Parkinson’s disease (PD) is a chronic, degenerative disease that leads to slowness of movement, balance disorders, tremors, and difficulty walking. PD results from the loss of dopamine-producing nerve cells in the brain. Dopamine is critical to stimulate the nerves of the muscular system in the body. PD affects approximately 1.5 million people in the USA with 60,000 new cases each year according to the National Parkinson Foundation. Most people know someone affected by PD. PD typically affects those over 65 years of age and only 15% are under 50. However, actor, Michael J. Fox brought national attention to the disease in 1991 when he was only 30 years old. Juvenile Parkinson’s, those diagnosed under the age of 40, is rare and only represents 7% of all those with PD.
While there is no current cure for PD, exercise can relieve some of its symptoms. Although PD affects an individual’s ability to move, exercise can help keep muscles strong, joints mobile, and tissues flexible. Exercise will not stop PD from progressing, but it will improve balance, enhance walking ability, reduce muscle weakness, and minimize joint stiffness. In 2007, a study published in the Journal of Neuroscience revealed that exercise will benefit individuals with PD because exercise encourages the remaining dopamine cells to work harder to produce more dopamine. Also, the researchers discovered that exercise decreases the rate at which dopamine is removed from the brain.
Depending on the stage of the disease and the level of assistance required, exercise to improve strength, balance, flexibility and ambulation for those with PD, can be performed independently at home or supervised at a rehab or fitness facility. Supervised exercise can include physical therapy, recreational therapy, water therapy, yoga, and Tai Chi… AND DANCE! Physical therapy can improve walking ability, enhance balance, reduce fatigue, increase strength, promote flexibility and minimize pain. Physical therapy uses movement techniques and strategies as well as various pieces of equipment to enhance an individual’s level of independence and improve his quality of life. Recreational therapy incorporates leisure activities (e.g. golfing and ballroom dancing) to reduce the symptoms and associated limitations of PD. Recreational therapy adapts these activities to meet the specific needs of the person with PD. The modified activities are taught by professionals who have significant knowledge and experience in this area. Water therapy is especially helpful to people with PD because the water provides enough buoyancy to lessen the amount of balance required to perform essential exercises. The cushioning effect of the water allows for freedom of movement while providing the appropriate level of resistance necessary to achieve the desired results. Using a combination of physical and mental exercises, yoga promotes flexibility, reduces stress levels, and increases stamina and strength in individuals with PD. Tai Chi, a total mind and body workout, and is a series of individual dance-like movements linked together in a continuous flowing sequence. Particular benefits for people with PD include reduced stress, increased energy, improved concentration and focus, better circulation and muscle tone, and significant improvements in balance.
If you choose the convenience of a home exercise program, consult your physician or physical therapist for recommendations regarding: (1) the types of exercise best suited for you and those which you should avoid, (2) the intensity of the workout, (3) the duration of your workout, and (4) any physical limitations you may have.
The type of exercise that works best for you depends on your symptoms, fitness level, and overall health. Your exercise program should address not only strength but also flexibility and endurance and should include all body parts: face, mouth, neck, torso, arms, legs, hands, and feet. Some general exercise suggestions include:
Since individuals with PD are at risk for falling and freezing (becoming rigid), work out in a safe environment and, if possible, when someone is present. Avoid slippery floors, poor lighting, throw rugs, and other potential dangers (e.g., watch out for the pooch because he might want to join in the fun). If you have difficulty balancing, exercise sitting down, lying on the bed or within reach of a grab bar or securely installed rail. Stop and rest if you feel tired during your exercise program since overexertion can make your PD symptoms worse.
Contributions: Janet Caputo, DPT, OCS,
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week: Part II of II: Dance for Parkinson ’s Disease.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.comPaul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
For all of Dr. Mackarey's articles visit: http://www.mackareyphysicaltherapy.com/forum
In 2000, President Bill Clinton dedicated March as National Colorectal Cancer Awareness Month. The purpose of this designation is to increase public awareness of the facts about colon cancer – a cancer that is preventable, treatable and has a high survival rate. Regular screening tests, expert medical care and a healthy lifestyle, which includes a proper diet and exercise, are essential for prevention. Several studies have demonstrated that exercise can also help prevent colon cancer.
The American Cancer Society estimates that there will be approximately 150,000 new cases of colorectal cancer in 2021. Of these, 52,980 men and women will succumb to the disease. It is the second-leading cause of U.S. cancer deaths for both men and women combined. The good news is incidence and mortality rates are dropping both nationally as well as in northeast Pennsylvania. The bad news is northeast Pennsylvania still has increased incidence and mortality rates when compared to the national average.
Studies show that prevention of this disease is multifaceted and includes: engaging in daily exercise, eating a low-fat diet with little red meat, avoiding smoking, drinking in moderation and having regular colonoscopy screenings.
Early detection is the key to survival. Death from colorectal cancer can be eliminated if caught at the earliest signs of disease. Colorectal cancer progresses very slowly, usually over years. It often begins as non-cancerous polyps in the lining of the colon. In some cases, these polyps can grow and become cancerous, often without any symptoms. Some symptoms that may develop are: blood in stool, changes in bowel movement, feeling bloated, unexplained weight loss, feeling tired easily, abdominal pain or cramps, and vomiting. Contact your physician if you have any of these symptoms.
The risk of colon cancer increases with age, as 90 percent of those diagnosed are older than age 50. A family history of colon cancer increases risk. Also, those with benign polyps, inflammatory bowel disease, ulcerative colitis or Crohn’s disease are at greater risk and should be screened more frequently.
The intestine works like a sewage plant, recycling the food and liquid needed by your body. However, it also stores waste prior to disposal. The longer the wastes remain idle in your colon or rectum, the more time toxins have to be absorbed from you waste into the surrounding tissues. One method in which exercise may help prevent colon cancer is to get your body moving, including your intestines. Exercise stimulates muscular contraction called peristalsis to promote movement of waste through your colon.
Exercise to prevent colon cancer does not have to be extreme. A simple increase in daily activity for 15 minutes, two times per day or 30 minutes, once per day is adequate to improve the movement of waste through your colon. This can be simply accomplished by walking, swimming, biking or playing golf, tennis or basketball. For those interested in a more traditional exercise regimen, perform aerobic exercise for 30-45 minutes four to five days per week, with additional sports and activities for the remainder of the time. For those in poor physical condition, begin slowly. Start walking for five to 10 minutes, two to three times per day. Then, add one to two minutes each week until you attain a 30-45 minute goal.
Dr. Christopher Peters is a partner of Radiation Medicine Associates of Scranton (RAMAS) and serves as medical director of Northeast Radiation Oncology Centers (NROC). He is an associate professor of clinical medicine at GCSOM.
Sources: American Cancer Society/Northeast Regional Cancer Institute, and CA Cancer J Clin.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
Spring is just around the corner so it is time for running enthusiasts to lace up their sneakers, get outside and run! Runners are addicted to running for good reason. There is nothing like it! No exercise offers so much in such little time. For example, the caloric expenditure while running is higher than for most other exercises, including biking. Also, it allows for fresh air and beautiful scenery with a minimal investment in clothing or equipment. It requires little skill and time to learn. Runners suffer from less depression, colds and flu symptoms, and experience less pain due to an endorphine release (natural chemical in the brain associated with euphoria and pain control) that is greater than found in other sports and activities. These are some of the motives that cause people to run every day, in spite of the constant loading and wear and tear on the joints.
To be a competitive runner and have longevity in the sport, optimal form is necessary. Moreover, a recent study shows that a runner can decrease the stresses on the lower body and reduce the incidence of stress fractures when trained to run with proper form using visual feedback while on a treadmill. The application of this information has significant implications for training programs for runners for the prevention and recovery from injury. One such low impact method is called the “Pose Running Technique,” by Dr. Nicholas Romanov. It is a “soft landing” method which promotes; an S-like body position with slightly bent knees, a slightly forward lean at the ankles to employ gravity and momentum, lifting the feet up under the hips, and landing on the ball of the foot under the body to absorb the center of mass.
It is my opinion, that the best runners, with the least injuries, such as Jordan Hoyt, speedster from Abington Heights, employ these techniques naturally. Additionally, many of the world’s best runners use coaches and trainers to assist them in their quest for success and injury prevention by using perfect form. However, for the rest of us, we must learn to maximize the efficient use of the body as it works with, not against gravity. We must learn to run “soft” to prevent injuries.
A slight upward tilt of the head to allow a view of the horizon ahead should be most comfortable. Avoid looking down or up to extremes. Do not rock or rotate the head while running.
Loose and relaxed shoulders set the tone for a good run. Keep them level without tilting side to side or rotating left to right. Avoid holding the shoulders in a tight and high position.
Loose and relaxed arms also set the tone for a good run. A good arm swing is always in forward motion in a linear direction and stays between the waist and lower chest. Never clench the fist. Do not rotate or twist the arms across the body.
If the head, shoulders and arms are in correct position, then the torso will be upright. An erect running posture is necessary to promote efficient movement and breathing. The posture that you assume when taking a deep breath is the correct torso position for good breathing while running.
The hips will follow the position of the parts above in a linear forward direction. However, if the torso leans forward because the head hangs down then the hips will tilt downward. If the arms swing and torso rotates side to side, then the hips will also rotate.
Sprinters need to lift the knees high to thrust the lower legs forward. Long distance runners cannot maintain a high knee lift for a long period of time, however, a slight knee lift with a shorter but quicker stride is more efficient. Proper running requires the foot to softly strike the ground with the knee slightly bent. If the knee is fully extended in front of the body upon impact, the stride is too long and the force too great.
To excel as a runner, when the foot hits the ground it should land lightly, between the heel and the midfoot. The ankle is flexed and rolls quickly forward to the toes to push off the ground with maximum force. The calf muscle propels the runner forward. Efficient running has a quiet and springy landing. A loud foot slap on impact is a sign of poor form and results in excessive force transferred to the lower leg. The foot should spend as little time as possible in contact with the ground…thus a soft runner “floats” when they run.
SOURCES: Runner’s World, Pose Running Technique (www.posetech.com), Journal of Orthopaedic and Sports Physical Therapy.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
Injuries due to falling are a very common problem in the elderly. Hip fractures are the most common injury due to falling in the seniors. According to the American Academy of Orthopaedic Surgeons, each year more than 300,000 people are hospitalized for hip fractures in the United States. These fractures represent 72% of all fracture costs, totaling more than 12 billion dollars in 2005 and, not surprisingly, 90% occurred in those 65 and older. Most hip fracture patients who previously lived independently will require family assistance, home or long term care and 50% will require a cane or walker.
A recent study by the American Physical Therapy Association found that patients benefited from a physical therapy evaluation to determine their risk level for falling. If a high-risk level is found on a falls assessment, physical therapy interventions can be successfully employed to improve strength, balance, and coordination and falls prevention. Also, a well-balanced diet, exercise, Calcium with vitamin D supplements and medications can help prevent or retard osteoporosis and prevent hip fractures.
***Always perform slowly, alternate right and left sides, limit other distractions and concentrate on the exercise to retrain the brain, 10-20 times each 2-3 times per day.
***Caution: Do not do standing exercises without assistance or supervision if needed
Face a countertop and hold onto it with both hands. Hike your hip and knee up to 90 degrees as if you are marching. Hold the position for 3-5 seconds on one leg and lower slowly. Repeat this on the other leg and alternate 10 times.
Face a countertop and hold onto it with both hands. Lift your leg up 30 degrees as if you are spreading your legs apart. Hold the position for 3-5 seconds on one leg and lower slowly to cross over the middle. Repeat this on the other leg and alternate 10 times.
Face a countertop and hold onto it with both hands. Bend your hip and knee down to 45 degrees to a squatting position. Hold the position for 3-5 seconds on both legs and return to standing slowly. Repeat this 10 times. Once strong enough try on one leg at a time and alternate.
Sit in a chair with arm rests. Get out of chair only using your legs. Hold the position for 3-5 seconds and return to sitting. If necessary, use 1 or 2 arms to assist. Repeat this 10 times. Focus on trunk core stabilization and leg strength. Use more leg muscles and less arm muscles as strength improves.
