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Kevin, This post is most timely for me. I would appreciate any other information you would be willing to share. ----- Original Message ----- From: "Kevin Lockette" <[log in to unmask]> To: <[log in to unmask]> Sent: Saturday, July 18, 2009 12:43 PM Subject: Re: Exercise Tips > Here is more on Exercise tips. If this is helpful information, I would be > happy to post additional articles. > > Much aloha, > > Kevin > > Role and Importance of Exercise with Parkinson’s Disease > By Kevin Lockette PT > (www.parkinsonsmoveit.com) > > The key to an effective exercise program with PD is to focus on posture > and > purposeful movement. The postural muscles are important to maintaining > range of motion in the shoulders for activities of daily living such as > dressing, key to balance and gait by keeping your center gravity over your > base of support (your feet) and to assist in combating fatigue. The main > antigravity and postural muscles are your scapular muscles/upper back, > back/hip extensors and your quadriceps. The stronger your postural > muscles > are, the better equipped you will be to battle “forward posturing” which > is > the tendency of being pulled or stooped forward which can also trigger > freezing and a shuffling gait (festination). > PD Exercise Research > Recent studies have shown that exercise can have beneficial effects in > patients with Parkinson’s Disease. One study looked at Treadmill exercise > and its effects between animal models with and without a loss of certain > cells that are similar to what a person with PD might suffer. Given the > importance of dopamine in Parkinson’s Disease, the researchers looked at > changes in dopamine levels and found that the subjects with cell loss and > that exercised, indeed, had an effect on dopamine levels while normal > subjects showed less of a difference in levels. A study by Viliani, > Pasquetti, Magnolfi et al aimed to evaluate whether motor training could > improve the straightening-up sequences in patients with Parkinson's > disease > and, consequently, could ease the capacity of the patients to change > body's > position. The results were statistically significant differences observed > in > all the motor parameters that were evaluated (supine to sitting and > sitting > to supine, supine rolling, standing from a chair). The conclusion was that > physical training can be effective in improving motor performance related > to > changes in position which affects the simple daily activities of the > patients.Researchers at the Washington University medical school in St. > Louis recently found that PWP can significantly improve functional > mobility > by taking Argentine tango lessons and exercise classes. The tango group, > however, showed greater improvement in balance, which is critical to > avoiding falls. Additional studies with larger groups of patients are > needed > to confirm these preliminary findings. > “The dance classes included stretching, balance exercises, tango-style > walking, footwork patterns, experimenting of timing of steps, and dance > with > and without a partner. The exercise classes included 40 minutes of seated > exercise, followed by standing exercises supported by a chair, core > strengthening and stretching.” (U.S. News & World Report ) > There many other studies that have been done and many that are currently > underway. More research is needed to fully understand the effects of > exercise on Parkinson’s Disease and the underlying reasons for the > effects. > Conclusion > The bottom line is that exercise is one thing that you can do to combat > many > of the physical symptoms of PD. There are many different modes exercise > that > are appropriate for PD including Tai Chi, Pilates, Dance and resistive > training. A clearly designed exercise program specifically for PD can > improve posture, reduce affects of fatigue, improve mobility and decrease > the incidence of freezing and falls. > > Your Body’s Response > The purpose of addressing the physiological effects of strength training > is > to give you a better understanding of how your body will react to a > strength > program that you design for yourself. Understanding the cause and effects > will allow you to better design and modify your exercise program to meet > your needs and goals. It is important to note that PD works on a > particular > area in your brain but does not directly work on your muscles, so your > muscles still can have the ability to maintain strength and flexibility if > you train them. A study by Scandalis, Bosak, Berliner et al showed that > patients with mild-to-moderate Parkinson's disease can obtain increases in > performance or strength similar to that of normal adults of the same age > in > a resistance training program. Resistance training can produce functional > improvements in gait and may, therefore, be useful as part of a physical > rehabilitation and/or health