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UTAH: Exercise Eases Parkinson's Dozens are finding relief by working out at U. clinic By Lois M. Collins - Deseret Morning News Monday, May 3, 2004 PHOTO: Parkinson's patient Tom Brewer works out as physical therapist Lee Dibble watches. Brewer is hoping exercise will let him start skiing again. - Jeffrey D. Allred, Deseret Morning News When she was diagnosed more than four years ago with Parkinson's disease, Deborah Mraz needed the support of a cane to walk even short distances. Recently, she ran the Salt Lake City Marathon, despite the fact that Parkinson's is a progressive, degenerative disorder. Exercise has made the difference, said Mraz, who works at Canyon View Elementary School. Twice a week, in a rehab clinic in Research Park run by the Division of Physical Therapy in the University of Utah's College of Health, people who have Parkinson's disease gather to work out. They're together, sharing companionship and mutual support. But their exercises are tailored to meet their individual needs. As many as 45 people participate, said Lee Dibble, the physical therapist and clinical instructor who heads the program. Parkinson's is a degenerative disease in the central nervous system that wreaks havoc on movement and balance. Common symptoms include tremors and rigidity, slowness, poor posture and balance problems. Individuals with Parkinson's may also experience involuntary movement, freezing, medication that suddenly stops working, sleep disturbances, trouble speaking or swallowing and urinary problems. There's no known cure, though medications can relieve symptoms. Research has proven that exercise slows the progression of the disease, Dibble said. An exercise program for people who have Parkinson's includes "intensive aerobics, significant stretching and a large focus on balance," since falling is commonplace, Dibble said. Much of the work focuses on improved posture, balance and walking. Current participants range in age from 33 to 90. The Rehabilitation and Wellness Clinic uses "eccentric" training, which imposes high force on muscles but requires low- energy output. Equipment, including a special eccentric exercise bicycle, are not available in regular clinics and gyms. And because most insurance companies don't pay for long-term physical therapy, the clinic manages to provide the service at minimal or no cost to the patients who have Parkinson's disease. The benefits are not just physical. They're important from an emotional and mental point of view. "The exercise is not to cure us but to help us cope," said Fred Buchanan, a retired University of Utah history professor who was diagnosed with Parkinson's in 1991. People who think they should take it easy after getting a diagnosis like Parkinson's are wrong, Dibble said. "We're trying to facilitate an active approach," he said. "You're not just dealing with musculoskeletal but also with brain function." "If you rest, you rust" was a sentiment expressed by several of those working out Thursday afternoon. Eileen Rencher, who retired after years as a spokeswoman for the State Office of Education, was diagnosed 15 years ago but "didn't admit it" to herself or others for some time, she said. Her exercise for a while consisted of walking around a single block in her neighborhood. Now she goes to the clinic faithfully to work out, including using the eccentric exercise bike, which provides strong resistance training for her legs. Legs are an especially important focal point for people with the disease, Dibble said, because they're so crucial to mobility and balance. Tom Brewer, who retired from an aviation facility run by the Utah National Guard two years ago, is pleased with the gains he's made by exercising. "It definitely helps," he said. "If I miss a couple of times and come back, I've definitely lost flexibility and ability." He's a longtime skier who hopes to return to the slopes next year and is willing to put the time in now to keep his legs, cardiovascular system and balance as healthy as he can. In January, Dibble received a grant to run a clinical trial evaluating the effectiveness of the eccentric training vs. traditional physical therapy in older people who have the disease. The randomized trial puts some of the clinic's participants on the extra-resistance bicycle-like device — and focuses on muscle strength, muscle size and hormonal factors that may alter strength gains. It also looks at balance, walking ability and quality of life. Mraz is too young to participate in the clinical trial. But she has no doubt the exercise will benefit patients. It was Dibble's program of exercise that "put me back together," she said as she moved briskly across the floor. These days, she swims, runs, walks and bikes. She's also trying to raise money so the rehab clinic can get more equipment. 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