Place a straight line on the floor and practice “walking the line” with the right then left foot on the line.
Hold onto a chair while bending one knee and shifting your weight to the other leg. Hold for 3-5 seconds and repeat with the other leg. Increase time 10 -15 -20 seconds as tolerated.
If you feel you or a loved one may be at risk for falling or a hip fracture, ask your family physician if a physical therapy consultation for a falls prevention program to prevent hip fractures may benefit you.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
For all of Dr. Mackarey's articles visit www.mackareyphysicaltherapy.com/forum
I am sure that many of you feel as I do…it is hard to believe that I am living in the year two thousand and TWENTY-TWO! Moreover, I hope you share my sentiments that each year, despite the trials and challenges of the pandemic, each month, week, day, and minute is a gift, not to be taken for granted. And that is why we resolve at this time each year to make a concerted effort to improve ourselves; mentally, physically and spiritually, so that we may live a longer and healthier life, in order to spend more time with the friends and family we love.
Not surprisingly, getting physically fit and losing weight are the top resolutions to begin each New Year. According to the University of Pittsburgh Medical Center, 10 million Americans choose to join one of the 45,000 health clubs and hope to get fit and healthy for life (in non pandemic years). Unfortunately, if starting an exercise program is the hard part, than sticking to it is the hardest part. And, with the Omicron surge limiting access to indoor gyms and fitness centers, compliance may be even more challenging this year.
Once the initial excitement and enthusiasm wears off, so too does the discipline and determination necessary to overcome the many distractions in our lives to make exercise a priority for life. Diane Klein, PhD polled long-term exercisers (those exercising at least 3 times per week for more than 13 years) what motivated them to “stick with the program.” The answers are in order of importance. Please note that “appearance” was NOT at the top of the list.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
For all of Dr. Mackarey's articles visit: mackareyphysicaltherapy.com
You are never too old to exercise! This is the second of two columns dedicated to appropriate exercise for the elderly. Last week I discussed basic strengthening exercises. This column will address three additional components necessary for independence in the elderly: flexibility, balance and endurance. While it may not be as valuable for those fortunate to be over 75 years of age and capable of running, skiing and playing tennis, you may still find a noteworthy pearl of wisdom.
Why would someone 75 or 80 be interested in a basic exercise program? Well, one must maintain adequate flexibility, strength, balance and endurance to safely function in daily activities around the house. For example, the most common goals of elderly patients are: climbing stairs, getting in and out of a shower, putting on shoes and socks, tucking in a shirt or fastening a bra, cooking, cleaning, and carrying groceries or laundry.
Remember, for most people it is more harmful not to exercise, so contact you physician to discuss whether independent exercise is appropriate for you. You may need to consult with a physical therapist to get started.
Flexibility Exercises involve moving the arms, legs and trunk through comfortable range of motion to give you more mobility in order to improve your ability to perform daily activities such as tucking in a shirt, tying shoes or fastening a bra. Best if performed after strength exercises because the muscles and joints will be warm and limber. Always perform slowly with slight stretch sensation and no pain. No bouncing or over stretching!
These exercises are to be performed while sitting in a chair with a backrest, slowly, 5 repetitions, 3-5 times per week.
Balance Exercises involve strengthening muscles that keep the body upright and stable in standing in order to improve your ability to perform daily activities without falling. According to the NIH, 300,000 US hospital admissions for broken hips occur each year due to falls. Check with your physician if you have a history of dizziness before performing these exercises on your own. Best if performed with someone at home or some assistance. Always use a countertop or back of chair to hold onto for support.
Endurance Exercises involve any activity such as walking, swimming, biking or raking leaves that elevates your heart rate and breathing for an extended period of time. Check with your physician if you have a history of heart problems or dizziness before performing these exercises on your own. Best if performed with someone at home or some assistance. Start off slowly for only 5 minutes and add 1-2 minutes each week or 2. Wear good and comfortable shoes – no heels!
While not all of these endurance exercises may be appropriate for you, one or two of these may offer a good starting point.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate profession of clinical medicine at Geisinger Commonwealth School of Medicine.
For all of Dr. Mackarey's articles visit mackareyphysicaltherapy.com
You are never too old to exercise! A reader who described herself as “elderly” asked me if she was too old to exercise. Without knowing her age, I replied that she was not. I did qualify my response with the fact that exercise must be adjusted to meet the individual needs of a person based on age, health status and goals. Her question, however, led me to think of the many “elderly” who may be apprehensive to begin an exercise program for a variety of reasons. Fear of injury and lack of information may be two reasons. Another reason, according to this inquiry, is the fact that so many exercise programs featured in the media are geared to the young and healthy or baby boomers and few focuses on the needs of those over 75, home bound and weakened by age and inactivity. Those running, biking, skiing, golfing at 75 and over and do not fall into this category, please do not be offended, you are the exception. God bless you!
Why would someone 75 or 80 be interested in an exercise program? Well, one must maintain adequate flexibility, strength, balance and endurance to safely function in daily activities around the house. For example, the most common goals of elderly patients are: climbing stairs, getting in and out of a shower, putting on shoes and socks, walking safely for functional distances, tucking in a shirt or fastening a bra, cooking, cleaning, and carrying groceries or laundry.
The National Institute of Health (NIH) recommends four areas of concentration for elderly persons to concentrate on in order to maintain safety and independence: strength, flexibility, balance and endurance. It will be the purpose of this column to recommend safe, practical and easy exercises that focus on each of these categories.
Remember, for most people it is more harmful not to exercise, so contact your physician to discuss whether independent exercise is appropriate for you. You may need to consult with a physical therapist to get started.
Strength Exercises involve using the muscles to move the arms and legs against resistance such as a weighted object, dumbbells, resistance bands, and body weight against gravity. Strength is necessary to perform daily activities such as walking, lifting a ½ gallon of milk, transferring to a shower or chair safely.
These exercises are performed while sitting in a chair with backrest, slowly, 5 -10 repetitions, and 3-5 times per week. No weight is used in the beginning, only the weight of the arm against gravity. In 1-2 weeks a light 1-2 pound weight and light resistance band may be added.
Once you have mastered these exercises against gravity, then advance to using light weights or light resistance bands. Ankle weights are very inexpensive and can be purchased in 1 pound increments. Light resistance bands are available in yellow and red in colors.
Visit your doctor regularly and listen to your body.
Keep moving, eat healthy foods, exercise regularly, and live long and well!
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week: Never To Old To Exercise – Part II of II
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate profession of clinical medicine at Geisinger Commonwealth School of Medicine.
For all of Dr. Mackarey's articles visit http://mackareyphysicaltherapy.com/forum
Dry Tech is the best thing that has happened to exercise apparel since “jogging suit” was donned by all the “cool dudes” in the 70’s and 80’s . It is has great style and even better function. The specially made material is light weight and breathable and wicks moisture from the skin to the outer layers. Therefore, it will not get heavy with sweat which can weigh you down and cause friction with your skin which can lead to chaffing and blisters. The following exercise apparel is now available in Dry Tech:
An exercise mat is helpful if you decide to exercise at home. Also, if you participate in yoga or Pilates classes, a mat is required equipment.
These are essential for those interested in home exercise. For the average beginner, 3-5-8-10 pound (two of each) weights will be adequate. Dumbbells are good for shrugs, biceps, and triceps, bent over rows and lats, and lunges. Incremented and stackable dumbbells are also available by Bowflex SelecTech 552 (5-52 pounds for $299). and NordicTrack $189. Sandbags, which can be purchased as graduated weights from 1 to 5 pounds, are good for leg extensions, hamstring curls, hip hikes and hip abduction.
These cheap and versatile bands are also essential for a home program. The bands come in different colors to represent the amount of resistance with yellow being the easiest and black the most difficult. They can be used for upper and lower body. For specific band exercises visit a previous column in “Health & Exercise Forum” at The Times Tribune or www.mackareyphysicaltherapy.com
This can be an opportunity for someone to either get the proper advice from a professional to begin a fitness program or to revamp and tune up an old stale program. Word of mouth is a good way to find a reputable certified trainer.
Peloton – ($1,495 bike, $2,495 treadmill); Mirror Exercise – ($995); FightCamp – ($1,219.)
These devices use GPS technology to help the user track their activity to get more out of their exercise routines. They monitor activity, heart rate, distance, location, calories, and more. Some examples are:
Note: Basic Apps are free and more advanced versions are under $10.
Sometimes you need professional help to get started and stay focused. Just as with a personal trainer, a qualified and licensed nutritional counselor will assist you in establishing a safe and effective program to meet your nutritional and dietary goals. Again, ask around to see who has a good reputation or who may be a good fit for the recipient of your gift.
These gifts can be purchased at most local sporting goods stores or on-line.
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
For all of Dr. Mackarey's articles visit: mackareyphysicaltherapy.com/forum
“Dance like nobody’s watching!” This is one of my favorite quotes from Mitch Albom’s book, Tuesdays With Mori, because it represents interesting facts about human behavior. One, of course, is the ability to be comfortable in your own skin. The other, maybe less obvious benefit, is that challenging your balance through dancing, even if it’s not pretty, is very effective in maintaining or improving quality of life for those with challenges in gait and balance, as found in Parkinson’s disease (PD). In fact, “Dance for PDR”, a new and popular treatment for PD, has recently been validated in the scientific literature as a valuable treatment tool for those with PD.
Research published in the Journal of Neural Transmission, shows that dancing is shown to help people with PD improve their ability to walk and enhances their quality of life. The program was applicable to those at various stages of PD, including those using walkers. Moreover, the results found that, in addition to physical improvements, participants also had psychological and social benefits through camaraderie, joy of movement and less isolation.
Participants, none of whom had never engaged in a dance class before, performed a structured dance program for 16 sessions over 8 weeks. Each class was 75 minutes long with seated warm-up activities 50% of the time. Results showed: 10% improvement in overall movement, 26% improvement in walking and 18% improvement in tremor.
Parkinson’s disease is a chronic, degenerative disease that leads to slowness of movement, balance disorders, tremors, and difficulty walking. PD results from the loss of dopamine-producing nerve cells in the brain. Dopamine is critical to stimulate the nerves of the muscular system in the body. PD affects approximately 1.5 million people in the USA with 60,000 new cases each year according to the National Parkinson Foundation. Most people know someone affected by PD. PD typically affects those over 65 years of age and only 15% are under 50.
While there is no current cure for PD, exercise is well documented to relieve some of its symptoms. Specifically, exercise can help keep muscles strong, joints mobile, and tissues flexible. Exercise will not stop PD from progressing but it will improve balance, enhance walking ability, reduce muscle weakness, and minimize joint stiffness. In 2007, a study published in the Journal of Neuroscience revealed that exercise may benefit individuals with PD because exercise encourages the remaining dopamine cells to work harder to produce more dopamine. Also, the researchers discovered that exercise decreases the rate at which dopamine is removed from the brain.
Exercise to improve strength, balance, and flexibility can be performed independently at home or supervised at a rehab or exercise facility. Supervised exercise can include physical therapy, recreational therapy, water therapy, yoga, and Tai Chi. Physical therapy can improve walking ability, enhance balance, reduce fatigue, increase strength, promote flexibility and minimize pain. Physical therapy uses movement techniques and strategies as well as various pieces of equipment to enhance an individual’s level of independence and improve his quality of life. PT can also incorporate leisure activities (e.g. golfing and ballroom dancing) to reduce the symptoms and associated limitations of PD. Tai Chi, a total mind and body workout, is a series of individual dance-like movements linked together in a continuous flowing sequence. Particular benefits for people with PD include reduced stress, increased energy, improved concentration and focus, better circulation and muscle tone, and significant improvements in balance.
According to Dance for PDR, their program offers internationally-acclaimed dance classes for people with Parkinson’s disease in Brooklyn, New York and, through a network of partners and associates, in more than 120 other communities and 16 countries. In Dance for PD classes, participants are empowered to explore movement and music in ways that are refreshing, enjoyable, stimulating and creative. For more information visit: www.danceforpd.org
So, if you like to dance, “keep on dancing!” If you don’t dance and notice some changes in balance and coordination, or if you have PD…it’s a good time to start! “Dance like nobody’s watching!”
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com. Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
For all of Dr. Mackarey's articles visit: https://mackareyphysicaltherapy.com
Parkinson’s disease (PD) is a chronic, degenerative disease that leads to slowness of movement, balance disorders, tremors, and difficulty walking. PD results from the loss of dopamine-producing nerve cells in the brain. Dopamine is critical to stimulate the nerves of the muscular system in the body. PD affects approximately 1.5 million people in the USA with 60,000 new cases each year according to the National Parkinson Foundation. Most people know someone affected by PD. PD typically affects those over 65 years of age and only 15% are under 50. However, actor, Michael J. Fox brought national attention to the disease in 1991 when he was only 30 years old. Juvenile Parkinson’s, those diagnosed under the age of 40, is rare and only represents 7% of all those with PD.
While there is no current cure for PD, exercise can relieve some of its symptoms. Although PD affects an individual’s ability to move, exercise can help keep muscles strong, joints mobile, and tissues flexible. Exercise will not stop PD from progressing but it will improve balance, enhance walking ability, reduce muscle weakness, and minimize joint stiffness. In 2007, a study published in the Journal of Neuroscience revealed that exercise will benefit individuals with PD because exercise encourages the remaining dopamine cells to work harder to produce more dopamine. Also, the researchers discovered that exercise decreases the rate at which dopamine is removed from the brain.
Depending on the stage of the disease and the level of assistance required, exercise to improve strength, balance, flexibility and ambulation for those with PD, can be performed independently at home or supervised at a rehab or fitness facility. Supervised exercise can include physical therapy, recreational therapy, water therapy, yoga, and Tai Chi… AND DANCE! Physical therapy can improve walking ability, enhance balance, reduce fatigue, increase strength, promote flexibility and minimize pain. Physical therapy uses movement techniques and strategies as well as various pieces of equipment to enhance an individual’s level of independence and improve his quality of life. Recreational therapy incorporates leisure activities (e.g. golfing and ballroom dancing) to reduce the symptoms and associated limitations of PD. Recreational therapy adapts these activities to meet the specific needs of the person with PD. The modified activities are taught by professionals who have significant knowledge and experience in this area. Water therapy is especially helpful to people with PD because the water provides enough buoyancy to lessen the amount of balance required to perform essential exercises. The cushioning effect of the water allows for freedom of movement while providing the appropriate level of resistance necessary to achieve the desired results. Using a combination of physical and mental exercises, yoga promotes flexibility, reduces stress levels, and increases stamina and strength in individuals with PD. Tai Chi, a total mind and body workout, and is a series of individual dance-like movements linked together in a continuous flowing sequence. Particular benefits for people with PD include reduced stress, increased energy, improved concentration and focus, better circulation and muscle tone, and significant improvements in balance.
If you choose the convenience of a home exercise program, consult your physician or physical therapist for recommendations regarding: (1) the types of exercise best suited for you and those which you should avoid, (2) the intensity of the workout, (3) the duration of your workout, and (4) any physical limitations you may have.
The type of exercise that works best for you depends on your symptoms, fitness level, and overall health. Your exercise program should address not only strength but also flexibility and endurance and should include all body parts: face, mouth, neck, torso, arms, legs, hands, and feet. Some general exercise suggestions include:
Since individuals with PD are at risk for falling and freezing (becoming rigid), work out in a safe environment and, if possible, when someone is present. Avoid slippery floors, poor lighting, throw rugs, and other potential dangers (e.g. watch out for the pooch because he might want to join in the fun). If you have difficulty balancing, exercise sitting down, lying on the bed or within reach of a grab bar or securely installed rail. Stop and rest if you feel tired during your exercise program since overexertion can make your PD symptoms worse.
Contributions: Janet Caputo, DPT, OCS,
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week: Part II of II: Dance for Parkinson ’s Disease.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.comPaul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
