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Finding, and Becoming, a Personal Trainer Specializing in Parkinson’s

personal trainer, guilt, Q&A

I received my Parkinson’s diagnosis five years ago. I fully intended to attack it head-on, starting with exercise. Parkinson’s is not for wimps. Dancing was an important part of my plan but I needed more.

The first step of my plan was to find a personal trainer. I went on a quest to find an experienced trainer with an understanding of Parkinson’s. Additionally, I needed someone who understood me. My research led me to a local community center that employed trainers who listed Parkinson’s disease as a specialty. Great. The first planning session was scheduled for that week.

First, the trainer reviewed my medical history with me. I was newly diagnosed, so my emotions were in overdrive and I was extremely guarded. Answering the questions that were not related to Parkinson’s was easy but then …

Trainer: “Do you have the shakes?”

Me: “Do you mean, do I tremor?”

Trainer: “No. I just call it the shakes.”

Really? The shakes? I was speechless, which is not an everyday occurrence. It was a small room so a quick escape was not feasible, but my mind left the building after question #1. The entire ordeal was only 20 minutes, but it left a lasting impression on me … the 45-year-old mom newly diagnosed with young-onset Parkinson’s.

The seed was planted. Could I be a personal trainer?

That very moment put me on the path to where I am today. I researched different programs and enlisted the help of a friend. Eventually, our Parkinson’s fitness program was up and running. We knew basic terms, including “tremor.” Initially, our program was PWRMoves! We added Rock Steady Boxing a year ago.

I never forgot that trainer who asked me if I had the “shakes.” (I guess I should thank him.) He planted the seed of my desire to earn a personal trainer certification. However, one thing held me back — the final exam. It intimidated me. Learning the material was not problematic, but the thought of going somewhere and taking a test terrified me. Ultimately, anxiety would hit and it would be game over. The right program was out there. I just needed to find it.

After keeping my toes in the water for years, I took the plunge and enrolled in an online course with ISSA. It was a perfect fit for me. The course fit my schedule and allowed me to work at my own pace. I also purchased a hardcopy of the training book; not an ebook but a real book with pages. It was exactly what I needed: a combination of the technology of an online course and the old-school approach of a hardcopy book.

Now I am the personal trainer and I still have a lot to learn. However, I passed Parkinson’s 101 for personal trainers — you tremor when your muscles are fatigued. You do not “have the shakes.” Understanding something so simple can make a world of difference for everyone.

***

Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to Parkinson’s disease.

The post Finding, and Becoming, a Personal Trainer Specializing in Parkinson’s appeared first on Parkinson’s News Today.

Pilot Study Supports Larger Trial on Exercise and Brain Health in Parkinson’s

exercise study

A pilot study in Sweden shows the feasibility of testing how exercise benefits neuroplasticity — the brain’s ability to adjust and make new connections in response to stimuli or damage — in people with Parkinson’s disease, making a larger and more scientifically rigorous clinical trial possible.

An ability to replicate on a larger scale previous studies of exercise on brain health in these patients has been lacking, its researchers noted.

The pilot trial was described in “Feasibility Aspects of Exploring Exercise-Induced Neuroplasticity in Parkinson’s Disease: A Pilot Randomized Controlled Trial,” published in the journal Parkinson’s Disease.

It is well-established that exercise can be beneficial for Parkinson’s patients, helping to improve balance and coordination. These benefits may be tied to physical changes within the brain, and understanding exactly how could be important for best managing PD.

“If these improvements in behavior can be specifically linked to brain plasticity,” the researchers wrote, “this knowledge could guide clinicians when choosing and progressing programs that are conducive to more enduring changes.”

While some studies have tried to define these changes, many were non-randomized and too small for firm conclusions to be drawn. In theory, these studies could be repeated, with more participants, to gather better data. However, their often complex designs are difficult to translate to a larger and more varied Parkinson’s group.

The pilot study, by researchers with the Karolinska Institutet, involved  13 people with mild to moderate Parkinson’s. Its goal was to assess the feasibility of the design for use in a larger and planned trial, and to highlight areas where improvements could be made before moving to that larger scale.

Feasibility goals included making sure that enough people could be recruited (based on interest and eligibility), making sure participants were able to stick to the exercise intervention, and confirming that data could be collected appropriately.

BETA-PD, as this follow-up trial is known (NCT03213873), took place at the institute in Stockholm and could enroll up to 96 patients also with mild to moderate disease. It concluded in December, and its results are not part of this published study.

