Parkinson’s disease patients turn to dance

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

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

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

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

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

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

 For more information visit us at www. parkinsonresearchfoundation.org.

By CARRIE SEIDMAN
Source:http://health.heraldtribune.com/2012/06/05/parkinsons-disease-patients-turn-to-dance/

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

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

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

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

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

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

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

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

Parkinson's disease patients find benefits in martial arts exercise

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

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

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

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

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

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

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

By MEREDITH JEAN MORTON

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

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

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

Why Exercise is So Important

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

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

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

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

According to the American Academy of Orthopaedic Surgeons:

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

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

Gameworld: Motion games broaden uses beyond exercise

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Effect of exercise on reactivity and motor behaviour in patients with Parkinson’s disease.

J Neurol Neurosurg Psychiatry.

Authors: Müller T, Muhlack S

Background Following cued levodopa (LD) intake, endurance exercise showed a beneficial effect on scored motor performance in patients with Parkinson’s disease (PD) in comparison with rest. This may result from an exercise induced increase in endogenous dopamine synthesis. As a result, beneficial effects on movement and reactivity may occur. Objectives To measure reactivity and motor performance in a repeated fashion with instrumental tasks after cued administration of soluble 200 mg of LD/50 mg of benserazide. Design PD patients consecutively performed paradigms, which assess reactivity and movement performance, after a standardised period of rest or of age-related, heart rate adapted endurance exercise on two consecutive days in a random order. Results Reactivity and execution of simple and complex motion series were significantly better following exercise than after rest. Discussion Endurance exercise has a beneficial effect on reactivity and movement behaviour in PD patients following cued application of LD probably due to an augmented synthesis and release of dopamine and other catecholamines and release in the prefrontal cortex, the nucleus accumbens and the basal ganglia. Small changes in catecholamine modulation of prefrontal cortex cells can have profound effects on the ability of the prefrontal cortex to guide behaviour. Previous exercise may also improve pedunculopontine nucleus function, which is involved in motor-related attention processes.

Can Regular Yoga “Cure” Diseases?

By Michael Hutch PhD

Various forms of yoga have been scientifically shown to handle and perhaps even “remedy” various persistent diseases. Listed below are various medical issues that have been proved scientifically to be improved by yoga.

Asthma: Yoga breathing exercises possibly could assist sufferers of mild asthma and may help decrease their use of low-dose drug inhalers in wheezing attacks. Researchers from the Respiratory Medicine Unit, City University, Nottingham, call for added studies of ways of improving breathing mastery which they say have been largely unheeded by Western medicine. while yoga practitioners have long believed in the benefits of pranayama breathing exercises for asthmatics, this has been difficult to examine formally. But, using a Pink City lung – a device that imposes slow breathing on the user and can mimic pranayama breathing exercises – it was possible to measure the effects of controlled breathing in a hospital test. Two simulated pranayama exercises were tested: slow deep breathing and breathing out for twice as long as breathing in. In asthma, the airways become restricted making breathing difficult. It is increasing in the UK, with more than three million children and adults affected, and are responsible for 2,000 deaths annually. The doctors used standard clinical tests to measure the volume of air patients were able to blow out in a second and to test the irritability of their airways. After yoga, their airways were two times less irritable.

Parkinson’s disease: Yoga has a key purpose in management of Parkinson’s as it has emerged as a helpful alternate therapy and an ideal mode of exercise for Parkinson’s patients because of its gradual movements. Following the steps mentioned below could successfully help individuals with Parkinson’s: 1. Concentrate on controlling your breath (Pranayama) as this brand of yoga helps in moments of panic – such as feet sticking to the flooring when walking. In this form of yoga, the mind is always watchful. 2. Few yoga exercises like back strengthening postures, lots of shoulder movements, breathing practices and some meditation positively helps. 3. One of the most useful forms of yoga used for Parkinson’s is Ashtanga Yoga. It works to strengthen the body and perform increases blood circulation. 4. day-to-day practice of yoga is all-important since Parkinson’s itself does not inevitably weaken the muscles. Weakening of muscles is ordinarily caused by lack of motion. Daily exercise should be encouraged, but not enough to generate tiredness. 5. Parkinson’s also result in the loss of motility of the facial muscles. Pranayama and supplementary yoga movements could aid in relaxing those muscles and bring a smile on the face of the patient.

Diabetes: Diabetes in a lot of forms affects up to 5percent of the world population with 12 million diabetics in Western Europe alone. Of the unique ways in which diabetes presents, noninsulin-dependent diabetes mellitus (NIDDM) is probably the most usually encountered genetic condition. NIDDM or Type II diabetes is multifactorial, depending also on environmental factors including obesity, sedentary lifestyles and nutritional imbalances. One of the studies conducted to cure diabetes was the one set up by the Yoga Biomedical Trust, founded in 1982 by biochemist Dr Robin Monro, and an Indian yoga research foundation which discovered that practicing yoga for 30 minutes a day for one month helped reduce blood glucose levels in some diabetics.The yoga patients took part in one or two 90-minute sessions a week and were asked to practise at home. The classes included the particular yoga exercises of the spinal twist, the bow and abdominal breathing. At the conclusion of the 12 weeks blood sugar levels fell significantly in all patients in the group and were slightly raised in a control group which had not joined in the yoga sessions. Three yoga students managed to cutback their medication, including one man who had not altered his drug regimen for 20 years. It is not necessarily the exercise element of the yoga therapy package which is most significant, as there is not adequate physical exercise to account for the changes, but stress decrease has a lot to do with it. Stress hormones increase sugar levels in the blood. individuals also benefit from the stabilisation of their moods which yoga brings, an increased perception of well-being and a belief of being more in mastery, which may assist with their diet control and consequently their diabetes.

Researchers Say Exercises Can Reduce Parkinson’s Effects

Scientists from the Harvard School of Public Health, University of Pittsburgh and University of Southern California discovered that exercise can slow the progression of Parkinson’s disease (known as “PD”).

Sat Feb 06 2010] The studies suggest that regular physical activity can help to reduce damage to neurons in the brain that causes Parkinson’s disease.

“Parkinson’s disease is an illness that affects muscle movement,” says Kay Mixson Jenkins, author of the new children’s book Who Is Pee Dee? “Anything that can help to maintain normal muscle tone and flexibility is extremely important.”

Ms. Jenkins was diagnosed with PD when she was just thirty-four. She decided to write her book to help her children understand the disease. The story follows a young boy named Colt as he tries to deal with his mother’s chronic illness.

Parkinson’s disease is a progressive neurological disorder that affects nearly 1.5 million Americans; approximately 50,000 are diagnosed with the disease every year.

According to the Mayo Clinic, “Exercise has important benefits for everyone regardless of age or physical condition... When your condition threatens to immobilize you, exercise keeps you moving... To retain your mobility and function, use it or lose it.”

Exercises cannot stop Parkinson’s disease progression, but based on the study, regular physical activity can help PD patients to:

• minimize further cell damage.
• decrease loss of cognitive skills.
• increase muscle control and build muscle strength.
• improve balance and coordination.
• reduce depression.

“Unfortunately, there is no cure yet for Parkinson’s disease,” says Ms. Jenkins. “I believe that exercise can help to delay the progression of Parkinson’s and improve emotional well-being, which is very important for PD patients.”

Kay Mixson Jenkins is the Georgia state co-coordinator for the Parkinson’s Action Network, leads the Effingham County Parkinson’s support group and was selected as a Parkinson’s patient advocate for UCB, Inc.

Exercise May Aid Parkinson’s Patients

ScienceDaily (May 16, 2007) — A new study from researchers at the Keck School of Medicine of the University of Southern California (USC) shows that treadmill exercises may benefit patients with Parkinson's Disease and those with similar movement disorders.
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Recent studies have shown that exercise can have beneficial effects in patients with Parkinson's Disease but the underlying reasons haven't been fully explored. This new study using treadmill exercise in animal models looked at the effects of dopamine in motor learning and execution.

Parkinson's Disease is a chronic and degenerative disease that leads to slowness, balance disorders, tremors and difficulty in walking. The disease results from the loss of dopamine-producing nerve cells in the brain. It is critical as a stimulator of motor system nerves in the body. While there is no current cure for the disease, several treatments do offer relief from its symptoms.

This particular study looked at treadmill exercise and its effects between animal models with and without a loss of certain cells that are similar to what a Parkinson's Patient might suffer. Given the importance of dopamine in Parkinson's Disease, the researchers looked at changes in dopamine levels, among other results.

