5 minute read
Parkinson’s
By Anne M. Pott The Continuum: Part Two
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In this second of a four-part series on the nature of Parkinson's disease (PD), we will provide a brief overview of PD, the benefits of an interdisciplinary team, explore its chief motor symptoms, and share some evidence-based interventions and activities. We hope that this information will be shared and lead to an enhanced quality of life for people with Parkinson's disease (PD) and greater awareness within our community.
Overview
According to the Parkinson's Foundation and the American Parkinson Disease Association, nearly one million people in the U.S. live with PD. The number of people living with PD will continue to increase with the rise in global aging. Although there is no known cause or cure for PD, the Michael J. Fox Foundation offers hope. Promising new medical efforts aim to protect and restore dopamine receptors in the brain from Parkinson's destructive path.
While PD's non-motor symptoms are significant and frequently overlooked, this article focuses on the motor symptoms. Parkinson's disease disrupts dopamine's ability to regulate movement. Over time, slow movements, muscle rigidity, tremors, and other secondary impairments develop and become more debilitating.
Interdisciplinary Team Approach
An interdisciplinary team of PD specialists and the individual and care partner/family can help develop an effective treatment plan through extensive knowledge, experience, and creative collaboration. These customized plans address the complex and unique ways that PD progressively changes an individual’s overall health.
An essential interdisciplinary team member is a movement disorder specialist (MDS), a board-certified neurologist who completed a specialized fellowship in Parkinson’s disease and other movement disorders. For years, people living with PD have strongly advocated for the University of Nevada Reno and local medical centers to pursue and secure an MDS for Northern Nevada. In late December 2020, Renown Health-Reno welcomed Dr. Christopher Way, a movement disorder specialist!
Three cardinal motor symptoms
According to the Parkinson’s Foundation, tremors affect 70 percent of people living with PD. In the early stages of the disease, tremors tend to occur on one side of the body. Typical places a resting tremor exists are in the hands, legs, jaw, and lower lip. Some people with PD will experience internal tremors in their limbs, abdomen, and chest.
Second, bradykinesia is slow movements. This slowness of movement lengthens the time it takes to complete daily tasks and generates more fatigue. Parkinson’s Victoria describes several specific ways bradykinesia affects people with PD. Slow movements lead to shuffling steps, smaller handwriting, difficulty rising from chairs and rolling over in bed, and temporary immobility.
Third, rigidity prevents muscles from stretching and relaxing properly. As a result, Parkinson’s Victoria explains that muscles become stiff and inflexible. This rigidity causes changes in posture, walking, and completing tasks requiring fine motor coordination. Tight muscles limit one’s natural ability to express happiness, sadness, anger, or fear through facial expressions.
Importance of physical activity
Since PD affects everyone differently, a customized physical therapy plan is key to managing one’s motor symptoms’ unique mixture, intensity, and progression. Physical therapist, Michelle Sanders of The Continuum, explains, “research shows targeted exercise is beneficial for people with PD and staying active is essential to managing this diagnosis.” A serious concern for people with PD is that they have a higher risk of falls. Physical therapy interventions may help reduce one’s risk for debilitating fall-related injuries. A 2020 study found that over 60 percent of people living with PD fall, some up to three to four times a day. These falls are frequently associated with poor balance, fall-related anxiety, and some PD medications. (Parkinson’s page 13)
Rock Steady Boxing class. https://rocksteadybergencounty.com
Evidence-Based Therapy Programs
Several evidence-based physical therapy programs exist to support the functional health of people with PD. The Lee Silverman Voice Treatment (LSVT) Big® breaks from the traditional physical therapy model to carefully train and certify physical and occupational therapists in their specialized approach. The evidence-based treatment focuses on improving and recalibrating specific movements to be bigger and more controlled.
Another Parkinson's specific physical therapy intervention approach is the Parkinson's Wellness Recovery (PWR!) program. PWR develops and adapts its exercise and wellness therapies based on the latest neurological research on PD. Certified physical and occupational therapists plan customized tasks to prevent falls, improve overall fitness, and maintain a healthy lifestyle.
Specialized Wellness Activities
The Brian Grant Foundation offers certifications for physical therapists, exercise instructors, and personal trainers. Their fitness approach supports people with PD through a combination of physical and cognitive exercises that improve brain health. PMD Alliance recently launched an online health and wellness program called BurnAlong. This program offers a vast digital library of on-demand exercise classes designed to meet people’s fitness needs across the PD continuum.
Many activities promote wellness for people with PD. Rock Steady Boxing aim is to “fight back against Parkinson’s disease.” Their fitness curriculum utilizes non-contact boxing exercises to improve people’s core strength, stamina, and agility. Another option is to purchase Imperium Boxing, a three-part fitness video series for people with PD. In addition to non-contact boxing,
Several martial arts programs targeted for people with PD use gentle, slow movements that integrate the mind, physical body, and breathing exercises to improve movement. According to Parkinson’s UK and the Davis Phinney Foundation, research confirms Tai Chi and Qigong’s effectiveness in strengthening balance, walking, posture, and overall flexibility in people with PD. With a community grant from the Parkinson’s Foundation, Tai Chi for Parkinson’s offers live-stream classes twice a week from their YouTube channel.
The Parkinson’s Foundation also describes the benefits of yoga for people with PD. Another activity that offers benefits in flexibility and physical control is Dance for PD®. Professional dancers are certified to lead dance classes for people living with PD and their friends, family, and care partners.
Research shows that staying active is essential for people living with PD as it alters the way people move. Early and ongoing evidence-based interventions help people with PD develop new strategies to move with greater intention, strength, and coordination. With a specialized PD interdisciplinary team and the support of friends, family, and care partners, people with PD can experience improved independence and quality of life.
