Articles

 

Why Walk? I Hate Walking!

 

My name is John Pepper. I am a Parkinson’s patient. My Parkinson’s disease started in 1963, when I found that I could not throw a ball properly. However, I was only diagnosed with Parkinson’s in 1992, when I developed a bad walking gait.

Why did it take twenty-nine years before I was diagnosed?

I am neither a doctor nor a gym teacher. Having said that - since diagnosis - I have taken note of every news item I could find, concerning Parkinson's. Many news articles claimed that certain types of energetic exercise can and do affect the progression of Parkinson’s Disease

What has been my experience regarding exercise?

I spent twenty-two years, from 1970 to 1992, going to the gym, for one hour a day, six days a week, doing aerobic exercises and weight-training exercises.

For the next two years, after diagnosis, I increased the gym to 90 minutes - doing 60 minutes of aerobic exercise on the treadmill, step climbing and bicycle machines; and then, thirty minutes on various other weight-bearing machines.

During those two years, my condition continued to slowly get worse. After two years in 1994, I gave up the gym entirely, and gave in to my wife, Shirley's, request to join her at Run/Walk for Life. Within three months, my performance had improved quite noticeably. That was the first time it had shown any improvement for many years. That was the turning point in my Parkinson’s Disease!

What actually happened, since giving up going to the gym?

At Run/Walk for Life, I only did aerobic walking for three sessions a week, having started at twenty minutes a session, which increased by five minutes every second week. At the end of three months, I was walking for 45 minutes a session. The reason for doing only walking every second day was to give my muscles a chance to recover, after each exercise session. I was only allowed to walk every second day. In the past, I had been doing the same exercise every day, thus, not giving my muscles a chance to recover. They ended up eating up muscle tissue, in order to get the required energy they needed. The result was, my muscles got smaller and my fatty tissue grew larger. Not a good situation!

Energetic Walking Produces a substance Called GDNF!

What produces GDNF (Glial Derived Neurotrophic Factor) and why is it produced?

The body has a survival system, which is only activated when it thinks the body is under attack, or in danger. When we are under attack, or in danger, we either stand up to it and fight for our life, or we run away from it - the fight or flight syndrome - of which you must have heard.

The body produces this Growth Factor in every area of the body, which repairs the damaged tissue, if and when required. GDNF repairs damaged brain tissue, whereas the Growth Factor produced in the liver produces liver tissue etc. Our problem is that we have damaged Glial cells, which are neurons, that produce dopamine. When the GDNF repairs some of the neurons, we produce more dopamine and we start to get better. However, as we have not done anything to stop the Parkinson's from killing off more glial cells, we have to continually try to produce enough GDNF to stay ahead of the Parkinson's.  

In other words, we have our own, built-in, repair kits!

What is the optimum time we should walk?

The optimum time for exercise has been found to be three, one-hour sessions, at maximum effort, per week, with a one day rest between sessions.

Why does more than one hour not produce more GDNF?

I don't know, but many tests have been done, and that was the result.

Why is walking or running the best form of exercise for this purpose?

It keeps our pulse-rate up to maximum level and maintains it there until we stop. Other forms of exercise tend to be stop-start, and cannot be sustained at any level, for the required one hour. If we were boxing, it would be just as good, but we could not sustain that for a full hour. As most Parkinson's patients have problems with balance, I would recommend walking, but running is just as good. Walking on the open road is better than walking on a treadmill, because we have to think about the surface on which we are walking and where we are going - whereas, on a treadmill, we merely have to put one foot in front of the other. This came out of many of the studies. The best results are produced when the brain is kept as active as the body. I assume that the condition required by the body to, produce the GDNF, would involve both the brain and the body.

Guess why I choose to walk?

I get lots of patients telling me that they don't like walking. It is boring! To me, it is not half as boring as the thought of being unable to move very well, or go anywhere, while living from one dose of medication to the next.

I have to concentrate so hard on walking properly, that I don't have time to get bored. It is so important to me, that I would not care if it got boring, as I enjoy my quality of life, even at the age of seventy-nine (2014).

We all have to make our own choices!

Either we do nothing, take our medication and put up with our Pd; or we exercise regularly and honestly, take the minimum medication and enjoy the benefits, by living a full life.

 The choice is all yours!

 

 

 

Rhythmic beat may help Parkinson’s rehab

Copied from The Northwest Parkinson’s Foundation Weekly News Update

Walking to an audible beat may be useful in rehabilitation for people with Parkinson’s disease and similar disorders, a study shows.

futurity.org - Researchers studied the effects of various metronomic stimuli (a mechanically produced beat) on fifteen healthy adults, ages 18 to 30. Walkers participated in two sessions consisting of five 15-minute trials in which the participants walked with different cues.

In the first, participants walked at their preferred walking speed. Then, in subsequent trials, participants were asked to walk to a metronomic beat, produced by way of visuals, sound, or touch. Finally, participants were asked to walk with all three cues simultaneously, the pace of which was set to that of the first trial.
 
“We found that the auditory cue had the greatest influence on human gait, while the visual cues had no significant effect whatsoever,” says Ervin Sejdic, an assistant professor of engineering at the University of Pittsburgh, who reports findings in the journal PLoS One.
 
“This finding could be particularly helpful for patients with Parkinson’s disease, for example, as auditory cues work very well in their rehabilitation.”

With illnesses like Parkinson’s disease—a brain disorder leading to shaking (tremors) and difficulty walking, — a big question is whether researchers can better understand the changes that come with deterioration.
 
“tentimes, a patient with Parkinson’s disease comes in for an exam, completes a gait assessment in the laboratory, and everything is great,” says Sejdic. “But then, the person leaves and falls down. Why? Because a laboratory is a strictly controlled environment. It’s flat, has few obstacles, and there aren’t any cues (like sound) around us.
 
“When we're walking around our neighborhoods, however, there are sidewalks, as well as streetlights and people honking car horns: you have to process all of this information together. We are trying to create that real-life space in the laboratory.”

In the future, Sejdic and his team would like to conduct similar walking trials with patients with Parkinson’s disease, to observe whether their gait is more or less stable.
 
“Can we see the same trends that we observed in healthy people?” he says. “And, if we observe the same trends, then that would have direct connotations to rehabilitation processes.”

The team feels that visual cues could be considered as an alternative modality in rehabilitation and should be further explored in the laboratory. Additionally, they plan to explore the impact of music on runners and walkers.

Funding for this project was provided, in part, by the University of Pittsburgh, the University of Toronto, and Holland Bloorview Kids Rehabilitation Hospital.

http://www.futurity.org/health-medicine/rhythmic-beat-may-help-parkinson%E2%80%99s-rehab/

 

 

More about Walking

 

My name is John Pepper. I was diagnosed with Parkinson’s disease in 1992.

Why can I walk properly, when I focus my full attention on each move?

Not having had any medical training and not being a scholar, I have to give my answer as a person with Parkinson’s disease - I don’t know!

Why is walking so important?

Here I am on safer ground! In 2006, the results of a lengthy scientific study, done in the USA, gave the answer to this question. These results were announced at the First World Parkinson’s Conference, held in Washington, DC. So why do we all not know about this important development?

Certain types of energetic exercise can slow down or even reverse Pd.

These results should be displayed on the walls of every neurologist in the world!

This was the reason why my Pd took so long to be diagnosed, in 1992, about twenty-nine years after my first symptom appeared in 1963.

Read all about this type of exercise and what I had been doing since 1970, which slowed down my Pd. My book, ‘Reverse Parkinson’s Disease’ tells my whole story, so that others can benefit from knowing what I did, in order to overcome my Pd. In a nutshell, I think that fast walking, MAO-b inhibitor medication, and stress control were responsible for my improved health! To tell the whole story in an article is just not possible.

This is the most exciting story for all Pd sufferers. It is the first story of REAL HOPE we have ever had!

The real question is:

Why don’t neurologists tell their patients about this good news? Why indeed!

 

 

Who is John Pepper?

I was born in 1934, in the English town of Harrow, which is famous for its public School. Harrow is now inside Greater London, but in those days, it was north of London. I started my schooling at the age of four, in Harrow. The Second World War started in 1939, before I turned five. I moved around a bit, due to the bombing, and had a narrow escape in 1940, when a landmine was dropped in the back garden of my home, and landed in a thick hawthorn hedge, and failed to explode. Had it exploded, I would not be here to tell the tale. My parents decided to leave Harrow in 1942, and moved to the country, away from the bombing. I went to nine different schools, before I gained entrance to another public school, in Winchester, at the age of ten, after passing a scholarship. I was then, at least two years younger than most of the boys in the class. That turned out to be a major mistake in my education. I found it impossible to settle amongst those, much older boys, and consequently became a loner, mainly due to the  bullying I continuously endured for the first two years. I finished school at the age of sixteen, when my father thought that I was old enough to help support my family.

My first job was as an office boy in a bank in Winchester. After one year, I applied for a transfer to an overseas branch of the bank, which turned out to be in Johannesburg, South Africa. There I worked for a further four years, during which I passed all but two of the exams for my Institute of Banker’s Diploma. My elder brother persuaded me to join his employers, Burroughs Machines Ltd, selling adding machines. I did not enjoy selling, but finished up in that company, running the third branch I had established, in the city of Kimberley, which is famous for its diamonds. There I married Shirley Hitchcock, and we had two children. In 1963, I started a new printing business, in partnership with Eric Sulter. That business grew very quickly, until I moved to Johannesburg in 1970, where I started another continuous stationery printing business, while Eric continued to run the Kimberley company.

My Parkinson’s symptoms started in 1963, when I found that I was unable to throw a ball properly. I had never had this problem before, but did not talk to anybody about it. This was followed very quickly by other symptoms, such as the inability to write properly, constipation and chest infections. Then in the seventies I suffered from chronic depression and speech problems, together with other movement problems, such as dropping things and spilling my food. I was finally diagnosed with Parkinson’s in 1992, when I had started to walk badly, while dragging one leg and shuffling my feet.

In 1960, I had an accident, on-stage, lifting a dancer. I prolapsed a disc in my lower back. After ten years of pain and suffering, I was advised to do exercise to strengthen my back muscles. This helped me overcome the back problems, until 1977, when I had the offending disc removed. From then onwards, right up till today, I have done regular exercise, mainly aerobic walking these days. I also have been going to the gym, on and off for over forty years. I am not a lover of exercise, but I am very grateful for what it has done for me, since I started in 1970.

There were three unusual situations regarding my Pd history. I was bodily, very fit, which was not very common amongst Pd patients at the time of diagnosis; In 1994 I was prescribed a monotherapy of an MAO-b inhibitor, which stops the natural breakdown of dopamine, in the brain, which gives us the use of a greater amount of our own dopamine; I did not take any levodopa medication after the first two years of being diagnosed, which was extremely unusual; I gave up my high-powered job within three months of diagnosis, which relieved me of an enormous amount of stress; Many patients are not in the position to lose a large amount of their monthly income, as I was prepared to do. 

All three of these circumstances have been responsible, in my opinion, for my good health today. Energetic exercise causes the brain to produce a substance called GDNF (Glial Derived Neurotrophic Factor), which repairs the damaged brain cells. This was proved by scientists and announced to the Parkinson’s world in 2006, in Washington DC, at the 1st World Parkinson's Cingress. The medication has also been independently proven to help slow down or even reverse Parkinson’s. From this you will see that doctors and scientists have known for many years that there is a lot we can do to help us overcome Pd. It does not appear to be in their interests to tell us this.

Because I no longer need to take any Patrkinson;'s medication and I live a normal life, I feel that I have to tell the world about my good fortune, and hope that others will follow in my footsteps. I am now seventy-nine, in 2014 and hope to live a normal life for many more years to come.

John Pepper 2014

 

 

The Five Most Important Actions Needed to Take Control of Parkinson’s Disease

 

I am not a doctor, I am a Parkinson’s Patient with 51 years of experience. These are the actions, which have helped me:

 

1.    Regular Energetic Exercise

 

2.    An MAO-b Inhibitor as the only Medication       

 

3.    Learn how to Take Conscious Control of all movements

 

4.    Manage Stress Levels

 

5.    Adopt a Positive Attitude

 

John Pepper

 

 

Take a Walk in The Park

04/28/2013

Walking improves stamina, energy, heart health, strength, and balance. As a form of exercise walking may even alter the physical and brain changes that occur with Parkinson’s over time.  Walking can also help the mind and the soul.   Research tells us that exercise including simply just walking, can protect our thinking abilities as we get older and protect from disease…

·        Reduce cognitive decline that can happen with aging

·        Reduce the risk of developing Alzheimer’s disease a form of dementia that attacks memory and thinking skills

·        Reduce the decline executive function in Parkinson’s.  (Learn more about executive function.)

Walking can also be good for our emotions and our soul. We have long known that exercise can help our mood and treat depression.  A walk in the park is like getting a double dose of therapy.

John Muir, a naturalist and nature lover once wrote,

“In every walk with nature one receives far more than he seeks.”

In a time when many of us are flocking to gyms, joining exercise classes or getting on the treadmill to get in ‘their exercise’, we may be missing an opportunity to move and feel well. Researchers evaluating the effect of walking on our mood showed that a walk in the park improved mood more than a similar walk in the shopping mall.  Our environment affects how we feel, think, move and behave.   Think about a walk in the park on a beautiful sunny day and the feeling and experience that comes to mind

·        The fresh air sharpens the senses and clears the mind of clutter

·        The marvel and good natured fun of watching nature

·        The stress dissolving effect of the peaceful calm of a gentle breeze

·        The sense of hope and anticipation that comes with the first spring buds.

·        The reflection of days past and what brings joy to us in life as we watch the sun set

·        The challenge and sure footedness of walking that is gained from walking on uneven ground

·        The chance to slow down, share your walk and connect with a loved one

·        The energizing feel of the sun

·        The joy and reminder that little things like a bird’s song or child’s laughter are important in life

·        The soothing effect of the sun’s warmth on our back

The benefits of nature are available to us all.  The power of exercise in Parkinson’s, healthy aging and emotional wellbeing are undisputed. Enhance this power by taking your next exercise activity outdoors.  Whether you take a stroll in your wheelchair in the park, take a walk around the block or a short stroll in your backyard, the benefit of nature is priceless.

Author: Monique Giroux, MD 

 

Copyright 2013 Northwest Parkinson's Foundation Wellness Center

 

 

Boxers work to knock out Parkinson's symptoms

Copied from The Northwest Parkinson’s Foundation Weekly News Update

Rock Steady gives people suffering from Parkinson's disease an outlet to improve their fitness.
Pamela Engel

USA Today - When Mary Yeaman was diagnosed with Parkinson's disease in 2006, she could barely bring herself to leave her house. Her muscles were weak, and she was having a hard time coping.

"I've always done sports and stuff like that, and it was getting to be too much just sitting and doing nothing," she said.

In 2007, she found Rock Steady Boxing in Indianapolis. She now attends classes every week and has seen her symptoms ease as a result of a rigorous regimen of punching, jumping, jogging and stretching.

"It makes my muscles stronger. I can walk better," said Yeaman, 64.

Rock Steady, founded in 2006 by former Marion County prosecutor Scott C. Newman after he was diagnosed with Parkinson's at age 40, gives people suffering from the disease an outlet to ease their symptoms and improve their physical fitness. Through boxing-inspired fitness classes, participants use exercise to slow the symptoms of a progressive neurological disease that causes tremors, muscle rigidity, loss of balance and cognitive, speech and vision impairment.

"Sometimes people get very discouraged when they are diagnosed with Parkinson's, understandably facing a disease that is progressive, that's going to worsen over time and that can take a big toll on them," said neurologist and Rock Steady board member Dr. S. Elizabeth Zauber.

"When they come to a gym and realize that ... there are people that are experiencing the same thing (and) there is something they can do about it to get better and perhaps slow down the course of their disease, then that improves their overall outlook. They realize they're still very capable physically even though they have a neurological disease."

Rock Steady offers 16 classes a week. The organization's 125 clients range in age from late 30s to early 90s.

Classes start slow with a warm-up before participants dive into more rigorous exercise. Coaches set up several stations throughout the small gym with a different exercise at each one. Participants punch hanging boxing bags and speed balls, jump rope and toss medicine balls.

The exercises at Rock Steady are based on boxing drills, and they're meant to extend the perceived capabilities of those suffering from Parkinson's. There are four different class levels, based on the severity of the symptoms.

Boxing works well to combat the disease because of the range of motion required in the exercises, Zauber said.

"I see all the time in my patients that start exercising or my patients that are exercising that they tend to function better," she said. "They have improvements in their balance, improvements in sleep, in mood and energy level."

The organization offers more than just physical improvement.

"It's a support system," said Joyce Johnson, executive director of the organization. "It's being able to come here where people understand the symptoms and challenges of the disease."

Yeaman said Rock Steady is the "best thing that's ever happened" to her and called her classmates her "second family."

"These people are always there for you no matter what happens," she said.

Classes are led by program directors Kristy Rose Follmar and Christine Timberlake. Follmar is a former professional boxer, and Timberlake is a certified personal trainer whose husband was diagnosed with Parkinson's in 2000.

Timberlake said she couldn't get her husband, Tom, "to do anything" before he starting coming to Rock Steady. About a month after he started attending classes, she said she saw a change in body, mind and attitude.

"He's completely transformed," she said. "He's making the most out of life."

Parkinson's affects about 1.5 million people in the United States. It currently has no cure.

 

Parkinson’s patients give disease a workout

Copied from The Northwest Parkinson’s Foundation Weekly News Update

Experts say exercise slows progression of illness, extends life

Paris Achen

The Columbian - Don and Cathy Crowe started exercising shortly after they were married eight years ago. At that time, the Vancouver couple didn’t know that Don Crowe would be diagnosed with Parkinson’s disease in 2010 and that exercise would be a key part of his treatment plan.

“We started exercising before Parkinson’s disease, but I’m sure that has helped slow the progression,” said Don Crowe, 77. “It makes a big difference.”

Exercise, combined with medication, remains one of the primary treatments for managing Parkinson’s disease, a progressive disorder of the nervous system, according to experts.

Especially early on in the disease, exercise can slow the progression of disease, which is caused by the loss of the brain chemical dopamine. The disease can manifest itself differently from patient to patient. It’s most commonly associated with body tremors, stooped posture, shuffling, an non-expressive face and loss of fine-motor control. It often strikes in the mid-60s.

“There are basic signs and evidence in clinical studies that regular aerobic activity triggers activity in the brain that seems to be protective,” said Matt Brodsky, assistant professor of neurology at Portland’s Oregon Health & Science University.

That’s why Don Crowe continued his exercise routine after his diagnosis. Two years ago, he joined the Parkinson’s Fitness class at Vancouver’s The Quarry Senior Living. The class is offered free of charge to the public every Tuesday and Thursday to help develop strength, flexibility, balance, gait, communication and fine-motor skills.

Researchers at OHSU have seen the protective effect of cardiovascular exercise on the brain tissue of mice after they ran regularly on a treadmill for a period of four weeks, Brodsky said. The effects also have been noted in humans. People with good cardiovascular health who have the disease score better on cognitive and muscle tests and tend to live longer, according to researchers at Harvard University.

‘The Art of Moving’

Cathy Lauder, instructor of The Quarry’s Parkinson’s Fitness, leads participants in a series of exercises based on the methods of John Argue, who wrote “Parkinson’s Disease & The Art of Moving.” The class begins with about 30 minutes of pole walking in or around The Quarry, depending on the weather. Walking with poles helps with balance and working the upper body, Lauder said. Then, the group assembles in a circle and does a series of exercises with resistance bands, inflatable balls, tennis balls and chairs. Participants follow Lauder’s lead to tunes from the United Kingdom. Lauder is from England. Her descriptions of the exercises, combined with the music, evoke images of the English countryside.

“Stand and then move beside the chair,” Lauder said to a group of seven Thursday. “Soften your knees. Imagine a horse now between the knees. Arms scoop in. We have a whole lot of berries we’re gathering toward us.”

Vancouver resident Helen Ramatowski, 67, was diagnosed with Parkinson’s in February 2011, said she does some kind of exercise every day, including Parkinson’s Fitness on Tuesdays and Thursdays.

“If we didn’t do this, we’d be a lot worse,” Ramatowski said. “Exercise is the No. 1 thing to do for Parkinson’s.”

Lauder concludes the class with facial and vocal exercises, which help patients maintain their ability to communicate with facial expressions and swallow.

“Blow as if you’re blowing out candles,” she said. “Loosen up your lips and do horse noises.”

“You can’t imagine how difficult it is to have a conversation when there is no facial expression,” Lauder explained. “You realize how much you gain from watching facial expressions.”

Lauder said she is trying to introduce more tai chi moves in the class. The slow, rhythmical movements help Parkinson’s patients maintain better balance and strength compared with patients who do other forms of exercise, according to a February study by the Oregon Research Institute in Eugene, Ore. The study was published in February in the New England Journal of Medicine.

Don Crowe said his balance has improved since starting the Parkinson’s Fitness class.

“His balance is better than mine,” his wife said.

There is a trove of local resources for people with Parkinson’s, including the free exercise classes at The Quarry and a free hiking group through Parkinson’s Resources of Oregon, which serves both Oregon and Southwest Washington. A 3-mile hike is scheduled for 9 a.m. today at the entrance of Portland’s Forest Park, 4099 N.W. Thurman St.

The Quarry offered one of the first few dedicated Parkinson’s assisted-living units in the nation, according to the National Parkinson’s Foundation. The unit opened in 2007.

It offers specialized services to its tenants, but it also has a philanthropic arm. The Quarry offers the fitness class, a support group and educational presentations to the public at no charge.

Paris Achen: 360-735-4551; http://twitter.com/Col_Trends; http://facebook.com/ColTrends; paris.achen@columbian.com.

http://www.columbian.com/news/2012/mar/26/parkinsons-patients-give-disease-a-workout-experts/

Note by John Pepper:

This piece of ‘News’ was made public at the 2006 First World Parkinson’s Congress, held in Washington DC. See full details about GDNF trials on this website.

 

 

A Virtual Coach Spurs Patients With Parkinson's

 

Copied from The Northwest Parkinson’s Foundation Weekly News Update

 

 

Ann Lukits

Wall Street Journal - People with Parkinson's disease walked markedly farther and faster after a month of daily motivational chats with a virtual exercise coach, according to a study in the American Journal of Physical Medicine & Rehabilitation.

Virtual coaches are animated computer characters that simulate face-to-face conversations with people. The technology has been used in studies of healthy adults, but this is the first to involve patients with a neurological disorder, researchers said.

Walking is an important indicator of both disability and quality of life in people with Parkinson's, they said.

Twenty Boston residents in their mid-60s with mild-to-moderate Parkinson's disease were recruited. Participants took daily walks wearing a pedometer and spent five minutes a day talking to a virtual exercise coach called Tanya. The conversations took place on a tablet computer, varied daily and consisted of a social chat, check of the subject's progress and daily exercise tip. Subjects took two walking tests before and after the study, which assessed distance covered in six minutes and gait speed, respectively.

Average walking distance on the six-minute test improved from 1,508 feet to 1,588 feet over the 30-day study period. Normal gait speed improved from 3.9 to 4.1 feet per second and maximum gait speed increased from 5.5 feet to 5.8 feet per second. All changes were statistically significant and clinically meaningful, researchers said.

Virtual coaches, with their humanlike characteristics, have a unique ability to build social and emotional relationships, researchers said, and can help promote healthy behavioural changes in people with chronic illnesses.

Caveat: The study was a small Phase I clinical trial that didn't include a control group.

 

Sexually alive with Parkinson’s Disease – A new perspective on sexuality

 

1.      A new perspective on sexuality:  An ongoing journey

We are born sexual beings and we die sexual beings. What keeps on changing throughout our lives, is how we speak, express, enjoy, hate, develop, stunt, grow, and adapt our sexuality throughout our lives.

Nelson has said about sexuality:

“We are being called and given permission to become body words of love.”(1)

This statement fills me with hope: It helps me to realise that in spite of the worst possible scenario, our bodies and our being can still be vehicles of love, closeness, tenderness and passion. We can choose to adapt and change our journey although we are different.

 I have been privileged to experience this with my husband in our marriage of 31 years, his journey with Parkinson’s disease, and even more, sitting with patients who had to go through:

 A spinal cord injury and adjust to new ways of caressing because of his paraplegia;

A stroke that robbed the ability to walk and talk but touching with one hand remained as well as the ability to relax when the healthy side of the body was caressed;

The woman with the second mastectomy whose husband had to nurse her wound and his own anxieties and after her death, give himself permission to enjoy a new relationship after years;

the patient who struggled with ED after his radical prostatectomy and hormone treatment and decided not to take medication for ED, because their relationship has stabilised on a limited level of intimacy after her chemotherapy; for him adapting in their sexual relationship was accepting that he could still be healthy, exercise and masturbate when needed.

Others with extra-marital affairs, sexual abuse, MND, amputation, grief, depression, bipolar mood disorder, Premature ejaculation, ED, Vaginismus, Lack of desire, Anorgasmia. Everyone of these patients made their individual decisions to adapt/ not, to use medication and counselling/ or not in moving on in their lives.

In moving on, we need to remind ourselves of some basic facts:

Our biggest sex organ

Our biggest sex organ is our skin. Laura Berman reminds us:

”The right touch can be as intimate and erotic as sex itself”(2)

 But to allow our erotic minds to stay alive, we need to get our most important sex organ, our brain, on our sides.

Our most important sex organ is our brain:

Parkinson’s disease is the result of Substantia Nigra Cells that stopped producing Dopamine, leading to the motor and non-motor symptoms. But the rest of the brain is  still working and can help one to adjust.

Understanding and discussing the illness, accepting it and and it’s effect on sexuality, is part of accepting and moving on. It leaves one with more choices, especially if normal functioning, sexual responses and differences between men and women as well as the effect of ageing on sexual responses are taken into consideration.

 

2.Sexual functioning

Sexual functioning depends on the neurological, vascular and endocrine systems allowing sufficient blood supply to and from genital organs, a balanced hormonal system and a healthy emotional state. Sexual functioning is influenced by psychosocial factors, family and religious background, the sexual partner and individual factors such as self-concept and self-esteem. Sexuality can be changed by aging, life experiences (e.g. abuse) and various illnesses and their treatments.(3) (Verschuren, et al,2010)

Sexual response

 Sexual response has identifiable stages – desire, arousal, climax, and resolution which are accompanied by bodily changes.

Desire  occurs when we see, smell, hear or experience emotions that trigger sexual energy and sexual potential is awakened.(4)Loving sex

During sexual arousal the heart rate quickens, cheeks flush and pupils dilate.

 A woman’s nipples become erect and blood flow to the genitals increase. In the woman the vagina becomes moist (vaginal lubrication), the clitoris ( which is 10-12 cm in length) fill with blood. The speed of response by the clitoris depends on whether it is stimulated directly by touch, fingers, mouth or erect penis or indirectly by touching of other erogenous zones.

Because of its position, the clitoris is not stimulated directly during intercourse, so movements of the penis on its own are often insufficient to excite the clitoris to orgasm.  Additional touch by fingers or mouth (masturbation by the partner or self) may be necessary to reach orgasm.

As sexual excitement increases the vagina lengthens and distends and the colour of the vulva change from pink to dark purple. During orgasm the vagina and  uterus  contracts 3-15 contractions at 0.8 second intervals. Women may have multiple orgasms or experience arousal without achieving an orgasm. After orgasm, the body relaxes and the vagina and clitoris return to normal, resolution.(4)Magic of sex

A man’s response to sex starts in the brain when he is aroused by something real or imagined. (predominantly visual stimulation or conditioned experiences).

The penis becomes erect and internal and external body changes occur. A “sex flush” that may appear over his abdomen, chest, neck and face, nipple swelling and increased heart rate, breathing rate and blood pressure. A feeling of “inevitability” is experienced two to three seconds before ejaculation and a drop of fluid may form at the urethral opening of the penis prior to ejaculation.(secretions from Cowper’s gland)

Orgasm occurs with simultaneous muscle contractions and rhythmic contractions of the penis and ejaculation. Orgasm and ejaculation are two separate processes and may, or may not occur at the same time. One can occur without the other.

During resolution , the penis becomes flaccid following intercourse and the man will not get another erection for some while.

3. Ageing and sexuality

The majority of older people still find sex thrilling and energy –giving; neither heir desires or capabilities vanish. Sex may wane a little in frequency and vigour, but not in sweetness and satisfaction.(4)

In both sexes, the sexual impulse declines with age but the general pattern differs in men and women. A man’s sex drive reaches a peak in late teens and thereafter gradually diminishes. A woman’s sexual feeling reaches a maximum much later in adult life, is sustained on a plateau of responsiveness which tends to decline in her late 60s. Much research support the existence of a strong sexual urge in 70- and 80-year old women and men.(4)

Goodwill, caring, thoughtfulness, a desire to comfort and shared intimacy keep long term relationships alive and mutual respect and affection help couples to remain close.(4)

 

Sex and the older man 

Until about the age of 50, men’s sexual responses stay stable. This is due to the testosterone levels remaining consistent through to his midlife.

Changing in sexual activity need open honest discussion to maintain a loving relationship.

·         Desire levels drop according to testosterone levels

·         Arousal changes – erections become more unreliable, erectile dysfunction more common; 40% chance of ED over the age of 40, 50% if over 50. ( MMAS; Feldman et al)

·         Orgasms are less intense and frequent.

·         Orgasms are prolonged.

·         Orgasms may happen without ejaculation

·         He may need days rather than hours before he is ready for intercourse. The resolution phase prolongs (5)

Coping with the changes, may need more active involvement from the partner. Changing the emphasis of sexual activity to longer and stronger foreplay, more tactile stimulation including caressing, rubbing, cuddling and the use of different sexual positions. The partner becoming more active as initiator.

Erectile dysfunction may be the indicator of other health issues, especially endothelial dysfunction, causing cardiovascular disease.  Medical evaluation to rule out underlying cardiovascular disease, DM, Testosterone deficiency or a neurological disease is crucial.(5 )

Sex and the older woman

Studies show that women have a more stable sex drive than men. Women over sixty-five continue to seek out, and respond to, erotic encounters, have erotic dreams, and continue to be capable of orgasms, even multiple ones. (5)

She can however expect the following sexual- response changes:

·         Decreased desire

·         Arousal takes longer because vaginal blood flow and genital engorgement are reduced; vaginal lubrication  is delayed and reduced in quantity.

·         Reaching an orgasm takes longer due to a decrease in vaso-congestion of the clitoris and vagina, as well as decreased sensitivity.

·         Decrease of breast and nipple erection.

·         Orgasmic capacity is retained- even multiple orgasms are still possible.

·         The number and intensity of vaginal contractions is reduced.(5)

The availability of a partner and the opportunity for regular sexual activity are the most important factors influencing sexual behaviour. Masturbation  is instrumental in keeping alive an older woman’s sexuality and sexual identity, and it will keep her physiological responses in good working order (especially during widowhood).(4)

Managing  changed sexual response may need more use of fantasy, openness about the kind of sexual touches that turns on and using additional lubrication or vaginal hormonal cream to prevent painful penetration and using hormonal replacement.

Use leisure time for leisurely sex, give more attention to foreplay and introduce something new like oral sex, sex toys, masturbation, new positions to increase arousal and desire.(5)

A satisfying relationship is crucial to enhance sexual responses.

 

4. Sexual dysfunction

Sexual dysfunction is not uncommon in the general population. It is linked to risk factors such as age, smoking, DM, CVD, other chronic diseases, menopause and ageing in the

male. It is multifactorial in chronic, neurological disease.

Sexual dysfunction in Parkinson’s Disease

Sexual dysfunction  is common in PD and associated with depression and relationship dissatisfaction.

Women: 75% difficulties with arousal &orgasm

                 50% low sexual desire

Men:        70% erectile difficulties

                 40% premature ejaculation

                 40% delayed orgasm (6)

In the general population without health problems, estimates of sexual problems vary from 10-52% of men and 25-63% of women.(7)

 

 

 

 

5. Sexual function is interfered with by typical PD symptoms 

1.  Muscle rigidity, bradykinesia and  clumsiness in fine motor control affect the ability  to  undress, touch and caress and indirectly the willingness to initiate. The slowness of movement , tremor or rigidity may interfere with practicalities of lovemaking.

 

      Undressing your partner with PD can become a necessary but also playful part of foreplay.

      A hot bath or shower before lovemaking, may lessen muscle stiffness and tiredness.

      Changing roles: the woman becoming the more active initiator if the man has PD

      The man spending more time to make his female partner with PD feel safe before caressing and touching.”Studies suggest that feeling safe may be the most important factor in determining whether or not a woman reaches orgasm.”(2)

 

2.  Sexual functioning may be worse in late evenings, especially with daytime     scheduling of medication.

      Rescheduling night time lovemaking to mornings  could overcome this problem.

      If you do feel sexual attraction, even if it is at a bad time for medication, follow your desire. Additional lubrication, or extra stimulation with a vibrator may surprise both of you.

 

           3.    PD medication can lower sexual desire or can enhance desire.

      It is more often the associated depression, fatigue associated with PD or  relationship strain that cause a lack of libido.

      Increase in desire may occur with levodopa and deep brain stimulation.

 

 

            4.   Tremor , dyskinesias can be enhanced during sexual arousal.

      Accepting this as a compliment  rather than a “put off” may bring some humour and a change in attitude.

       Switching your side of the bed, may enable touching and caressing with “the              better side”.

      Use positions that will lessen the strain on stiff muscles (side by side)

 

                 5.  Hypersalivation and sweating

      Has never been a turn on!!! Shower/ brush your teeth/ suck a sweet.

 

6. The mask–like face may reduce the appeal for the partner. Subjectively it                    influence the self–image of the partner in a negative way.

      Deliberately practise open eye kissing, smiling while you caress.

      Try to look into your partner’s eyes while you have an orgasm.

 

                7. Men can have problems getting and keeping an erection.

Causes: lack of dopamine/ anti-depressants/performance anxiety/ other physical causes.

 

               8. Treatment of ED:

      Sildenafil  85% efficacy in PD patients with depression

      Tadalafil & Vardenafil are also effective.

      It enhance the response to sexual stimulation. The partner remains crucial.

      Sildenafil should be taken 1 hour before intended sexual activity.

      Often the larger dose needs to be used.

      A longer time of onset is needed because of slowed gastrointestinal mobility.

      It can be used once / twice per week.

 

             9. Contra –indications for PDE5I

         Nitrates

         Retinitis pigmentosa

         History of priapism (prolonged erection)

         Hypotension

         Coronary artery disease

 

 

 

10.  Non-responders to oral treatment

      Intrapenile injections of Alprostadil

      Taught under medical supervision

      Vacuum-device : rarely adopted by elderly

      Difficulty placing / removing bands, bruises

 

11.  Ejaculation problems with PD

      Rapid ejaculation: SSRI like Sertraline/ Paroxetine

      Rapid ejaculation linked to ED: Sildenafil may help both

 

      Delayed ejaculation: ejaculation is a reflex

      Increased stimulation with a vibrator

      Share this information with the partner

      Decrease marital tension , embarrassment

 

12.  Women may experience vaginal dryness

      Use additional lubrication to prevent pain with penetration.

      Give more caressing/ foreplay.

      Use a vibrator for clitoral stimulation to ensure an orgasm.

 

13.  Women may struggle with urinary urgency and incontinence

      Empty the bladder before lovemaking

 

14.  PD symptoms worsen at night / sleeping apart reduces opportunities for spontaneous sex

      Talk frankly and openly about sexual needs. Communication is the best remedy for all relationship problems.

      Consider outercourse if intercourse is not an option.

 

          15.   Depression and the use of anti-depressants  in PD are common.

      Both are associated with higher frequency of Sexual dysfunction.

      PDE5I are recommended for arousal problems( ED or lack of lubrication)

 

16.  High prevalence of Testosterone deficiency in elderly PD patients

      20-25% of males over 60 years

      Depression, fatigue, decreased libido, ED, decreased work performance

      Respond to testosterone treatment.

      Motor and non-motor symptoms of PD improved with daily transdermal T-patch.

 

17.  Hypersexuality in PD

      Rare side-effect of Dopamine agonists, Levodopa, Deep brain stimulation.

      Discuss adjustment of dosage / medication with your neurologist.

 

18.  Issues for the person who has PD

      Besides the effect of the condition and the medications, sexual problems may develop because of a negative body image, reduced self-esteem, depression and grief, anger and stress.

      Open communication and understanding are

   

Can you ride a bike? Then you're a marvel

Copied from The Northwest Parkinson’s Foundation Weekly News Update

 

A runner-up in the Wellcome science writing prize considers the extraordinary human ability to cycle
Catherine Hess

www.guardian.co.uk - Most of us remember our first proper bike. It's a rite of passage, symbolising our transition from "little" to "big" kid. Even more exhilarating is the day we take our first ride without stabilisers. What most of us don't realise is just how complex the art of riding a bicycle actually is. So complex, in fact, that researchers are just beginning to investigate how on earth we manage to propel ourselves, constantly rocking back and forth with the movement of our legs, on two skinny wheels; simultaneously navigating movement in multiple planes while trying to avoid countless obstacles.

Most extraordinary is what the act of riding a bicycle can tell us about the human brain. In 2010 researchers from the Netherlands published a dramatic case study in the New England Journal of Medicine. Medical researchers at Radboud University in Nijmegen examined patients afflicted with Parkinson's disease, a neurological disorder that results in tremors and involuntary muscle movements. In severe cases, Parkinson's affects balance, co-ordination and limb control and can leave patients unable to walk or carry out basic tasks.

One such patient, a 58-year-old man, suffered from what researchers call "gait freezing". He was incapable of walking to the extent that he required visual guides to help him move one foot in front of the other and was unable to turn while walking. After a few steps the patient would lose his balance and would require his wheelchair.

Astonishingly, however, this patient could still ride his bicycle. Flawlessly. Video evidence, submitted with the published case study (and now available on YouTube), shows the patient, with severe tremors in his arms, shuffling slowly and unsurely down a hallway while being guided by another individual. After several steps he begins to stumble forward until he falls to the ground.

In a second video he is seen riding a bicycle with perfect movement and balance, the marked tremors in his arms are gone and he pedals at a consistent pace and with perfect balance and co-ordination. He cycles away from the camera, turns around and cycles back, slowing, stopping and dismounting perfectly. Once dismounted, however, he is again incapable of walking.

This phenomenon is called kinesia paradoxica. While the mechanisms involved are still not understood, the knowledge is invaluable. It may lead to new forms of physical therapy and exercise for people with Parkinson's disease or other neurological disorders that affect movement, co-ordination or balance.

Currently, the "bicycle sign" is being suggested as an effective and inexpensive way to differentiate between Parkinson's and the rarer atypical Parkinson's. One way in which the two diseases differ is in the ability or loss of ability to ride a bicycle. Individuals with Parkinson's who were able to ride a bicycle before the onset of symptoms retain the ability to cycle. Those with atypical Parkinson's do not.

But how is it possible for a man to ride a bicycle when he is essentially wheelchair-bound? More importantly, how does anyone adapt to the sensory whirlwind that is bicycle riding? Research teams at the University of California, Davis in America and the University of Delft, Netherlands, are trying to find out. What they have discovered is surprising.

While we take it for granted that riding a bicycle is as easy as, well, riding a bicycle, it turns out that it is anything but. Led by Professors Mont Hubbard and Ron Hess, American researchers are attempting to model human-bicycle interactions in a similar manner to pilot-aeroplane or motorist-car interactions. However, there are many more physical and neurological processes involved in riding a bicycle than driving a car.

Riding a bicycle involves continuous use of all the human's primary sensory capabilities, visual, vestibular [balance] and proprioceptive [the awareness of one's body and limb positioning]," says Hess. "The latter involves sensors in the arms providing information about steering inputs. What is more interesting though is the ability of the trained cyclist to ride a bicycle 'hands-free'."

Recent research at the University of California, Davis has demonstrated how subtle body leaning by the cyclist enables this behaviour.

"Imagine trying this control technique in an automobile or an airplane," says Hess.

The goal of this research is to understand how the cyclist interacts with both the environment and the bicycle and to develop bicycles that maximise performance, whether the rider is a Tour de France cyclist or a disabled cyclist needing greater stability or control.

What is clear from research into both the human brain and the bicycle is that despite the bicycle's simplicity we have yet to fully understand how it is that we manage to control it, and what is happening in the brain when we do. Our first wobbly bicycle ride, then, is a more remarkable event than we ever imagined


 

 

How pedal power could ease Parkinson's: Cycling can improve connections in brain regions linked to the disease

Copied from The Northwest Parkinson’s Foundation Weekly News Update

 

Scans revealed pedalling boosted connections between brain regions linked to movement
Fiona Macrae

www.dailymail.co.uk - Cycling could help ease the symptoms of Parkinson’s disease, scientists believe.

The exercise improved connections between brain regions linked to the disease and boosted patients’ co-ordination and balance, research has shown.

Exercising on a bike is ‘an effective, low-cost therapy for the disease’, one researcher said.

Some 120,000 Britons have Parkinson’s. Symptoms include tremors, speech problems and a gradual slowing down of the body.

As the disease progresses, speech and balance can be affected and some sufferers become wheelchair-bound.

High-profile patients include Michael J Fox, who was just 30 when he was diagnosed with the condition, and Muhammad Ali.

US neuroscientist Jay Alberts began the research after noticing improvements in his companion, a Parkinson’s patient, after a long-distance tandem ride across Iowa.

Dr Alberts, of the Cleveland Clinic Lerner Research Institute, Ohio, said: ‘The finding was serendipitous. I was pedalling faster, which forced her to pedal faster.

'She had improvements in her upper extremity function, so we started to look at the possible mechanism behind this improved function.’

In the study, he carried out a series of scans on the brains of 26 Parkinson’s patients who used exercise bikes three times a week for two months.

Some pedalled at their own pace, while others undertook ‘forced-rate’ cycling, in which they were made to pedal faster by motors fitted to their bikes.

The scans revealed pedalling, particularly vigorous pedalling, boosted connections between brain regions linked to movement, the annual meeting of the Radiological Society of North America in Chicago heard.

Researcher Chintan Shah, also from the Cleveland Clinic, said: ‘The results show that forced-rate bicycle exercise is an effective, low-cost therapy for Parkinson’s disease.’

The scientists are now studying how patients fare with exercise bikes in their homes. They also want to see whether other forms of exercise such as swimming and rowing have similar benefits.

The charity Parkinson’s UK welcomed the research, saying the balance and co-ordination can be badly damaged as the disease progresses.

However, it also cautioned that not all patients will be capable of exercising intensely.

Dr Kieran Breen, the charity’s director of research, said: ‘While it is too soon to encourage people with Parkinson’s to get on their bikes three times a week on the basis of this study, we do know that exercise can be beneficial.

‘A regular exercise routine can help those with the condition to not only improve their general fitness but can also help to improve movement and balance as well as other symptoms of the condition such as anxiety and depression.’


 

 

Active healing: Exercise class serves Parkinson’s patients

Copied from The Northwest Parkinson’s Foundation Weekly News Updare

 

Canada Fuqua

Corvallis Gazette Times - When Mark Smith read that exercise can delay symptoms of Parkinson’s disease, he immediately searched the Internet for books and videos that would help him create an exercise plan.

As a young, active man diagnosed with the degenerative neurological disease, he was more than disappointed with what he saw; he was depressed.

“What I found was, you sit down in a chair and you move your arms,” he said. “… That leaves you with almost no hope.”

