Parkinson’s disease (PD) is a neurological disorder that results from insufficient dopamine, a brain chemical. For reasons not completely understood, specialized nerve cells deep in the brain gradually stop producing dopamine. The loss of dopamine causes four major neurological signs of PD to develop:
- Tremor—shaking that usually begins in one hand or foot, but may progress to include all 4 limbs. Occurs at rest, but disappears during sleep and activity.
- Muscular rigidity—an increased resistance to joint movement. May feel like stiffness, achiness, fatigue, or pain. Leads to impairments in walking, breathing, facial expression, swallowing, and speaking.
- Bradykinesia (slowness of movement)—Slow movement; generalized fatigue; difficulty with simultaneous movements, complex activities, starting or stopping movement. Automatic movements, such as the arms swinging during walking, may disappear. Most disabling sign of PD.
- Balance problems—difficulty changing directions while walking, taking faster and faster small steps while walking, or frequent falls.
Common physical impairments of Parkinson’s include:
- Forward stooped posture
- Decreased joint range of motion
- Decreased strength
- Bowel and bladder dysfunction
- Cardiovascular changes
- Oily skin, excessive sweating
- Mask-like facial appearance
- Difficulty chewing and swallowing
- Speech difficulties
- Visual impairments
- Shortness of breath, poor breath control
- Gait impairments—small shuffling steps, festination (rapid small steps with forward movement of the body) loss of automatic movements, difficulty stopping or starting, freezing, falling
Exercise and Parkinson’s (PD)
Exercise is an important part of treatment for the person with PD. The earlier exercise begins the better. Activity and exercise will delay some of the effects of aging and inactivity usually seen with Parkinson’s, and will improve the overall quality of life. The exercises must be appropriate for each individual, so always check with your doctor before beginning any exercise program.
Here are some general exercise guidelines for Parkinson’s:
- Find the right balance between activity and rest. Too much activity increases fatigue, but too little increases disability.
- Exercise during peak medication coverage and during times of decreased stiffness and soreness. This may be later in the day.
- Adjust your exercise program, as needed, as your condition changes, and also from day to day, depending on your fatigue level.
- Seek help from your doctor if your condition changes. Your doctor may recommend that you see a rehabilitation professional for specific therapeutic exercises or for help with balance and walking.
- Begin exercise training gradually, working at a moderate, comfortable intensity.
- A goal of 30 minutes of endurance exercises most days is recommended for adults, even those with PD. Three 10-minute exercise sessions, spaced throughout the day, are nearly as beneficial as one 30-minute session. Some people with PD may not be able to exercise aerobically because of their health status. Your doctor can help to determine if and what type of aerobic exercise would be best for you.
Types of exercises beneficial for the person with Parkinson’s (PD)
- Build cardiovascular endurance. Endurance, or aerobic exercise, designed to benefit your heart, lungs, and circulation will improve your overall endurance and minimize some of the declines associated with PD. Walking or cycling on a stationary bicycle are examples of aerobic exercises.
- Posture training and being aware of posture during activity and rest will help your body resist its tendency toward flexion that accompanies PD. Go through your body a segment at a time to “check” your body alignment. Good posture enhances social interactions, speech, vision, balance and fall prevention.
- Range of motion exercises with an emphasis on fully straightening the joints. PD causes a selective weakness in the muscles that straighten the joints (extensor muscles), so the joints tend to bend, and may even lose their ability to fully straighten.
- Strengthening exercises, especially concentrating on the extensor muscles that straighten the spine and the legs, should be done in moderation to prevent loss of strength. Resistance initially should be light, perhaps just the weight of the limb, and increase slowly. Overzealous strength training uses dopamine which is already in short supply when PD is present, so it should be avoided.
- Facial exercises help reduce stiffness in the muscles of the face that occurs as a result of Parkinson’s. Range of motion exercises for the eyes, tongue, jaw, and lips, and exaggeration of facial expressions are used to fully lengthen and shorten the facial muscles. This type of exercise helps to delay the onset of chewing and speech difficulties, as well as the mask-like facial appearance characteristic of PD.
- Deep breathing exercises help to keep the muscles used for breathing strong and flexible. This is important to avoid shortness of breath and loss of the breath control necessary for speech.
- Balance and standing exercises help the person with PD to maintain or increase leg strength and improve balance to prevent falls.
Sit and Be Fit workouts for those managing Parkinson’s Disease;
- Neuro Rehab Workout
- Parkinson’s Workout
- Balance & Fall Prevention Workout*
- Season 8
- Season 9
- Season 10
- Season 11
- Season 12
- Season 13
- Season 14
- American Parkinson Disease Association (APDA) Toll free: 1-800-223-2732 Web site: www.apdaparkinson.com Funds research; sponsors support groups, symposia, and information and referral centers; and publishes a newsletter and other educational manuals.
- National Parkinson Foundation (NPF) Telephone: 1-305-243-666 Web site: www.parkinson.org
- NIH Neurological Institute Telephone: 1-301-496-5751 or Toll free: 1-800-352-9424 Web site: www.ninds.nih.gov The National Institute of Neurological Disorders and Stroke, a component of the National Institutes of Health, is the leading Federal support of research on disorders of the brain and nervous system. The Institute also sponsors an active public information program and can answer questions about diagnosis, treatment and research related to Parkinson’s disease.
- Parkinson ’s Disease Foundation (PDF) Telephone: 1-212-923-4700 or Toll-free: 1-800-457-6676 Web site: www.parkinsonsdiseasefoundation.org This foundation supports research, promotes the formation of support groups; and offers professional training fellowships and symposia, patient and professional information, counseling, advocacy and referral.
- Parkinson ’s Disease Foundation Telephone: 1-312-733-1893 or Toll-free: 1-800-457-6676 Web site: www.pdf.org This foundation funds research; offers information for patients, families and professionals; and publishes a newsletter, brochures and fact sheets.
- Parkinson’s Action Network Toll free: 1-800-850-4726 pdweb.mgh.harvard.edu This site has information and links to related websites.
- Neurology Web Forum Web site: neuro-www.mgh.harvard.edu/forum This site is for online patient and caregiver discussions.