The specific intervention assessed in both trial is called HiBalance, and reported to be beneficial in Parkinson’s disease. It consists of exercises that target core areas of balance control that are often hindered in people with PD.

Half of the participants in the pilot trial were randomized to a HiBalance program consisting of two hour-long sessions, twice per week. The other half were randomized to an equal amount of speech and communication therapy. (Randomization to either of these same groups — HiBalance or speech/communication therapy — was used in the larger trial as well.)

This speech group served as the control — the idea behind having them participate in a different type of therapy is to test the effect of variables apart from exercise, such as increased social interaction, that could impact the results.

Both groups were also instructed to participate in home-based exercises programs, which for the HiBalance group involved doing aerobic/strength exercises, or for the other group involved speech exercises.

Participants underwent tests measuring physical ability, cognitive function, and well-being. Magnetic resonance imaging (MRI) brain scans were also taken.

These scans posed a number of unanticipated obstacles, researchers reported, including patients falling asleep while in the machine and being unable to undergo an MRI because of concerns that weren’t disclosed until the last minute.

“All in all, only four participants allocated to the HiBalance group and three participants in the control group had acceptable behavioral data at the pretesting session,” the researchers wrote. Because of this, “it was not deemed sensible to make any analyses of the data but very basic quality assessments.”

There were also problems with the dual-gait assessment — a paradigm where a person is assessed while they try to do two tasks simultaneously. In this case, patients were asked to do a word puzzle while walking. Many earned perfect scores from the beginning, making it impossible to identify improvements.

Another problem had to do with blinding. Since human bias can affect outcomes, studies are usually conducted so that investigators are not aware of what treatment the person they are evaluating has been receiving. But assessors in the pilot study were often able to correctly guess which treatment participants were given, indicating a need for better blinding procedures to minimize bias in the larger trial.

Beyond these issues, this study design was deemed feasible for use in the larger study.

“Attendance rates and follow-up questionnaires suggest that both the HiBalance intervention and control group intervention were acceptable to participants. The low number of adverse events further indicates that both interventions are safe for the definitive trial,” the researchers wrote.

Although the trial was not designed to assess treatment responses, measures were taken for both groups of physical performance, well-being, cognitive function, and voice intensity.

Balance performance showed no trends toward effect in either group. However gait speed showed a tendency to increase and health-related quality of life showed positive trends in the HiBalance group compared to the control group.

Some results of executive function test also favored the HiBalance group, while others favored the control group. People in both groups seemed to show better cognitive flexibility.

“Voice intensity measures showed that control group participants improved, while the HiBalance group did not which indicates that the components of the control group were active for the intervention-targeted behavior,” the researchers wrote.

Still, the small number of participants “makes it difficult to draw firm conclusions.”

“Overall, the different elements of the design were feasible,” they concluded. “However, ahead of the definitive trial, we recommend modifications specifically with respect to blinding procedures and expectancy as well to the MRI paradigm and the dual-task gait assessment.”

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Interviewing My Husband Five Years After My Parkinson’s Diagnosis

Q&A

When you’re young, you think you have it all figured out. The future is limitless.

I was no exception. My life was moving right along when, all of a sudden, it wasn’t. I was diagnosed with young-onset Parkinson’s, and my husband and I found ourselves on a different journey, one we never could have imagined. But, for the last five years, that journey has been ours, for better or worse.

For Parkinson’s Awareness Month in April, I want to share our story by interviewing my husband, Mike.

Lori: It’s been five years since my diagnosis. How did you envision our life at this moment?

Mike: At the time of the diagnosis, I had no idea. Neither of us knew much about Parkinson’s. We tried to wrap our heads around what this meant. Early on, there was a lot of emotion, a lot of crying, a lot of hugging.

At the beginning, I felt that five years down the road, you would still be OK. You were otherwise healthy when diagnosed, you were young for Parkinson’s, so I couldn’t imagine a scenario where you would progress quickly. You, on the other hand, assumed you would progress rapidly. As a result, we spent a lot of time reconciling these two beliefs.

One thing I did not envision is that we would take ballroom dancing lessons and continue taking them over this five-year period. Who knew?

I feel our life is two chapters — life before Parkinson’s and life with Parkinson’s. How would you write an introduction to each chapter?

Before Parkinson’s: The following is the story of our lives. Getting married, raising three sons, working, playing, and experiencing all of those “normal” joys of growing up and going through life.

With Parkinson’s: Hang on! It’s going to be a little bumpy here in the beginning, but it gets a little smoother as we learn to adapt. There are also a lot of “normal” life-changing events that have occurred, which either masked the reality of Parkinson’s, or magnified it. Depending on the event, it could be either, or both.

Our kids are growing up, graduating, and “adulting.” These are significant events even without Parkinson’s, and are emotional for parents, so it’s hard to gauge how much of the emotion comes from the normalcy of these events, and how much they were magnified by Parkinson’s.

Parkinson’s makes me feel helpless at times. Do you ever feel the same way?

It did at the beginning, because of the unknowns. I would tell you that it’s going to be all right, but what did I know — this was unchartered territory for us. However, now I don’t feel helpless.

I see how you attacked this disease once the shock of the diagnosis wore off. You researched Parkinson’s, you learned that exercise was a powerful tool, and you took this to the next level. I am extremely proud of the way you have embraced exercise, not just for yourself, but also for others. You have been active in becoming certified in Parkinson’s-specific programs so you could teach others. This purpose has been important for your own well-being, and quite frankly, I’m a little scared of you now!

We face a future of unknowns. How has my diagnosis changed our lives?

Parkinson’s has changed our lives, but there are many unknowns still to come. We have all learned how to deal with adversity. Not theoretical adversity, but real-life stuff. You can’t prepare for this, but you can definitely learn from it.

Parkinson’s has brought us closer. It obviously is not something that either of us would have wished for, but it’s here. And so far, it has been different, but not all bad.

What advice would you give the partner of someone with newly diagnosed young-onset Parkinson’s?

Be supportive and understanding. Be there to comfort when needed. And be there to give a little push when needed. Sometimes it’s difficult to know which approach is most appropriate at the time, but you will figure it out. Most important, hang in there and continue to love (both of you).

What do you think we have gained from my Parkinson’s experience as a family?

I think we are closer as a family. It seems like this impacted our sons more than we knew. But as time passed, and everyone understood that Parkinson’s is not a death sentence, we all came to terms with it and realized this is the “new normal.”

Your father made a comment shortly after you were diagnosed, and I will never forget it. He said, “So you shake a little. … We still love you.” It’s maybe not the most politically correct thing to say, but I think it hits the nail on the head.

***

Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to Parkinson’s disease.

The post Interviewing My Husband Five Years After My Parkinson’s Diagnosis appeared first on Parkinson’s News Today.

COVID-19 Presents Distinct Challenges, and Opportunities, with Parkinson’s

pandemic and Parkinson's

People with Parkinson’s disease can face “hidden sorrows” during the COVID-19 pandemic, like increased stress and limits on physical activity, that could worsen their symptoms. But ways exist to mitigate these “less visible” threats of social distancing and other changes in daily routines.

Indeed, the pandemic may facilitate wider access to helpful online resources, and could open new opportunities for research, two neurologists suggest.

These difficulties and opportunities were discussed in the commentary article, “The Impact of the COVID-19 Pandemic on Parkinson’s Disease: Hidden Sorrows and Emerging Opportunities,” published in the Journal of Parkinson’s Disease.

The COVID-19 pandemic poses many challenges, the most readily apparent being the health-related impact of the disease. This is particularly true for people who are older or have underlying conditions, as they are more likely to have complications if infected. Parkinson’s disease is no exception — people with PD are typically older, and lung problems (most notably pneumonia) are common.

“Although documented reports are thus far lacking, it is conceivable that having a diagnosis of PD is a risk factor for worse respiratory complications or even an unfavorable outcome after a COVID-19 infection,” the researchers wrote.

Yet the pandemic’s impact extends far beyond health alone; it also carries social, cultural, and economic effects. The commentary, by two Parkinson’s experts at Radboud University Medical Centre in the Netherlands, focused on how these might affect patients.

Primarily, the authors point out that the pandemic itself, as well as measures being taken to control it like social distancing, represent a large change to daily life in a short period of time.

While stressful for most, distancing may be a particular burden to people with PD, because the ability to rapidly adapt to new circumstances is largely dependent on brain systems involving the neurotransmitter dopamine. In Parkinson’s patients, these systems are compromised as part of the underlying disease.

“Thus, the pathophysiology of PD puts patients at increased risk of chronic stress, and a further worsening of this may well be one of various hidden sorrows of the COVID-19 pandemic,” the researchers wrote.

