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Home fitness can help Parkinson's patients Published: July 13, 2009 Second of three parts. Last week, we described various forms of exercise to reduce the symptoms associated with Parkinson's disease. Now we'll outline a comprehensive home exercise program for people with Parkinson's. You should begin with the easiest exercises first, slowly introducing the more difficult ones as your fitness level improves. If you fatigue easily, try exercising in the morning. Plan to perform your routine three times each week. For safety, all exercises can be performed while seated. Warm-up Take a slow walk or slowly march in place for two to three minutes. If standing is difficult, "march" while seated. Flexibility stretching This should be gentle and pain-free. Hold each position for 15 to 30 seconds and repeat two or three times. - Neck: look up and down; tilt head to right and left; turn and look right; turn and look left. - Torso: With hands on hips, lean slightly forward; lean slightly backward, pushing belly forward; squeeze shoulder blades together. - Arms: Raise to the front and overhead; out to the side and overhead; clasp hands behind head and open elbows out to sides; reach behind buttocks and up the back with one hand, then repeat with the other hand. - Legs: While seated, straighten one knee and then repeat with the other; while seated with knee straight, point toes toward nose, then repeat with other side, and do the same pointing toes away from the nose; while seated, pull one knee toward chest, then repeat with the other side; while seated, open and close knees. - Facial exercises: surprise - lift eyebrows and open mouth; displeasure - frown and purse lips; disgust - crinkle nose; pleasure - make a big smile. Muscle strengthening - Perform 10 slow, full and pain-free repetitions without weights. Exercise left and right limbs. Complete repetitions with one side, then the other. To increase difficulty, slowly advance the number of repetitions. When three sets of 10 repetitions can be performed comfortably, weights can be added. - Weights with velcro straps can be purchased, or household items may be used, such as soup cans or water-filled bottles. - Starting weight should allow pain-free completion of at least 10 repetitions. Weight should not be advanced until three sets of 10 repetitions can be completed comfortably. Don't advance weight more then one pound at a time. When weight is advanced, reduce repetitions back to one set of 10 and advance to three sets as tolerated. - Arms (both simultaneously): Shrug shoulders up and down; raise arms out to the front, but not higher than shoulders, then out to the side; bend elbows up and down; with elbows at 90 degrees, bend wrists up and down; open and close fingers as if making a fist. - Legs: Hold onto a stationary object and place feet shoulder-width apart; keeping knee straight, move leg out to side, then backward; then bend knee. Using both feet simultaneously, lift toes toward the ceiling, then rise up on toes. While seated, lift knee toward the ceiling, then straighten knee. Endurance exercise - Start with no more than 10 minutes; gradually increase by a minute or two as tolerated, to 30 minutes. - Walking: Choose flat, obstacle-free terrain. Focus on taking long strides while lifting each foot and placing the heel down first. Counting each step can facilitate rhythm and smoothness. Swing arms while walking. Use a walker with wheels if balance is a problem or if pain prevents progression. If walking is not an option, try stationary bicycling. Cool-down Take a slow walk or slowly march in place for two to three minutes. If standing is difficult, march while seated. Next week: Home safety and preventing falls. JANET CAPUTO, P.T., O.C.S., guest contributor, is a physical therapist specializing in the management of orthopedic and sports injuries, with a special interest in vestibular rehab and falls prevention, at Mackarey Physical Therapy in downtown Scranton. She is completing her doctor of physical therapy degree at the University of Scranton. PAUL J. MACKAREY, P.T., D.H.Sc., O.C.S., is a doctor in health sciences specializing in orthopedic and sports physical therapy. He is in private practice and is an affiliated faculty member at the University of Scranton physical therapy department. His column appears every Monday. E-mail: [log in to unmask] Rayilyn Brown Director AZNPF Arizona Chapter National Parkinson Foundation [log in to unmask] ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn