression exercises and yoga-like stretching.
A year ago, South, 64, of Portland refused to admit to himself that he needed help. "I had some minor tremors and was in denial," he said.
After checking out the Y class, "I couldn't believe how hard everyone was working and how courageous they were," he said. "I thought I'd give it a try, and I've been coming ever since."
An estimated 25,000 men and women in Oregon -- most in their 50s, 60s and 70s -- have been diagnosed with Parkinson's. The slowly debilitating disease often causes side effects such as tremors, muscle stiffness, speech impediments and balance problems. These, in turn, can lead to depression and anxiety.
Drugs help control the symptoms but research shows a strong relationship between gentle exercise and improved flexibility, endurance and mood.
"It was trial and error for us at first, but then we started attending seminars and talking with experts in the field," Johnson said. "One of the best parts of each class is watching the way everyone works together."
Nelson, who calls the 90-minute workouts the highlight of her day, said she loves the positive energy that comes from the group. Still, she'd like to do more.
"We know there are people out there who would benefit from the classes but aren't sure it's for them," Nelson said. "So we're saying to come in and give it a try. If a few more join us, we'd like to offer a second or third tier to address a wider range of abilities."
-- Joe Fitzgibbon;
If you go
What: Parkinson's Exercise
When: 1 to 2:30 p.m. Mondays, Wednesdays and Fridays
Where: Sherwood Regional Family YMCA, 23000 S.W.Pacific Hwy.
How it works: After medical release from health care provider, ambulatory men and women with Parkinson's disease work on individual and group exercises to improve alance, flexibility and muscular control. Participants enjoy social events and support groups to manage mood swings.
Parkinson’s Disease & TAI CHI THERAPY
Tai Chi movement’s gentle balance enhancing motions can obviously help the Parkinson’s patient by helping to reduce the gradual loss of balance that Parkinson’s sufferers often experience. However, there may be much more it offers. For example, Tai Chi movements rotate the human body in about 95% of the ways the body can move, when a long form is practiced. This is far beyond what other exercise offers, and in fact the closest would be several swimming strokes, which together would only rotate the body in about 65% of the ways it can move. For Parkinson’s sufferers, or anyone for that matter, this would indicate that by “using” 95% of the body’s possible motion several times a week, the possibility of “losing” the ability to do so diminishes accordingly. This isn’t rocket science, but simple common sense.
Rush University Medical Center And Hubbard Street Dance Chicago Collaborate To Provide Parkinson's Patients With New Outlet Through Dance
In a first-time collaboration, Hubbard Street Dance Chicago (HSDC) is working with Rush University Medical Center to launch a pilot program in contemporary dance specifically designed for people with Parkinson's disease and related movement disorders. The class, which features live piano accompaniment, takes place Saturdays from 1 p.m. to 2:15 p.m. at the Hubbard Street Dance Center, 1147 W. Jackson Blvd., in Chicago. The next 12-week fall session begins Saturday, September 6.
The class is as an opportunity for those with Parkinson's disease, as well as their loved ones and caregivers, to derive both physical and emotional benefits from participating in a contemporary dance class, according to physicians at Rush.
"Dance may be an appropriate and effective strategy for improving functional mobility deficits in people who are living with brain disorders such as Parkinson's, stroke and traumatic brain injuries," said Dr. James Young, chairman of physical medicine and rehabilitation at Rush.
Parkinson's is a progressive neurological disorder that causes tremors, rigidity, a slowing of movement and difficulty with balance. The movement problems of Parkinson's are caused by loss of the brain chemical messenger dopamine as a result of dysfunction or death of brain cells that manufacture this essential chemical.
"Medications are important in the treatment of Parkinson's, but many symptoms don't respond as well to medications as we would like," said Dr. Kathleen Shannon, neurologist at the Movement Disorders Center at Rush. "Music and other rhythmic stimuli help Parkinson's patients to move better, so dance may help patients regain balance and make more fluid movements. The thought is that by moving to music the brain will reinforce movement pathways, or simply create new ones. Dance also may help the fight against depression seen in Parkinson's disease."
Leading the class is Sarah Cullen Fuller, who danced with HSDC for nearly seven years and is on the faculty of the Lou Conte Dance Studio at the Hubbard Street Dance Center. She trained in the Parkinson's program developed eight years ago by the Mark Morris Dance Group in Brooklyn to learn the fundamentals of the program and how to modify a traditional dance class to accommodate the circumstances of the participants.
"I'm very excited about this class," said Cullen Fuller. "Dance for me has always been therapeutic in many ways, although it's important to note that this is not a therapy session. This is a dance class that combines the artistry of dance with live music to encourage one's natural instincts for movement and the benefits that movement can produce physically and socially. It's an opportunity for participants and their loved ones to do something fun together."
Rush is working to secure enough funding to offer these classes on a regular basis and conduct research on the benefits of dance on individuals with Parkinson's.
The class is as an opportunity for those with Parkinson's disease, as well as their loved ones and caregivers, to derive both physical and emotional benefits from participating in a contemporary dance class, according to physicians at Rush.
"Dance may be an appropriate and effective strategy for improving functional mobility deficits in people who are living with brain disorders such as Parkinson's, stroke and traumatic brain injuries," said Dr. James Young, chairman of physical medicine and rehabilitation at Rush.
Parkinson's is a progressive neurological disorder that causes tremors, rigidity, a slowing of movement and difficulty with balance. The movement problems of Parkinson's are caused by loss of the brain chemical messenger dopamine as a result of dysfunction or death of brain cells that manufacture this essential chemical.
"Medications are important in the treatment of Parkinson's, but many symptoms don't respond as well to medications as we would like," said Dr. Kathleen Shannon, neurologist at the Movement Disorders Center at Rush. "Music and other rhythmic stimuli help Parkinson's patients to move better, so dance may help patients regain balance and make more fluid movements. The thought is that by moving to music the brain will reinforce movement pathways, or simply create new ones. Dance also may help the fight against depression seen in Parkinson's disease."
Leading the class is Sarah Cullen Fuller, who danced with HSDC for nearly seven years and is on the faculty of the Lou Conte Dance Studio at the Hubbard Street Dance Center. She trained in the Parkinson's program developed eight years ago by the Mark Morris Dance Group in Brooklyn to learn the fundamentals of the program and how to modify a traditional dance class to accommodate the circumstances of the participants.
"I'm very excited about this class," said Cullen Fuller. "Dance for me has always been therapeutic in many ways, although it's important to note that this is not a therapy session. This is a dance class that combines the artistry of dance with live music to encourage one's natural instincts for movement and the benefits that movement can produce physically and socially. It's an opportunity for participants and their loved ones to do something fun together."
Rush is working to secure enough funding to offer these classes on a regular basis and conduct research on the benefits of dance on individuals with Parkinson's.
Cognition in Older Women: The Importance of Daytime Movement
Deborah E. Barnes, PhD, MPH *† , Terri Blackwell, MA ‡ , Katie L. Stone, PhD ‡ , Suzanne E. Goldman, PhD, APRN § , Teresa Hillier, MD, MS ∥# , and Kristine Yaffe, MD *†**†† , for the Study of Osteoporotic Fractures
From the Departments of *Psychiatry, **Neurology, and ††Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California; †San Francisco Veterans Affairs Medical Center, San Francisco, California; ‡San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California; §Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee; ∥Department of Endocrinology, Oregon Health & Science University, Portland, Oregon; and #Kaiser Permanente Center for Health Research, Portland, Oregon.
Address correspondence to Deborah E. Barnes, PhD, MPH, Assistant Professor, Psychiatry, University of California, San Francisco, 4150 Clement Street, 151R, San Francisco, CA 94121.
Copyright Journal compilation 2008 The American Geriatrics Society/Blackwell Publishing
ABSTRACT
OBJECTIVES: To determine whether an objective measure of daytime movement is associated with better cognitive function in women in their 80s.
DESIGN: Cross-sectional.
SETTING: A study of health and aging.
PARTICIPANTS: Two thousand seven hundred thirty-six older women without evidence of dementia.
MEASUREMENTS: Daytime movement was assessed using actigraphy, which involved wearing a watch-like device that objectively quantified accelerometer motion over a mean of 3.0±0.8 days. Cognitive function was measured using the Trail-Making Test, Part B (Trails B) and the Mini-Mental State Examination (MMSE). Cognitive impairment was defined as performing 1.5 standard deviations (SDs) worse than the mean on a given test.
RESULTS: Participants had a mean age of 83±4; 10% were African American. After adjustment for age, race, and education, women in the highest movement quartiles had better mean cognitive test scores (20±0.3 seconds faster on Trails B and 0.3±0.2 points higher on MMSE, both P<.001) than those in the lowest quartile and were less likely to be cognitively impaired (odds ratio (OR)=0.61, 95% confidence interval (CI)=0.41–0.92 for Trails B; OR=0.68, 95% CI=0.44–1.07 for MMSE). Associations were similar in different subgroups and were independent of self-reported walking, medical comorbidities, physical function, and other health-related behaviors.
CONCLUSION: Daytime movement as measured objectively using actigraphy was associated with better cognitive function and lower odds of cognitive impairment in women in their 80s. Additional studies are needed to clarify the direction of the association and to explore potential mechanisms.
From the Departments of *Psychiatry, **Neurology, and ††Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California; †San Francisco Veterans Affairs Medical Center, San Francisco, California; ‡San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California; §Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee; ∥Department of Endocrinology, Oregon Health & Science University, Portland, Oregon; and #Kaiser Permanente Center for Health Research, Portland, Oregon.
Address correspondence to Deborah E. Barnes, PhD, MPH, Assistant Professor, Psychiatry, University of California, San Francisco, 4150 Clement Street, 151R, San Francisco, CA 94121.
Copyright Journal compilation 2008 The American Geriatrics Society/Blackwell Publishing
ABSTRACT
OBJECTIVES: To determine whether an objective measure of daytime movement is associated with better cognitive function in women in their 80s.
DESIGN: Cross-sectional.
SETTING: A study of health and aging.
PARTICIPANTS: Two thousand seven hundred thirty-six older women without evidence of dementia.
MEASUREMENTS: Daytime movement was assessed using actigraphy, which involved wearing a watch-like device that objectively quantified accelerometer motion over a mean of 3.0±0.8 days. Cognitive function was measured using the Trail-Making Test, Part B (Trails B) and the Mini-Mental State Examination (MMSE). Cognitive impairment was defined as performing 1.5 standard deviations (SDs) worse than the mean on a given test.
RESULTS: Participants had a mean age of 83±4; 10% were African American. After adjustment for age, race, and education, women in the highest movement quartiles had better mean cognitive test scores (20±0.3 seconds faster on Trails B and 0.3±0.2 points higher on MMSE, both P<.001) than those in the lowest quartile and were less likely to be cognitively impaired (odds ratio (OR)=0.61, 95% confidence interval (CI)=0.41–0.92 for Trails B; OR=0.68, 95% CI=0.44–1.07 for MMSE). Associations were similar in different subgroups and were independent of self-reported walking, medical comorbidities, physical function, and other health-related behaviors.
CONCLUSION: Daytime movement as measured objectively using actigraphy was associated with better cognitive function and lower odds of cognitive impairment in women in their 80s. Additional studies are needed to clarify the direction of the association and to explore potential mechanisms.
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