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Can exercise ward off progression of Parkinson's disease?

Tuesday, May 20, 2003
By Gary Rotstein, Post-Gazette Staff Writer

As Parkinson's patients Dick Beyer and Jim Cordy jog backward through
the UPMC Center for Sports Medicine parking lot, tossing a soccer
ball to each other, they show no signs of the tremors, stooping and
balance loss typical of people with the disease.

PHOTO:
Parkinson's patients Dick Beyer of Bethel Park, left, and Bill Perer
of Squirrel Hill pass a soccer ball back and forth as part of one of
their regular workouts at the UPMC Center for Sports Medicine on the
South Side. (Darrell Sapp, Post-Gazette)

The idea of their experimental exercise program is to keep them that
way.

They and two other men within the 55-to-70 age range are guinea pigs
for a theory under development by neurologists, neurochemists,
physical therapists and others at the University of Pittsburgh. The
theory is that exercise can either slow or reverse the effects of
Parkinson's, long considered an irreversible disease.

The prospect sounds almost too simple to believe, but studies on rats
at Pitt and the University of Texas have given the idea credibility.
Researchers here are expecting approval this month of a $5 million
National Institutes of Health grant to help them explore it further.

To someone like Beyer, 60, whose subtle Parkinson's impairments
include difficulty using a fork, the exercise theory is worth
examination. He works out on a Nordic Track in his Bethel Park home
regularly, six years after being diagnosed with the disease.

"I think it's plausible ... and hey, exercise is cheap," the recently
retired engineer said of the potential value, moments after he and
the three others completed an hour of jogging stairs, stretching,
playing basketball, kicking soccer balls and other activities
sometimes considered too difficult for individuals with Parkinson's.

Members of the group under the direction of physical therapist Kathi
Brandfass are still in the mild stage of Parkinson's, which gradually
robs the motor skills of about 1 percent of the population over age
55.

 From January to April, Brandfass said, the abilities of her exercise
participants improved drastically. They became able to nimbly take
quick steps on and off platforms without tripping, to run up and down
two flights of stairs five times instead of once without stopping,
and to coordinate multiple physical tasks simultaneously.

PHOTO:
Members of Kathy Branfass' informal exercise group at UPMC -- all of
who are in early stages of Parkinson's disease -- from left are Bill
Perer, Fred Kramer and Jim Cordy, all of Squirrel Hill. They're doing
a stepping drill. (Darrell Sapp, Post-Gazette)

"I have this sort of Cadillac group here, very motivated," said
Brandfass, noting that two of the volunteers are officers of the
Pittsburgh chapter of the National Parkinson Foundation.

"For the general geriatric population, you know what's at stake if
you don't keep moving. These men have the disease process
superimposed upon that, and they have even more at stake. It's very
important for them to keep active."

Researchers led by Dr. Michael Zigmond, a Pitt neurochemist and
associate director for basic research at the Pittsburgh Institute for
Neurodegenerative Diseases, are aiming to determine how much and what
kind of exercise can make a difference to someone with Parkinson's,
and at what juncture in the disease it's valuable.

For now, the work is focused on animals, because the effects on their
brains and key nerve cells can be studied in a way that isn't
possible with humans. Brandfass' work with the four men who have the
disease is just a small sidelight to the laboratory work until
clinical trials are conducted on larger numbers of humans, which may
be several years away.

University of Texas researchers led the first study, published in
2001, to show that rats forced to use limbs that mimicked the effects
of Parkinson's could regain motor skills within a week of physical
activity. Examination of the rats' brains showed that cells that had
died in sedentary rats survived in those forced to be active.

The findings echoed those of previous studies in which stroke victims
forced to use impaired parts of their bodies could regain functioning
better than if they'd been left alone.

Zigmond, who focused previously on other aspects of Parkinson's,
became enthused by the Texas findings and now heads a group of 20
faculty from Pitt, Texas and Wake Forest University examining the
possibilities in more detail.

In addition to expanding animal studies over the next several years,
the five-year, $5 million project would examine ways to diagnose
Parkinson's in humans earlier.

"The objective is to have treatment such as the exercise programs,
which will be neuroprotective, instituted at the earliest possible
time," Moore said.

Exercise not only is less costly than medications, it has no side
effects, Zigmond said.

"The most conservative guess would be for exercise to slow
[Parkinson's] down. I actually think it's not unreasonable to expect
it will reverse the disease."

The researchers encourage anyone with Parkinson's or a hint of it to
begin exercising, if they're not doing it now. A full-fledged
clinical trial won't take place until after more is learned from rats
and mice.

"It's not like an experimental medication, so it's certainly not
going to hurt anybody to exercise," Zigmond said. "It seems there's
no reason to wait."

He has agreement from Fred Kramer, 70, a Squirrel Hill resident
participating in Brandfass' informal experiment. Diagnosed 12 years
ago, he has sloppy handwriting and some mild signs of the disease,
but he hopes to hold off more serious effects.

He visits the Jewish Community Center regularly to use its stair-
climbing and Nautilus machines.

"I think it'd be foolish to think it's the magic bullet, but anything
that can be even a little helpful is worth doing," Kramer said.

Gary Rotstein can be reached at [log in to unmask] or 412-263-
1255.

SOURCE: The Pittsburgh Post Gazette, PA
http://www.post-
gazette.com/healthscience/20030520hparkinsons0520p1.asp

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