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Rethinking Exercise With Parkinson’s

exercise, chemical hazards, coping skills, frustration, relationships, things, what ifs, shut in, toilet paper, serenity, laughter

I hate facing the effort it takes to start daily exercise. I hate the way I feel the next day — like I have been pummeled with nunchuks. But ever since my Marine Corps training I have enjoyed the benefits of exercise. I know it is hard to get up and engage in physical activity. This is particularly true when facing the motor hesitation of Parkinson’s. It is hard to exercise facing the level of discomfort that is going to follow. This is particularly true when the post-exercise stiffness is compounded by the rigidity associated with Parkinson’s. Yet, despite these difficulties, the benefits of exercise far exceed the temporary increase in discomfort.

Starting exercise after being sedentary combined with neuromuscular malfunctions requires special considerations. The Marine Corps boot camp approach just is not going to work. Last time I tried that I ended up with multiple muscle injuries. A new approach to exercise came from three ideas: mindful movements, little things practice, and long movements adapted from Lee Silverman Voice Treatment (LSVT) exercise recommendations.

In the study “Effect of Exercise on Motor and Nonmotor Symptoms of Parkinson’s Disease,” the authors report that “LSVT BIG therapy is designed to overcome amplitude deficits associated with PD. This therapy improves proprioception through increasing amplitude together with sustained attention and cognitive involvement by mentally focusing on individual movements.” In other words, I am concentrating on where my body is and what it is doing, and I’m paying attention by focusing on the task at hand.

My new exercise program incorporates activities that focus on long and slow movements while I’m simultaneously engaged in a mindful focus on the little things. This new exercise program is also tied to something that will continually motivate me to move past the Parkinson’s hesitation to start. I discovered, in some ways rediscovered, the answer with landscape gardening.

What is great about landscape gardening is that there are so many different types of motor tasks that need to be accomplished: shoveling, hauling with a wheelbarrow, planting, raking, clipping, and pruning. Knowing that I need more light physical activity for both warming up and for bad days, where I can only put in short durations, I am installing a white gravel Zen path. The small gravel pieces, less than an inch in diameter, are incredibly easy to rake with long mindful movements. Light and easy warm-up exercise has become mandatory for me before any physical activity. The one day I forgot resulted in strained muscles that required too much time to heal. The good thing is I now know what strained muscle pain feels like and how it is different from Parkinson’s muscle pain and different from post-exercise pain. I now know why the light warm-up exercise in a mindful state needs to happen before I tackle the larger landscape gardening projects.

Getting back into exercise after being sedentary for so long requires patience — lots and lots of patience. I see so many things in my vision for our yard. But I know if I push myself in that old boot camp way I am going to end up injured and unable to accomplish my vision. But patience means slowing down and slowing down feels like I am not accomplishing “great” things. If I think I am not accomplishing then I am not successful, and if I cannot be successful, then I feel no need starting at all. It is a devious cycle that ignores the practice of “little things” and becomes a reason to not exercise. Mindful, light motor exercise activities break that cycle. Like Tai Chi and yoga, the long, mindful movements help motivate me out of sedentary life and into a balanced exercise regime.

Gardening is also good for the mind and what is good for the mind is good for the body. My approach to gardening is different now. My first impression of the change is that my actions are calmer, framed in sacred intent. But, in all honesty, I am still sorting all that out. Using this new approach to exercise, while being creative with landscape gardening, is making a huge difference in my health. We just did a teleconference with my new primary provider and Mrs. Dr. C said, “He’s the healthiest he’s been in four years.”

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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 Rethinking Exercise With Parkinson’s appeared first on Parkinson’s News Today.

Can Brain Therapy Help with the Stress of Moving?

brain therapy

“Hey, Doc, you don’t look so good. Like a walking zombie,” Neo says with genuine concern. (Neo is my brain’s neocortex. I’ve mentioned him in previous columns.)

I let out a bigger sigh than usual. “This move to St. Louis, Missouri, halfway across the country is unusually difficult. The surges of exaggerated mood (SEM) attacks are worse with stress. While preparing to move, I am practicing mindful movement as often as possible and supporting my partner through the process. I am also practicing brain therapy to moderate these SEM attacks. I feel like ‘The Walking Dead‘ because I’m still not fully recovered from the ruin of stagnation.”

Neo snorts, “You have always been your worst enemy, pushing yourself to exhaustion. Maybe the old ways aren’t working for you anymore. You need to take a good dose of your own advice!”

Neo always surprises me by how he cuts to the heart of the matter. “Absolutely!” I respond. “I have to find a new way. That’s what this brain therapy is about. It’s a new way of monitoring and changing how I live with the symptoms of chronic illness, especially the SEM attacks.”

“Never heard of such a thing. How can you prove this brain therapy works for anybody but yourself?” Neo doesn’t completely discount my idea, but he’s not buying it 100 percent.

“I am in the hypothesis clarification stage right now,” I respond with confidence. “Not ready yet to explore the therapeutic efficacy of brain therapy. We are still exploring the idea that the brain has a built-in conductor, which can be trained to moderate the SEM attacks.”

Neo ponders this idea. “Have you found any clues that might indicate what this might look like?”

