Exercise for Parkinson’s Disease

Neurological diseases are one of the leading causes of disability worldwide (1). Among this, Parkinson’s Disease (PD) It is the second most common neurological condition in Australia and it is estimated that PD will affect 8.7-9.3 million people worldwide by 2030 (2). Being such a significant health burden, it is paramount to minimise this and work to find appropriate treatment, management and an eventual cure. Thankfully, exercise is deemed a safe and cost-effective preventative tool to manage idiopathic PD with mild to moderate symptoms and improve the overall quality of life of those affected. At Aevum we utilise a multidisciplinary team combining some of the most advanced pieces of technology available to assist you and your family to live your best life. You will work with Physiotherapists, Occupational therapists, Exercise Physiologists and if needed Speech Pathologist all working together as a cohesive team to support your and your families needs.

Let’s talk a little more about PD

PD is a complex, progressive neurodegenerative condition whereby dopamine-producing neuron’s in the brain are depleted. The loss of this influences movement regulation, cognition, motivation, sleep, mood, attention, working memory, decision-making and learning (3).

Primary motor impairments for people with PD include:

  • Bradykinesia- slow movements

  • Tremor- usually most noticeable when limbs are at rest

  • Rigidity- increased muscle tone causing muscle stiffness and resistance to range of motion

  • Weakness- one or both sides in the limbs

  • Dyskinesia- involuntary muscle movements such as twitching and jerking

  • Dystonia- involuntary muscle movements causing repetitive or twisting movements

  • Akinesia- difficulty initiating movements, freezing of gait

  • Apraxia- difficulty with executing familiar movements

  • Dysarthria- weak or difficulty controlling speech muscles

  • Postural instability- poor balance when standing or walking


Common non-motor symptoms include:

  • Mood changes- depression, anxiety, irritability

  • Cognitive impairments- memory problems, personality

  • Hyperhidrosis- excessive sweating

  • Urinary urgency and incontinence

  • Loss of sense of smell

  • Fatigue

  • Sleep disorders

  • Sialorrhea- excessive salivation or drooling

Diagnosis 

Recognising PD can be a prolonged, complicated process as there is no specific diagnostic test. Rather, neurologists base their PD diagnosis on medical history, physical and neurological examinations, as well as one’s current presentation (signs and symptoms). The slow development of symptoms over years makes identification even more challenging, with the average age of onset being people in their 60s, despite potential unrecognised symptoms earlier.

Treatment and management

The best treatment plan for PD incorporates a biopsychosocial approach from a multidisciplinary team (GP, neurologist, exercise physiologist and physiotherapist, speech pathologist, occupational therapist, psychologist). Medication is commonly prescribed to replenish, mimic or enhance the effect of dopamine and peoples symptoms. Deep Brain Stimulation (DBS) is also beneficial for certain candidates. However, there is currently no medical treatment that prevents PD progression, and medication may cause problematic adverse effects. Excitingly, scientific evidence shows that exercise is a promising intervention to actually slow down the progression of Parkinson’s Disease and provide a neuroprotective effect… but what kind of exercise?

Neuroactive exercise

The PD-specific exercise sessions here at Aevum Health & Physiotherapy are unlike neuropassive movements like walking, swimming and gardening. Neuroactive exercises are performed to promote neuroplasticity and neuroprotection, the ability of the brain to rewire itself and make new connections that were lost and destroyed by PD. To do so, exercises at Aevum Health & Physiotherapy follow the Star Formula:

People with PD are often sedentary which increases their likelihood of developing co-morbidities such as cardiovascular disease, diabetes and obesity. Education around the importance of exercise for this population at Aevum Health & Physiotherapy is what sets us apart from other non-specified exercise groups.

Aevum Health & Physiotherapy offers the “PD + EP” service, which includes:

  • A 1:1 initial consultation with an exercise physiologist or physiotherapist

  • Additional 1:1 exercise sessions with the transition into group neuroactive exercise classes

  • PD and exercise education, driven by the Star Formula, to provide appropriate exercise programs

  • A confidence-boosting, friendly environment where you can tackle PD head on

For more information, contact Aevum Health & Physiotherapy today 02 8544 3231, info@aevumhealth.com.au

References

  1. E. Ray Dorsey et al., (2018). Global, regional, and national burden of Parkinson’s disease, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet, 177 (11), 939-953. https://doi.org/10.1016/S1474-4422(18)30295-3

  2. Mindgardens Neuroscience Network (2019). Review of the burden of disease for neurological, mental health and substance use disorders Australia. https://www.pc.gov.au/__data/assets/pdf_file/0020/239213/sub064-mental-health-attachment.pdf

  3. Juárez Olguín, H., Calderón Guzmán, D., Hernández García, E., & Barragán Mejía, G. (2016). The Role of Dopamine and Its Dysfunction as a Consequence of Oxidative Stress. Oxidative medicine and cellular longevity, 2016, 9730467. https://doi.org/10.1155/2016/9730467

  4. Johansson, M. E., Cameron, I., Van der Kolk, N. M., de Vries, N. M., Klimars, E., Toni, I., Bloem, B. R., & Helmich, R. C. (2022). Aerobic Exercise Alters Brain Function and Structure in Parkinson's Disease: A Randomized Controlled Trial. Annals of neurology, 91(2), 203–216. https://doi.org/10.1002/ana.26291 https://onlinelibrary.wiley.com/doi/10.1111/ane.13579

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