Parkinson's disease is one of the most prevalent neurodegenerative disorders, after Alzheimer's. The onset of the disease occurs on average from 60 yrs of age and causes a disruption to the function of the brain (basal ganglia & cerbellar) resulting to movement disorders. This topic of the week will outline some typical symptoms and medications used that will have an effect on activities of daily living. Of course we outline how exercise can be incorporated into the life of a person with PD for improved quality of life.
Symptoms (may have >1 types)
- Slowness of movements
- Small amplitude of movements
- Oscillating movement regular in beat
- Rhythmical type movements
- Muscle stiffness
- Inability to maintain upright position
Medication:
The prescribed medicine is known as Levedopa which has reduced death rates but has not altered the disease progression. Levedopa has been able to prolong independence and ultimately quality of life. It is important to note that an increase in duration and dosage of Levedopa increases the likelihood to side effects (6-25yr time frame) which has an effect to the type and timing of exercise and physical activity.
Type of side effects:
- Nausea
- Quick drop in blood pressure
- Fatigue
- Confusion
- Blurred vision
- Medication cycle
- Person must be in an ON Phase to allow normal function.
- OFF Phase Increase symptoms of PD will make it very difficult to perform exercises
- OVER Phase During peak dosage will experience extra movement
- Awareness of Environment open spaces, less clutter & noise, level of light
- Comorbidities other conditions such obesity, blood pressure & other medications
Once considerations have been made, exercise can be done normally with progression just like a healthy person. Some basic recommendations that would benefit individuals muscle tone, smoothness of movement, strength and aerobic capacity;
- Treadmill walking helps improve walking efficiency, stride length & speed
- Multi-joint exercises helps cover more muscle groups at one time
- Functional exercises exercises that mimic typical activities of daily living for the individual is ideal
- Core function Vital for maintaining upright posture and overall balance
- Flexibility/Mobility exercises helps reduce rigidity and stiffness to those affected area
Remember to ensure that exercise is specific to the individual's stage of PD (stage 1-5) according the Unified Parkinson's Disease Rating Scale (UPDRS). Always seek professional guidance for appropriate assessment, prescription and supervision.