My thoughts start flowing. “It’s preliminary, but perhaps brain therapy will include wellness mapmaking using the CHRONDI Creed, threshold management, mindful movement, a psychological awareness method called self-monitoring, and regular involvement in novel problem-solving.”

Neo’s concentration is glazing over. “That’s a lot for a person to try to do when they have to battle a chronic disease, support a partner with a chronic disease, and deal with the stress of moving.”

“Getting overwhelmed happens to me every day,” I tell him. “If I can practice high self-monitoring, it helps to keep things in check. It’s not about perfection, but rather calm reflection. No matter what’s in front of me, I try to calmly reflect on my perceptions prior to acting. On the good days, I don’t revert to the old ways of thinking. But on the bad days, the old ways still get me in trouble.”

Neo responds with a sense of authority. “And what is your partner doing through all your efforts?”

I am quick with an answer. “I wouldn’t be able to do a lot of what I do without her. She has her own medical issues. Her demons, she calls them. She has had to make a lot of adjustments to her life at the same time I’ve been adjusting to mine. Most of the time, she says she can monitor my actions and knows when I’m not doing well. The times when the SEM attacks occur seemingly out of nowhere and with no provocation are the hardest.

“But one of our strengths as a couple is we’ve always been able to talk through most anything. We work together on not harboring hurt feelings when the medical issues create problems — unexpected or expected. We talk, we adjust, we share, and we keep walking together through all of what we are both experiencing.”

I pause, take a bite of the scrumptious, peppermint chocolate pie provided by friends. “It’s easy to get overwhelmed, but I remind myself it’s just chemistry while I put the brain therapy to work. I have to do this multiple times a day. The good news is the brain therapy program is helping. I deeply believe that the brain is designed to do this, and I can strengthen its natural ability as a conductor. I’m still in the early stages of discerning the details, and a long way from teaching others how to do it.”

Neo nods. “I think you’re onto something here. I look forward to hearing more. Hopefully, your readers will provide informative comments and compassionate support for your continued journey into the frontiers of chronic disease rehabilitation. Oh, and by the way, you might just give your partner an extra hug today.”

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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 Can Brain Therapy Help with the Stress of Moving? appeared first on Parkinson’s News Today.

Mindful Movement Can Help Motor Hesitation

mindful movement

At my last presentation to a support group for Parkinson’s disease (PD), one attendee said, “My husband wobbles a lot when getting up from the sofa. I’m afraid he will fall. What can we do about that?”

I asked her husband to stand, which he did with grace. A slight hesitation accompanied motor initiation, but no severe wobbling was present. I explained how PD movement fluidity can improve in formal settings.

This information was new to the audience, but not to me. I have been told by people with PD that motor symptoms are less disabling in formal settings, such as entertaining company or presenting to a group, than in informal settings, such as sitting at home on the sofa watching TV with a partner.

Unfortunately, patients often view the doctor’s office as a formal setting. When doctors ask me to stand or sit, I perform excellently — occasionally with a little hesitation, but no serious wobbling.

Motor hesitation commonly accompanies motor initiation in formal and informal settings. Wobbling, instability, and stumbling when transitioning from sitting to walking can follow motor hesitation, particularly in everyday settings. We can use this knowledge to explore possibilities with PD, especially in the early stages of the disease.

Why does motor hesitation occur?

I have previously talked about autopilot and scenario looping. We don’t have to think about walking. Walking is an overlearned motor sequence, stored in our memory, accessed via autopilot, and tied into the scenario looping process.

People with PD experience scenario looping breakdowns and a broken autopilot. We cannot rely on our bodies to automatically and smoothly transition from sitting to walking. Broken autopilots will likely result in wobbling, instability, and stumbling — particularly in informal settings, because our minds tend to focus on other things.

We assume our body will automatically get off the sofa and walk into the kitchen without requiring anything special of us. But that is no longer the case for people with PD. Formal settings show us that our movements become less problematic when we pay extra attention to them.

Mindful movements

We need to do anything and everything we can to decrease the possibility of falling, which is a serious concern. It may seem strange, but I’ve started to “perform” my daily movements. It’s similar to practicing tai chi or dancing every time I get out of a chair, walk from the bathroom to the living room, or even leave the bed.

We can incorporate mindful movements into our lives in formal and informal situations. Mindful movements start with a pause. Before I transition to a new position, I pause, focusing on the movement of my arms, legs, and feet. My movements are slower, slightly exaggerated, and — at least in my mind — graceful.

The LVST BIG program touches on mindful movement. The incorporation of mindful movement needs to be personal, intentional, and eventually, common practice. It took me about six months of daily practice before mindful movement became a regular part of how I move in the world. However, we can tailor mindful movements to fit our lifestyles.

Mindful movement turns informal to formal. Remember that improved quality of life, not perfection, is the goal. It takes time for mindful movement to become a regular part of your routine and impact your quality of life, but it is well worth the effort.

Do you practice mindful movement? Do you notice a difference in your movements in formal situations versus informal ones? Please share in the comments below.

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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 Mindful Movement Can Help Motor Hesitation appeared first on Parkinson’s News Today.