Elevated stress, in turn, could have health consequences: previous research suggests that increased stress can worsen motor symptoms, and make levodopa (a mainstay of PD treatment) less effective.

Another “hidden sorrow” of the ongoing pandemic for Parkinson’s patients is reduced physical activity. “Many people are now largely and sometimes completely stuck at home, being unable to go out for a regular walk, let alone to see their physiotherapist or attend a fitness class,” the researchers wrote.

Moderate exercise has been suggested to ease PD symptoms; as such, being unable to exercise could lead to worsening of the disease for some people. Exercise is  also a well-established way to lower stress, so the lack of exercise could compound stress-related problems.

But these obstacles are not insurmountable.

The authors highlight that resources are available online. In particular, they emphasized online courses in mindfulness that could help alleviate feelings of stress, as well as online exercise classes that can help promote physical activity.

“Such interventions are not entirely new, but the current crisis has certainly accelerated their adoption by large groups of patients, paradoxically making the access to these important interventions more accessible than ever before, particularly for those living in loosely populated areas of the world,” they wrote.

The COVID-19 pandemic may also create research opportunities related to Parkinson’s.

For example, it is relatively rare to have many people all experiencing increased stress at the same time. Particularly in existing longitudinal clinical trials, this shared stress could aid studies aiming to better untangle the precise effect of stressful events on PD progression, and in understanding what factors make a person with Parkinson’s more or less vulnerable to the detrimental effects of stress.

“As such, deleterious as the current crisis may be, it will hopefully also bring some long-term positive outcomes for the many people living with PD worldwide,” the authors concluded.

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Brian Grant Foundation Launches Online Education Program for Exercise Pros

Grant's Army

The Brian Grant Foundation (BGF) has opened a new online education program that seeks to help exercise professionals provide safe and effective classes for Parkinson’s disease (PD) patients.

Called Grant’s Army, the program features a compilation of cutting-edge PD exercise research, case studies of exercise programs nationwide, and stories about patients who use fitness classes to help deal with symptoms. There also are video tutorials demonstrating activities known to help patients manage the neurodegenerative disorder that affects about seven to 10 million people globally.

“Research has found that exercising on a consistent basis is one of the best tools that people with Parkinson’s can use to manage symptoms of their disease,” Katrina Kahl, the foundation’s executive director, said in a press release. “Our goal with Grant’s Army is to ensure that exercise professionals are equipped with knowledge of evidence-based activities that are safe for people with Parkinson’s, and have been shown to effectively manage the symptoms.”

Exercise is important for those living with PD because it helps maintain balance, mobility and the ability to perform daily tasks. Researchers have found that patients who exercise at least 2.5 hours weekly also experience a slower decline in quality of life.

Specifically, research has indicated that exercise can lessen PD-associated tremor and improve gait, balance, flexibility, grip strength and motor coordination. Exercise also may improve cognition and lessen depression and fatigue, but studies in these areas remain ongoing.

A Grant’s Army’s patient profile features former pickup basketball player, long-distance swimmer and marathon runner Dale Moss, who experienced improvements in gait and balance after incorporating more Parkinson’s-specific exercises into his fitness routine.

Living with PD for about a decade, Moss enjoys the Parkinson’s fitness program at Northwestern Medicine Lake Forest Hospital in Illinois, where he has participated in clinical trials and had deep brain stimulation surgery (DBS) three years ago. DBS is a neurosurgical procedure in which doctors implant thin metal wires in the brain that send electrical pulses to help control some motor symptoms.

“I’m not always as steady as I want to be,” Moss stated on a program webpage. “These days I’m more focused on exercises that target Parkinson’s rather than doing some of those more grandiose events I used to do in the past. That’s the direction I’m going now athletically. I know that I need to be working out every day.”

He said he focuses on exercises such as squats, lunges and those that help improve balance. “These are the types of exercises that will help improve my quality of life and make it easier to do things like get up out of chairs.”

With a focus on PD exercise, nutrition and emotional health programs, the 20-year-old Brian Grant Foundation offers evidence-based tools to enhance patients’ well-being. Since 2016, the BGF has been training exercise experts on activities specifically for individuals with Parkinson’s. Its Exercise for Parkinson’s training program for professionals is offered online as well as in person.

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Boxing May Improve Quality of Life for Parkinson’s Patients, Study Finds

boxing, quality of life

A non-contact boxing program could improve quality of life and willingness to exercise in people with Parkinson’s disease, new data shows.

A preliminary study with these findings will be presented at the American Academy of Neurology‘s Annual Meeting, to be held in Toronto at the end of April.

“Moderate exercise has long been associated with having positive impact on some people with Parkinson’s,” Danielle Larson, MD, a neurologist at Northwestern University McGaw Medical Center and one of the researchers behind the findings, said in a press release, “but the outcome of this specific regimen seems particularly favorable for the majority of people.”

The researchers looked at a boxing regimen called Rock Steady Boxing, a nonprofit program designed for people with Parkinson’s. The program is non-contact: that is, people aren’t hitting each other. Instead, participants attend 90-minute group classes, led by a coach, that feature boxing exercises aimed at increasing agility, speed, muscular endurance, coordination, footwork, and overall strength.

In the study, 1,709 people with Parkinson’s, with an average age of 69, were given a survey on their quality of life. A total 1,499 of the survey respondents were either current or previous participants in the boxing program, while 210 had never participated. The two groups were similar in terms of time since diagnosis.

Among the boxing participants, on average, 43% attended three or more classes per week, 48% attended two classes per week, and 9% attended one class per week.

Overall quality of life was measured on a scale from 0 to 100, with 0 representing the best quality of life. Participants in the boxing program scored better than non-participants — 25 vs. 32 points.

Willingness to participate in an exercise regime was measured on a scale from 0 to 90, with 90 representing the greatest confidence in taking part in the regimen. Boxing participants scored higher than non-participants, with scores of 54 versus 48 points.

Further, 99% of current boxing participants and 94% of previous participants said they would recommend the program to other people with Parkinson’s disease.

Among boxing participants, 70% reported a better social life, 63% had less fatigue, 62% felt less afraid of falling, 60% had mood improvements, and 59% felt less anxious. However, the survey was only administered once; scores were not actively followed for changes over time.

“This demonstrates that Rock Steady Boxing participants have improvement in the non-motor symptoms of the disease and, compared to non-participants, have significantly better quality of life and are more likely to feel confident engaging in continued exercise,” Larson said.

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Study Finds Tai Chi Improves Motor Function in Parkinson’s Patients

tai chi, Parkinson's

Tai chi improves motor function in people with mild to moderate Parkinson’s disease and may slow down disease progression, a new study has found.

The study, “Tai Chi versus routine exercise in patients with early- or mild-stage Parkinson’s disease: a retrospective cohort analysis,” was published in the Brazilian Journal of Medical and Biological Research.

Tai chi is a Chinese martial art that involves a series of fluid motions, generally accompanied by deep, meditative breathing. The slow-moving and low-impact practice offers some benefits of exercise, particularly in people who may not be able to engage in more intense physical activity.

Tai chi has been recommended as a supportive therapy for people with Parkinson’s disease. However, there hasn’t been much data to support these recommendations.

In the new study, 500 people with mild-to-moderate Parkinson’s were divided into two groups. The tai chi (TC) group received tai chi lessons, 80 minutes per day, three days per week, for two months. The routine exercise (RE) group received classes in routine exercises (including treadmill training, aerobic training, and dance) for 90 minutes per day, three days per week, for two months.

Prior to enrollment in the study, there were no significant differences between the two groups. The study population was predominantly male.

Before and after the training, the participants’ motor function was evaluated through a number of routine measurements, such as recording the time it took to walk 50 feet. Both groups showed improvement over the two months of the intervention, but across measures, improvements were significantly higher in the TC group. For example, after the intervention, the time to walk 50 feet was, on average, 8.37 seconds in the TC group and 9.71 seconds in the RE group.

Participants in the TC group also reported a significantly reduced number of falls (average of 3.45 vs. 7.45 over the past six months), and many of them discontinued or reduced the use of other therapies, such as levodopa.

When hypothesizing about why tai chi produces such positive outcomes in Parkinson’s patients, the researchers believe that it normalizes the levels of neurotransmitters that are present at lower levels in this patient population — such as dopamine and acetylcholine — in various regions of the brain.

“When tai chi is practiced daily, it promotes the development of various de novo neural pathways in a [Parkinson’s] patient that results in fast response to posture challenges,” the researchers said.

Interviews were conducted with participants after the intervention. In general, participants in both groups were positive: “Participants reported that exercises helped them improve their confidence and balance,” the researchers wrote. Notably, a greater proportion of TC participants said their intervention felt safe and helped with balance.

No adverse events were reported in the study.

“Although the study spanned over a short period of time, its results supported tai chi as an effective therapy for [Parkinson’s] patients,” the researchers wrote. They noted that further studies, evaluating such exercises over a longer period of time, will be necessary to fully understand the impact of the practice on patients.

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Does an Exercise Lifestyle Before Parkinson’s Onset Affect Progression?

exercise, columnist graphic, don't use

 “When it comes to eating right and exercising, there is no ‘I’ll start tomorrow.’ Tomorrow is disease.” –V.L. Allineare

In December, I asked members of the Parkinson’s News Today Forums if anyone was an athlete prior to their diagnosis. By “athlete,” I mean a recreational athlete who consistently trains and challenges themselves, not elite or Olympic-caliber athletes.

The benefits of exercise for people already diagnosed with Parkinson’s are well-known, but I’ve been wondering whether an active lifestyle before disease onset makes a difference in the rate of symptom progression. Could consistent exercise before Parkinson’s onset be an investment in an individual’s future quality of life?

Food for thought

The majority of forum respondents stated that they exercised for much of their adult life and continue to do so post-diagnosis — some of them quite vigorously. Many said their Parkinson’s progression is slow. Is that because of their current exercise regimen, their pre-diagnosis activity levels, or a combination of both?

One forum respondent theorized that his lifelong commitment to exercise may have delayed Parkinson’s onset until his early 60s.

A former soldier who’s continued training post-diagnosis said his medical team observed that his progression is slower than the roughly 2,000 Parkinson’s patients they see. He said they believe their fittest patients have the slowest rate of progression.

Noticeable pros and cons of pre-diagnosis exercise

My pre-diagnosis training regimen consisted of:

  • Dancing and training like a professional for 15 to 20 hours per week
  • Weight training two to three times per week
  • Cardio, such as cycling, spinning, heavy bag classes, or race walking three to five times per week

Unfortunately, due to aging and Parkinson’s, my current exercise routine is nowhere close to that.

For me, the only downside to my pre-diagnosis exercise lifestyle has been that I am much more aware of what I’ve lost to this disease. However, the traits developed from years of training far outweigh that downside: My past active lifestyle has aided in retaining muscle memory, the self-discipline to get myself off the couch so I can push through workouts, and the ability to go on “autopilot” when feeling unmotivated.

Exercise is medicine

The forum discussion and my own life experience have convinced me that both pre- and post-diagnosis exercise lifestyles go a long way in staving off Parkinson’s progression. As one responder noted, “In summary, based on the experience of the participants in this thread, it seems there might be a correlation between a person’s pre-PD exercise regimen and delayed onset and/or slower progression of PD.”

Unfortunately, it appears exercise as a lifestyle does not fully prevent Parkinson’s. The good news is that I don’t see any real negatives to safe exercise, pre- or post-diagnosis. Now, if only I could eliminate other symptoms like fatigue, apathy, and lack of motivation …

As if you needed another reason to exercise consistently.

What have you got to lose?

“Those who think they have no time for bodily exercise will sooner or later have to find time for illness.” –Edward Stanley

***

Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to Parkinson’s disease.

The post Does an Exercise Lifestyle Before Parkinson’s Onset Affect Progression? appeared first on Parkinson’s News Today.

Table Tennis Program May Ease Motor Symptoms in Parkinson’s, Early Study Shows

table tennis, Parkinson's

Table tennis may offer benefits as a form of Parkinson’s physical therapy, according to a preliminary study that showed lessening of symptoms in patients who participated weekly in the sport for six months.

“Pingpong, which is also called table tennis, is a form of aerobic exercise that has been shown in the general population to improve hand-eye coordination, sharpen reflexes, and stimulate the brain,” study author Ken-ichi Inoue, MD, of Fukuoka University in Fukuoka, Japan, said in a press release. “We wanted to examine if people with Parkinson’s disease would see similar benefits that may in turn reduce some of their symptoms.”

The study will be presented at the American Academy of Neurology’s 72nd Annual Meeting in Toronto, Canada, taking place April 25 to May 1.

Parkinson’s disease is a neurodegenerative disorder, characterized by progressive loss of motor control. This loss stems from the death of neurons in the brain that create a neurotransmitter called dopamine. Dopamine is vital to communications between muscles and the central nervous system.

In the study, the researchers had 12 people with mild to moderate Parkinson’s play table tennis once a week for six months. Participants were 73 years old on average and had been diagnosed with Parkinson’s for an average of seven years.

First, the researchers tested them to assess the types and severity of their symptoms.

The 12 participants then each played a five-hour session every week. The sessions were designed specifically for Parkinson’s patients, by experienced table tennis players from the university’s sports science department. Sessions consisted of stretching exercises followed by table tennis exercises, all under the instruction of an experienced player.

Parkinson’s symptoms were evaluated again after three months and at the end of the study. At both assessment points, participants demonstrated significant improvements in speech, handwriting, getting dressed, getting out of bed, and walking. Participants reportedly improved in their efforts to get out of bed from requiring two attempts, on average, at the beginning of the study to needing one attempt by the end of the study.

Participants also showed significant improvements in facial expression, posture, rigidity, slowness of movement and hand tremors, all of which are common symptoms of Parkinson’s disease.

To measure neck muscle rigidity, the researchers scored each participant on a scale of increasing rigidity from zero to four. Participants received an average initial score of three, which fell to an average of two by the end of the study.

The only side effects reported during the study consisted of a backache in one patient and another in a patient who fell.

The study was limited by the small number of participants, not having a control group to compare results to, and having only one specialist assess all the patients.

While preliminary, the results are nonetheless encouraging, the researchers said.

“[T]hey show pingpong, a relatively inexpensive form of therapy, may improve some symptoms of Parkinson’s disease,” Inoue said. “A much larger study is now being planned to confirm these findings.”

Notably, this study is not the first time that table tennis has been used as therapy for Parkinson’s. Ping Pong Parkinson has its own program developed specifically for people with Parkinson’s and holds weekly meetups at their Pleasantville, New York, headquarters.

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Motion Machine’s Ability to Ease Motor Symptoms in Parkinson’s Entering Trial in Australia

Parkinson's and balance

A trial in Australia will test a motion machine, called the Reviver, to understand whether it can improve balance, mobility and sensory-motor coordination in people with moderate to advanced Parkinson’s disease and atypical parkinsonism.

Exercise has been shown to help ease Parkinson’s symptoms. The Reviver machine, by Isodymanics, is designed to stimulate the vestibular system, the sensory system that provides a sense of balance and information about body position.

The machine works by placing the user at a tilted angle and rotating them in a slow and radial, wave-like motion.

The reaction to being tilted off-balance can induce a brain response that activates muscles across the body, including those that may be dormant as a result of age, infrequent use, damage, or disability. Specifically, it activates nerve pathways that then aid in balance, enhance muscle strength, and help resist the effects of gravity.

Isodynamics reports early evidence suggesting the Reviver’s use can improve mobility and lessen Parkinson’s symptoms, with patients demonstrating a 22% increase in mobility; namely, quicker “up and go” test times over an average of 26 days. This test measures the time it takes for a person to rise from a chair, walk three meters (about 10 feet), turn around and return, then sit down again.

“The anecdotal results with our patients have been very positive,” Geoffrey Redmond, Reviver’s developer, said in a press release. “We’re really glad to see the Reviver being used in a formal trial.”

The trial will assess whether a 12-week program using the Reviver machine improves balance, mobility, and sensory-motor coordination. It plans to enroll 30 patients with moderate to advanced Parkinson’s disease or atypical parkinsonism. People with atypical disease have some evident Parkinson’s symptoms, like muscle stiffness or balance issues, but who do not respond well to standard medications. Their symptoms are caused by other disorders.

The trial is being overseen by Terry O’Brien, a neurologist at Monash University and led by Ben Sinclair, a brain imaging expert at Monash and with Alfred Health. Participants will be required to attend twice weekly sessions for 12 weeks at The Alfred in Melbourne.

Enrolled patients will be split into two groups, based on their diagnoses. One group will undertake the Reviver exercise regime on top of their standard of care, and the second (a control group) will continue with standard of care without using the Reviver.

Those interested in participating or receiving more information about the trial can call Isodynamics at 02-9524-2188 (in Australia, country code +61) or email the company.

“We now need to see what kind of results can be generated during a formal, randomised controlled trial,” Sinclair said.

“It’s an exciting project because people affected by Parkinson’s have a limited range of treatment options. This study provides a rare opportunity to explore and uncover a new possible treatment pathway for people affected by Parkinson’s,” he added.

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