Researchers found that the subjects with cell loss and that exercised indeed had an effect on dopamine levels while normal subjects showed less of a difference in levels.

"Our study shows that the beneficial effects of exercise in Parkinson's Disease may be due to a more efficient use of dopamine, "says Giselle Petzinger, M.D., assistant professor of neurology at the Keck School of Medicine of USC and the study's first author. "Surviving dopamine cells in our animal models- made to simulate what Parkinson's patients suffer with- subjected to intensive treadmill exercise appear to work harder."

Studies with John Walsh, Ph.D., associate professor at the USC Andrus Gerontology Center and a co-investigator of the study, showed that these cells release greater amounts of dopamine and decrease the rate of its removal from the synapse compared to neurons in subjects that do not undergo exercise.

The findings suggest that the benefits of treadmill exercise on motor performance may be accompanied by changes in dopamine neurotransmission that are different in the injured subjects compared to the non-injured."Studies in our animal model of Parkinson's disease support the fact that exercise is beneficial for patients with Parkinson's," says Jakowec. "Exercise may help the injured brain to work more efficiently by allowing the remaining dopamine producing neurons to work harder and in doing so may promote stronger connections in the brain."

Further studies will investigate if beneficial effects of exercise have long-term effect on the injured brain, identifying the molecular links between exercise and the brain, and to better understand the molecular mechanisms within neurons that lead to these changes.

The study is led by USC neuroscientist Michael Jakowec, Ph.D., assistant professor of neurology and appears in the May 16 issue of the Journal of Neuroscience.

Funding for this study comes from the Parkinson's Disease Foundation, Team Parkinson Los Angeles, the George and MaryLou Boone Foundation, the National Institute of Neurological Disorders and Stroke and the US Army Neurotoxin Exposure Treatment Research Program.

Reference: "Effects of Treadmill Exercise on Dopaminergic Transmission in the 1-Methyl-4-Phenyl-1,2,3,6-Tetrahydropyridine-Lesioned Mouse Model of Basal Ganglia Injury", Petzinger, G.,Walsh, J.,Akopian, G., Hogg, E., Abernathy, A., Arevalo, P.,Turnquist, P., Vuckovic, M., Fisher, B.,Togasaki, D., Jakowec, M. Journal of Neuroscience, May 16, 2007.

Rehab Can Be Fun And Games

Music is helping Sally Smith find her groove.

In recent years, the tremors of Parkinson's disease have made many once-routine tasks a lot more difficult for the Topeka woman. She says she had trouble walking, sitting up straight and balancing.

She even struggled to get up from a chair, which made her feel left out at her Eagles Auxiliary meetings. When everyone else would stand to salute the flag, Sally says, she would always be sitting at the table.

Kansas Rehab therapist Karen Farron is helping Sally overcome those challenges. Many of the tools they use, though, fancy – scarves and balls for instance.

Farron says therapists at Kansas Rehab evaluate people’s strengths and people’s challenges and identify exercises to address them in a fun way. She says most people don't like to exercise, but if when told they'll feel like a kid again, it's a less threatening way to begin.

The fun does serve a serious purpose. Reaching for the scarves, for example, improves range of motion. A series of exercises with raquetballs works on coordination and grasping skills. The balls even helped Sally work to easily rise from a chair again. Ferron explains that bouncing the ball already has the weight shifted forward, and focusing on the bouncing of the ball helps a person complete the standing movement without thinking.

Many of the tasks are founded in rhythm. Working with an interactive metronome program helps patients like Sally see the reaction time in their movements. It’s a feeling that can be mimicked with music.

Ferron says Parkinson's patients in particular often have difficulty initiating movement. She says they know what they want to do but the information doesn’t translate into action. She says rhythm will help initiate movement without hesitation, which decreases the risk of falling and the feeling of frustration.

Using rhythm also helps reinforce new ways of doing familiar actions to improve function, like drawing or writing. Just a few days after learning new strategies for forming letters, Sally's writing went from illegible to clear.

Ferros says using exercises with concrete results offers another benefit. She says instead of telling a doctor they simply don't feel right, a patient can offer very specific information, such as the how much longer it takes to get up and down, or the number of steps it's now taking to cover a certain distance.

Sally says it’s working for her. She's noticed a marked improvement, and is proud she’s once again able to join in that show of patriotism, standing with her fellow group members to salute the flag.