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."
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