maintenance program for people with > Parkinson's > disease. > > The human body has a remarkable ability to adapt to the stresses placed on > it. When the muscle fibers and the anaerobic energy system are stressed by > weightlifting or resistive training, they adapt. With appropriate stress > on > these systems, rest and recuperation, the muscle will become stronger as a > positive adaptation to the stress put on it. > > Initial gains in strength are most likely due to both effects on the > muscles > and the nervous system. The nervous system stimulates and controls the > muscles. During the initial training phase, the nervous system basically > learns the skill of the movements (exercises) and learns how to > efficiently > recruit the muscle fibers to have the best coordination for those desired > motions. > > BASIC TRAINING PRINCIPLES AND CONSIDERATIONS > Progressive Resistive Exercise (PRE) > As a muscle adapts to applied stresses, resistance must gradually be > increased for further positive changes to occur- thus the term progressive > resistive exercise. Large increases in resistance should be avoided; if > the > stress is too great, you could injure your muscle or tendons. If your > increase in resistance results in poor technique, then it is too much > weight. One guide that you can use is to make sure that the last 2-3 > repetitions are at least somewhat challenging. If repetitions 8,9,10 are > as > easy as repetitions 1,2,3 you may want to challenge yourself more. > Sets and Repetitions > With use of the appropriate training load, the number of sets and > repetitions govern the goal and outcome of the exercise program. Sets and > repetitions can be set up for muscular endurance, muscular strength, and > muscular power routines. Core muscles such as the scapular and pelvic > girdle musculature are best trained via a muscular endurance routine since > they are more endurance and postural muscles. Since keeping or achieving > a > more upright posture is key, it is best to train your muscles for muscular > endurance. > Make table or box with the below information > Muscular Endurance Routine is 8-20 reps/ 3-5 sets with Low to Medium > training load > The following can be converted to text boxes or tables > General recommendations > Consult closely with your doctor, physical therapist or health care > professional when devising your exercise program. General recommendations > on > getting started include: > > * Aim for at least 15 minutes of exercise every day. > * Make sure to include a thorough stretching program that targets each > joint and muscle group. > * Spend a few minutes warming up and cooling down. This could include > marching in place or stretching. > * Start with the easiest exercises first. Slowly introduce the more > difficult exercises as your fitness increases. > * Try to perform each movement to the best of your ability. > * If you suffer from fatigue, try exercising first thing in the > morning. > > Safety suggestions > If you are at risk of falling, general safety suggestions include: > > * Perform your exercises sitting down or > * Hold onto a chair when performing standing exercises. > * Don’t perform floor exercises if you can’t get up by yourself. > * Only exercise when other people are at home who can help if > necessary. > * Exercise with others. > * Ask for assistance from a family member or friend. > > > Walking for fitness > Walking is excellent for overall fitness. Suggestions include: > > * Choose flat, obstacle-free terrain. > * Taking larger strides may help you keep better balanced. > * Focus on lifting each foot and placing it down heel first. > * Count each step – this can help to make a smoother, more rhythmic > walking style. > * Move your arms as you walk, if possible. > * If walking isn’t practical or possible, explore other options such as > stationary bicycling. > . > > > -- > Kevin Lockette PT > www.ohanapacificrehab.com > www.parkinsonsmoveit.com > Kailua Clinic 808 262-1118 > Honolulu Clinic 808 593- 2610 > Cell Phone 808 228-0340 > > > SPECIAL NOTE: This communication is intended solely for the individual or > the entity to which it is addressed and may contain information that is > privileged, confidential, and/or prohibited from disclosure. If the > reader > of this communication is not the intended recipient, you are hereby > notified > that any dissemination, distribution, or copying of this communication is > strictly prohibited. If you have received this communication in error, > please notify us immediately at the above telephone number provided and > return the original message to us at the above address via the U.S. Postal > Service. Your cooperation is greatly appreciated. Thank you. > > ---------------------------------------------------------------------- > To sign-off Parkinsn send a message to: > mailto:[log in to unmask] > In the body of the message put: signoff parkinsn ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn