Tuesday 22 May 2012

Exercise to Manage Parkinson's Disease


What is Parkinson’s disease?
Parkinson’s disease is a progressive disorder that affects the central nervous system. According to MedicineNet.com, it is the most common movement disorder. This condition occurs when there is an insufficient production of the chemical – dopamine – in the brain. Dopamine is a messenger in the brain that is responsible for producing smooth, coordinated muscle movements. Thus, in people with Parkinson’s disease, this lack of dopamine in the brain results in limited and uncoordinated movement.

Causes
The cause of Parkinson’s disease is unknown; however genetic and environmental factors, such as exposure to toxins, are potential contributing factors.

Symptoms
The following symptoms may occur with Parkinson’s disease:
·         Tremors
·         Rigidity
·         Bradykinesia (limited movement of the extremities)
·         Poor motor control when rising form a chair
·         Stooped posture
·         Shuffled and stiff gait (walking pattern)
The figure below illustrates the typical standing posture of an individual with Parkinson’s disease.


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Treatment and Exercise
Parkinson’s disease is treated with medication. But, because it is a movement disorder, it is essential that people with this condition also receive supervised physical therapy on a regular basis, in order to maintain functional ability for as long as possible. The condition is progressive; however, exercise can help to slow the progression and maintain mobility.

Falls are a common problem in people with Parkinson’s disease because of the shuffled and stiff walking pattern. Individuals with this condition will tend to stoop forward, shuffling their feet along the ground instead of picking them up. This may result in them tripping over the smallest uneven surface and possibly falling. These people also often have a slower reaction time, meaning they are less likely to catch themselves if they lose their balance. Falls are very serious in elderly people, as their injuries become more severe, resulting in less mobility, thereby creating a vicious cycle.

So, the first and most important aspect to consider when working with a Parkinson’s patient is that of gait, or walking pattern. It is essential to make these people aware of how they walk and make the necessary corrections, explaining why these corrections are made. Also, practice walking in various directions and around different objects, so that they become comfortable with moving in different directions.

Fluid movements must be encouraged. These include walking, cycling and swimming, amongst others. If a person has already developed a tremor, one does not want to exacerbate this by getting them to lift excessive weights. Keep weight training to a minimum and rather do more repetitions, keeping the movements smooth and manageable. This will also create a feeling of achievement which is important for motivation.

Stretching and flexibility exercises are important to maintain range of motion. Therapists must be aware of how the person is feeling. If one overstretches a patient, they may respond by tensing up the muscles, thereby exacerbating rigidity. The patient must remain relaxed during stretching.

It is important to ensure that exercises are functional, thereby assisting patients to maintain their ability to perform the activities of daily living. Find out what an individual struggles to do at home and work on ways to improve those movements.

So, for those of you who may have been diagnosed with this condition, don’t sit back feeling sorry for yourself. Get up and keep moving! With the help of a Biokineticist, you can still have prolonged functional ability and quality of life!