He knew that the disease, which has no cure, was expected to continue to weaken his body and decrease his balance and range of movement. That was six years ago. Studies since then have verified the benefits of more vigorous exercise — especially the kind that focuses on balance. But programs offering exercise specifically for Parkinson’s patients are limited, according to Dr. David Blatt.

Blatt, who is Smith’s friend and exercise partner, also has Parkinson’s. The two met six years ago and soon began a Pilates class that focused on balance. The results have been better than they expected.

“For both of us,” Blatt said, “it was a turning point in that we started improving our condition instead of just slowing down how fast it was getting worse.”

The improvement encouraged them to bike, take ski conditioning classes and to box — anything to keep their muscles moving.

Blatt and Smith say they are proof not only of the power of exercise but of a certain kind of exercise. Forcing the body to move faster than it wants to, performing difficult balancing exercises, juggling and playing soccer is more beneficial, Blatt said, than repetitive motions such as jogging or lifting weights.

“Fifteen years after I was diagnosed, I was afraid that I wouldn’t be able to walk,” Blatt said, “and I’m still running, playing soccer, hiking up South Sister and skiing down steep mountains.”

Blatt believes that beyond building muscle and improving balance, vigorous exercise actually stimulates the production of new nerve cells to replace some of those destroyed by the disease.

A former anesthesiologist, the 56-year-old opened a practice two years ago in which he consults with people who have Parkinson’s disease. He helps them cope, and he sets them up with fitness trainers.

It didn’t take long before the gym became his office. Since 2010, he has been a fitness trainer for people who have Parkinson’s and other chronic illnesses. He also looks for ways to get the word out about his program to more people.

“I started teaching other people because I was inspired to do that. I wanted to share with them the benefits I had gained,” Blatt said. “Now, what I’m trying to focus on is putting the program together on videotape that can be distributed to more people.”

A videographer has filmed some of the classes for Parkinson’s patients, which are held at Fitness over 50 and the Timberhill Athletic Club. Within a few months, Blatt hopes to have a product to distribute to trainers and people with Parkinson’s.

He borrowed some methods and tailored them to fit people with Parkinson’s and other neurological diseases.

“We took, for example, some of the exercises we learned in the ski conditioning classes and we scaled those down to a level that these people could safely do,” he said. His students vary in age and ability, but he always tries to safely challenge them.

“We do a much more aggressive exercise program than I have heard of done anywhere for Parkinson’s,” Blatt said. “And we do not like sitting in chairs. My philosophy is, if you’re trying to help someone improve their balance, you do so walking.”

http://www.gazettetimes.com/news/local/active-healing-exercise-class-serves-parkinson-s-patients/article_ad3e28ca-e6bb-11e1-9e77-001a4bcf887a.html

 

  

Forced Exercise

What Parkinson’s Teaches Us About the Brain

Copied from Northwest Parkinson’s Foundation News Update

 

GRETCHEN REYNOLDS

The New York Times - Scientific discoveries can be serendipitous, and so it was when Jay L. Alberts, then a Parkinson’s disease researcher at Emory University in Atlanta, mounted a tandem bike with Cathy Frazier, a Parkinson’s patient.
 

The two were riding the 2003 RAGBRAI bicycle tour across Iowa, hoping to raise awareness of the neurodegenerative disease and “show people with Parkinson’s that you don’t have to sit back and let the disease take over your life,” Dr. Alberts said.
 

But something unexpected happened after the first day’s riding. One of Ms. Frazier’s symptoms was micrographia, a condition in which her handwriting, legible at first, would quickly become smaller, more spidery and unreadable as she continued to write. After a day of pedalling, though, she signed a birthday card with no difficulty, her signature “beautifully written,” Dr. Alberts said. She also told him that she felt as if she didn’t have Parkinson’s.
 

Impressed, Dr. Alberts, who now holds an endowed research chair at the Cleveland Clinic in Ohio, embarked on a series of experiments in which he had people with Parkinson’s disease ride tandem bicycles. The preliminary results are raising fascinating questions not only about whether exercise can help to combat the disease but also — and of broader import — whether intense, essentially forced workouts affect brains differently than gentler activity does, even in those of us who are healthy.
 

Scientists have known for some time that in lab animals, forced and voluntary exercise can lead to different outcomes. Generally, mice and rats enjoy running, so if you put a running wheel in a rodent’s cage, it will hop aboard and run. That activity, obviously, is voluntary. But if you place an animal on a treadmill and control the speed so that it must keep pace, often with help from a finger prod or electrical shock, the activity becomes forced.

 

Interestingly, in animals, the effects, especially on the brain, typically are more beneficial after forced exercise. In one study from 2008, rats forced to run wound up with significantly more new brain cells after eight weeks than those who ran when they chose, even though the latter animals ran faster. And in another, similar experiment, mice that were required to exercise on treadmills subsequently performed better on cognitive tests than those given access to running wheels.
 

Before Dr. Alberts’s work, there had been few comparable experiments in humans, primarily because no one had known how, ethically, to “force” people to exercise. Dr. Alberts solved that problem by placing volunteers with Parkinson’s on the back seat of a tandem, which had been modified to ensure that the back rider would have to actively pedal; he or she could not just passively let the pedals turn. First, though, he had each volunteer ride a solo stationary bicycle at his or her own pace. Most chose a pedalling cadence of around 60 revolutions per minute, an un-strenuous level of exertion.
 

But on the tandem, the rider in front had been instructed to pedal at a cadence of about 90 r.p.m. and with higher force output or wattage than the patients had produced on their own. The result was that the riders in back had to pedal harder and faster than was comfortable for them.
 

After eight weeks of hour-long sessions of forced riding, most of the patients in Dr. Alberts’ study showed significant lessening of tremors and better body control, improvements that lingered for up to four weeks after they stopped riding.
 

These findings are exciting, Dr. Alberts says, because they contrast with some earlier results involving voluntary exercise and Parkinson’s patients. In those experiments, the activity was helpful, but often in a limited, localized way. Weight training, for instance, led to stronger muscles, and slow walking increased walking speed and endurance. But such regimens typically did not improve Parkinson’s patients’ overall motor control. “They didn’t help people tie their shoes,” Dr. Alberts says.
 

The forced pedalling regimen, on the other hand, did lead to better full-body movement control, prompting Dr. Alberts to conclude that the exercise must be affecting the riders’ brains, as well as their muscles, a theory that was substantiated when he used functional M.R.I. machines to see inside his volunteers’ skulls. The scans showed that, compared with Parkinson’s patients who hadn’t ridden, the tandem cyclists’ brains were more active.
 

Why forced exercise would have a greater effect on brain functioning than gentler regimens isn’t clear. Scientists have speculated that in animal experiments, being forced to work out may cause the release of stress-linked hormones in rodents’ brains, which then prompt various reactions in the cells and tissues. But Dr. Alberts suspects that in Parkinson’s patients, the answer may be simple mathematics. More pedal strokes per minute cause more muscle contractions than fewer pedal strokes, which, in consequence, generate more nervous-system messages to the brain. There, he thinks, biochemical reactions occur in response to the messages, and the more messages, the

 

Whether forced exercise would similarly affect healthy brains is unknown at this point, he says, as is the question of whether riding on the back of a tandem behind a stronger cyclist is the only qualifying exercise. “Pedalling at 90 r.p.m. is a fairly intense activity,” he says.
 

“It seems likely,” he continues, that intense exercise of any kind should produce comparable brain reactions. “There is data showing that people who exercise intensely have less risk” of developing Parkinson’s and other neurological diseases, he says. So perhaps, if you have no access to a tandem (or no stomach for being harangued to pedal harder by the rider in front), try cranking up the speed on your next treadmill session, until you are outside your normal running comfort zone.
 

Dr. Alberts remains most enthused, though, about the implications of his findings for people with Parkinson’s and other brain-related conditions. He has partnered with Y.M.C.A.’s in several cities to offer special tandem cycling programs for Parkinson’s patients and is hoping to expand the program nationwide. He’s also planning studies with patients who’ve suffered strokes, in hopes that the brain changes following forced exercise could ease the relearning of physical skills.
 

“This is not a cure” for Parkinson’s or other brain conditions, he cautions. “But it seems to help significantly” with tremors and other symptoms, “and it gives people a chance to be active participants in their own treatment.”
 

He plans to return to the Iowa bike event next summer, as a representative of a program he founded, Pedalling for Parkinson’s, and expects, he says, to be joined by Ms. Frazier, who still frequently rides a tandem and signs her name legibly.
 

*Note by John Pepper:

I am very interested in this article, as it relates to my own experiences.

 

When I wrote the first edition of my book, I had managed to PUSH my performance up from over ten minutes per kilometre to under seven minutes per kilometre. During that time, my PD symptoms got appreciably better.

 

Then, being happy with my performance times, I managed to maintain that performance level for several years. However, After picking up an injury, over three years ago, I was unable to do my walking for over two years, because of various other injuries and PD related chest problems.  I have still not been able to get back to less than seven minutes per Kilometre.

 

Interestingly; over the past three years, many of my symptoms have got noticeably worse, and I am also getting a lot older, so have not pushed myself to the limit, thinking that I just needed to walk for one hour, three times a week.

 

This appears not to have done me any good. My symptoms are nowhere near as good as they were, three years ago, and are not improving, even though I walk for one hour, three times a week.

 

After reading this article, I am going to force myself to walk faster and see what happens. This is not going to please my daughter, who thinks I should start taking things easy. After all, I am over seventy seven and not getting younger. If I injure myself again, as I did three years ago - when I was pushing hard in soft sand, on the beach - I will be unable to continue my quest and will have to be prepared to see my Pd get worse. I will keep you informed.

 

 

 

 

 

Parkinson’s patients give disease a workout

Copied from The Northwest Parkinson’s Foundation Weekly News Update

 

Experts say exercise slows progression of illness, extends life

 

Paris Achen

 

The Columbian - Don and Cathy Crowe started exercising shortly after they were married eight years ago. At that time, the Vancouver couple didn’t know that Don Crowe would be diagnosed with Parkinson’s disease in 2010 and that exercise would be a key part of his treatment plan.

 

“We started exercising before Parkinson’s disease, but I’m sure that has helped slow the progression,” said Don Crowe, 77. “It makes a big difference.”

 

Exercise, combined with medication, remains one of the primary treatments for managing Parkinson’s disease, a progressive disorder of the nervous system, according to experts.

 

Especially early on in the disease, exercise can slow the progression of disease, which is caused by the loss of the brain chemical dopamine. The disease can manifest itself differently from patient to patient. It’s most commonly associated with body tremors, stooped posture, shuffling, an non-expressive face and loss of fine-motor control. It often strikes in the mid-60s.

 

“There are basic signs and evidence in clinical studies that regular aerobic activity triggers activity in the brain that seems to be protective,” said Matt Brodsky, assistant professor of neurology at Portland’s Oregon Health & Science University.

 

That’s why Don Crowe continued his exercise routine after his diagnosis. Two years ago, he joined the Parkinson’s Fitness class at Vancouver’s The Quarry Senior Living. The class is offered free of charge to the public every Tuesday and Thursday to help develop strength, flexibility, balance, gait, communication and fine-motor skills.

 

Researchers at OHSU have seen the protective effect of cardiovascular exercise on the brain tissue of mice after they ran regularly on a treadmill for a period of four weeks, Brodsky said. The effects also have been noted in humans. People with good cardiovascular health who have the disease score better on cognitive and muscle tests and tend to live longer, according to researchers at Harvard University.

 

‘The Art of Moving’

 

Cathy Lauder, instructor of The Quarry’s Parkinson’s Fitness, leads participants in a series of exercises based on the methods of John Argue, who wrote “Parkinson’s Disease & The Art of Moving.” The class begins with about 30 minutes of pole walking in or around The Quarry, depending on the weather. Walking with poles helps with balance and working the upper body, Lauder said. Then, the group assembles in a circle and does a series of exercises with resistance bands, inflatable balls, tennis balls and chairs. Participants follow Lauder’s lead to tunes from the United Kingdom. Lauder is from England. Her descriptions of the exercises, combined with the music, evoke images of the English countryside.

 

“Stand and then move beside the chair,” Lauder said to a group of seven Thursday. “Soften your knees. Imagine a horse now between the knees. Arms scoop in. We have a whole lot of berries we’re gathering toward us.”

 

Vancouver resident Helen Ramatowski, 67, was diagnosed with Parkinson’s in February 2011, said she does some kind of exercise every day, including Parkinson’s Fitness on Tuesdays and Thursdays.

 

“If we didn’t do this, we’d be a lot worse,” Ramatowski said. “Exercise is the No. 1 thing to do for Parkinson’s.”

 

Lauder concludes the class with facial and vocal exercises, which help patients maintain their ability to communicate with facial expressions and swallow.

 

“Blow as if you’re blowing out candles,” she said. “Loosen up your lips and do horse noises.”

 

“You can’t imagine how difficult it is to have a conversation when there is no facial expression,” Lauder explained. “You realize how much you gain from watching facial expressions.”

 

Lauder said she is trying to introduce more tai chi moves in the class. The slow, rhythmical movements help Parkinson’s patients maintain better balance and strength compared with patients who do other forms of exercise, according to a February study by the Oregon Research Institute in Eugene, Ore. The study was published in February in the New England Journal of Medicine.

 

Don Crowe said his balance has improved since starting the Parkinson’s Fitness class.

 

“His balance is better than mine,” his wife said.

 

There is a trove of local resources for people with Parkinson’s, including the free exercise classes at The Quarry and a free hiking group through Parkinson’s Resources of Oregon, which serves both Oregon and Southwest Washington. A 3-mile hike is scheduled for 9 a.m. today at the entrance of Portland’s Forest Park, 4099 N.W. Thurman St.

 

The Quarry offered one of the first few dedicated Parkinson’s assisted-living units in the nation, according to the National Parkinson’s Foundation. The unit opened in 2007.

 

It offers specialized services to its tenants, but it also has a philanthropic arm. The Quarry offers the fitness class, a support group and educational presentations to the public at no charge.

 

Paris Achen: 360-735-4551; http://twitter.com/Col_Trends; http://facebook.com/ColTrends; paris.achen@columbian.com.

 

http://www.columbian.com/news/2012/mar/26/parkinsons-patients-give-disease-a-workout-experts/

 

 

Note by John Pepper:

This piece of ‘News’ was made public at the 2006 First World Parkinson’s Congress, held in Washington DC. See full details about GDNF trials on this website.

 

 

 

  

Exercise Is Not Optional, It Is Mandatory.

Exercise is Not Optional, it is Compulsory

Copied from SPRING Times No 40. Page 14-16.

 

The World Parkinson Congress, the first of its kind, took place from February 22^nd to 26^th, 2006 at Washington Convention Centre, USA, attracting some 3,200 participants, 1,100 of whom were patients or caregivers.

The Congress supported by the Movement Disorder Society, the National Institute of Health, U.S. Army Medical Research Acquisition and over 100 professional and patient organizations from all over the world, was unique not only in size and scope but also in that it brought together patients, caregivers and many of the world’s leading Parkinson’s experts, doctors and scientists.

Michael Kelly, a SPRING member, who attended the Congress, has written this article for SPRING Times.

With almost 200 papers to choose from, it was not an easy task for me to select those that might be of special interest to patients. In taking the subject of exercise as being worthy of special attention, I have singled out three papers for comment based on the following criteria:

 

·           Scientific importance of medical information

·           Originality of content

·           Immediate relevance for patients

 

The three papers are supplemented by an addendum, based on work currently in progress at the University of Frankfurt. Taken together, the material presented provides good grounds for a major re-evaluation of the role of exercise in patient therapy.

In the first talk entitled how exercise affects the brain: Towards a rationale for exercise-induced protection, Dr Michael Zigmond from the University of Pennsylvania spoke about the benefits of exercise, pointing out that it has been accepted for a long time that exercise is recommended for people suffering from numerous conditions, including cardiovascular problems and diabetes. He referred to the fact that studies carried out showed that the incidence of Alzheimer’s disease, stroke and PD was lower for those who exercised regularly compared to control groups.

The question is: What is it about exercise that confers a benefit? The work of Dr Greeno at the University of Illinois was referred to. He has been testing, a) animals walking fast or running, b) animals having to balance on a tightrope to obtain food, and c) couch potato animals relaxing all day. It has been found that running very significantly increases blood vessel density in the brain, with enhanced flows of blood improving the supply of nutrients and facilitating removal of waste. Furthermore, the tightrope group showed an increase in the number of synapses and overall, exercise increased the supply of survival or trophic factors. Running or fast walking had no effect on synapses and tightrope walking had no effect on blood supply. So, the type of exercise taken; needs to be considered, when designing a program. Reference was made to the work of Dr Carl Cotman at the University of California, showing that there is an increase in survival factors in the brain with exercise.

The question then becomes: what kind of exercise is needed and how much? The answer is: “lots of different types of exercise”.

Dr Zigmond then went on to talk about an animal model using the 60HDA neurotoxin (6 hydroxy dopamine). In a series of elegantly designed experiments using rats (referred to by Dr Zigmond as animals with front-wheel-drive) with individual forelimbs immobilized in casts and thus with the rat being forced to use a particular limb, it could be shown that forced exercise prior to or immediately after lesioning, with 6OHDA and continued for 7 days, could completely counteract the toxic effects of 6OHDA. Video clips of this phenomenon were shown for various configurations and provided an impressive demonstration of the benefits of exercise. If exercise was initiated seven days after lesioning, no beneficial effects occurred. Dr Zigmond could give no precise data on how long the effects lasted and how intensive the exercise had to be. This aspect will be referred to later.

 

The second talk with the somewhat unwieldy title: The effect of high-intensity exercise using body-weight supported treadmill training on neuroplasticity and functional recovery in individuals with Pd was given by Dr Beth Fisher from the University of Southern California. Dr Fisher has been involved for some years in translating over animal movement research for use in human applications. She spoke about the re-modeling that the brain is capable of, pointing out that, in recent years, a much greater degree of plasticity has been found to exist than was formerly thought to be the case. This applies not only to animal models but also to stroke and spinal injury models.

Dr Fisher reported on studies of mice using MPTP (a neurotoxin, causing immediate damage to dopaminergic neurons) in which one group receiving MPTP was exercised intensively for 30 days, a second group receiving MPTP did no exercise and a third group exercised without receiving MPTP. It was found that the MPTP group, which was forced to exercise, caught up with the non-MPTP exercise group and, in terms of speed and endurance, could match them after 30 days. This provides powerful evidence of the benefits of exercise in an animal model.

 

For exercise-testing of patients, use was made of a treadmill with an overhead bodyweight-support suspension harness to allow high-intensity exercise without any danger of falling or injury. Patients were divided into three groups: a high-intensity exercise group with MET 3.5 and above, a low-intensity group with MET below 3.0 and a no-exercise control group (1 MET=1kcal/kg, h). Testing was carried out in 24 sessions, each of 60 minutes duration, over a period of 8 weeks.

The outcomes of the exercise were measured in terms of changes in disease severity, functional performance (stair climbing, stand/sit movements) and brain function testing. This latter test, carried out using Trans-cranial Magnetic Stimulation (TMS) techniques, provided the most significant indications of the benefits of exercise. At various levels of stimulation, TMS was used to provide a Motor Evoked Potential (MEP) response, with peak-to-peak maximum amplitude and cortical-spinal rest time (Silent Period Duration, SPD) being measured independently in both brain hemispheres. This enabled a comparison to be made between the more the less affected sides in Pd patients and between Pd patients and healthy controls. SPD tends to be shortened and MEP shows higher peak-to-peak rest values (hyper excitability) in Pd.

 

Comparison between pre- and post-exercise readings showed that exercise led to a convergence to normal values in Pd patients, with the higher intensity exercises having the greatest effect.

 

A third very engaging talk entitled, 'People with Pd should have weekly Parkinson exercise classes for the rest of their lives', was given by John Argue from San Francisco. John is a former actor and, for the past 23 years, a physical therapist, working with People with Pd.

His approach to exercise and movement is a very practical one, using the activities of everyday life to counteract the restrictions imposed by Parkinson’s. A book he published in 2000 has sold over 20 000 copies and he now has a DVD out containing details of this program.

As an actor, John is able to slip into the role of a Person with Pd (PwP) and gave a completely convincing performance in terms of posture and movement. His somewhat unconventional approach to physical therapy involves three main headings: Stretching – as a preventive measure, countering foreshortening and restrictions of movement, Strength – to prevent muscle atrophication and to maintain ability to perform movement, along the lines of ‘use it or lose it’, Movement strategy – managing movement such that one is mindful of the sequence of actions required to complete the execution of a task. Examples shown included motion sequences associated with sitting down on a chair, rising from a supine position etc. Such sequences are executed automatically, when a person is healthy, but can pose severe problems for a PwP.

 

 John’s program involves 10 lessons, the first 5 of which are performed lying or sitting. Video clips with examples of straight stretch, rotational stretch, tilt side stretch etc. were shown.

Very early on in therapy, PwPs are given fall training, long before falls become a factor in disease progression. Patients are shown how to protect their face and head and how to mitigate the effects of falling.

John emphasized the importance of group therapy, not only in terms of the fellowship created among patients and benefits accruing from getting a sense of control over the disease, but also in as far as it gives caregivers time to rest and recuperate.

 

Addendum: As a spin-off from programs developed for performance improvement of top-class athletes, the University of Frankfurt has been carrying out extensive testing on the effects of various types of motion stimuli. One such program has been aimed at off-season training supplementation for downhill alpine skiers. This has led to development of the so-called Zeptor, a treadmill-like device with two oscillating footplates. This has been in use for past 2-3 years in specialized Parkinson clinics in Germany. Extensive tests in Germany and in Spain have shown it to have positive effects due to interactions between variable-intensity semi-stochastic (random) oscillations and neuro-muscle systems.

Dr Haas, a researcher in the Institute of Sport Medicine in Frankfurt University, has reported on tests showing that exercise/movement of a particular type can lead to nerve growth factors (NGF) being released by nerve cells (through activation of muscle sensors referred to as spindles). NGF initiates a cycle leading to enhanced formation of proteins, thereby assisting in neuron survival and growth. Increased physical activity is thus found to protect nerves but NGF release is dependent on the type and range of movement. Exercise carried out while standing have little or no effect on NGF, swimming has a small effect and treadmill exercises give good results. To achieve the best results, exercises should meet the following criteria:

 

·      Be quasi-rhythmic but with a stochastic element (a degree of randomness)

·      have a frequency of 1-10 Hz, about 5 Hz is optimal

·      involve a learning situation (complexity) and, if possible,

·      have an element of spatial variability.

 

Swimming is apparently too slow to be of major benefit but jogging/walking fast* (over uneven ground) would seem to come close to the ideal. Completely rhythmic or repetitive movements (such as might arise for example when holding a pneumatic tool) lead only to fatigue, with no beneficial effects on the nervous system. To get maximum physiological and neurological benefit, it would appear to be important to exercise on a regular basis because muscular degeneration begins within some days of stopping exercise.

The exercise sessions should involve a challenging degree of intensity, duration and complexity, factors that will vary widely depending on the abilities and impairment status of the individual.

 

Summary: While the benefit of exercise has been appreciated for many years, only in recent times has research begun to unravel the mechanisms underlying this phenomenon and to provide a differential evaluation of what different kinds of exercise can do. Findings that exercise can counteract the effects of neurotoxins and can lead to increases in nerve growth factors are especially encouraging. By establishing a solid basis for the benefits of exercise, it is hoped that patients on a wider front will be encouraged to include it as an integral part of their daily routine.

 

 

 

EXERCISE and other NON-DRUG TREATMENTS

More evidence for disease modifying, neuro-restorative effects of exercise

But which forms of exercise are best?

Excerpt from  Spring Times No 57, October 2010

 

Further evidence was presented at the WPC that:

 

exercise actually causes changes in the brain.

 

Dr Giselle Petzinger, who is Assistant Professor of Research in the Department of Neurology, University of Southern California, told us of new results that further advanced our understanding of the effects of exercise on Parkinson's since SPRING held a conference on this topic last year.

 

Following on from last year when we learned that laboratory animals that had been given a condition resembling Parkinson's could regain function if made to do a significant amount of exercise, the detailed, positive changes in the brain that resulted from exercise were being further teased out.

 

The brain appears to be remarkably plastic. Connections between nerves – the synapses – that are lost as a result of the disease can be regenerated and a class of receptors for the neurotransmitter dopamine which reduce in number with Parkinson's can be restored. Both of these effects result from exercise and both have an effect on symptoms. In Parkinson's certain cells become hyper-excited by the action of excess glutamate and – you guessed – exercise also helps suppress this. Furthermore Dr Petzinger said that it has been found that exercise leads to an increase in the numbers of activated microglia in the brain. These are part of the innate immune system and are the first line of defence against invading pathogens. With exercise, however, their active state is not the destructive one with 'all guns blazing', but a neurotrophic state of activation whose role is to

repair and restore damaged tissue.

 

The bad news, unless you enjoy therapeutic pain,

 

is that for exercise to work well it needs to be intense.

 

An encouraging trainer who can persuade their patients to push themselves quite hard is apparently what is needed. And there is evidence that the sort of exercise that involves a good problem-solving element is the most effective. Good news for those who find treadmill-walking boring – but extending your body by novel physical contortions and exposing yourself to physically and mentally challenging situations could be the right prescription instead.

 

Are you game for it?

 

 

Society looks to stretch the smile muscles in the south

Copied from The Northwest Parkinson’s Foundation Weekly News Update

 

The Herald - The curriculum of Karen Gilmour’s exercise class seems a bit unusual at first glance.

Beyond the regular stretches you might find in an aerobics class,

Gilmour leads her students through exercises that practice voice projection, and even stretch the muscles needed to smile and yawn.

That’s because Gilmour’s course is specifically for people with Parkinson’s disease, and she says every muscle in the body needs to be stretched to prolong the ability to use it.

"I believe exercise can slow (the disease’s) progression," Gilmour said.

And she would know. The North Kildonan resident was diagnosed with Parkinson’s about eight years ago.

It was at that time she joined Parkinson Society Manitoba’s Movers and Shakers program, the official name for the exercise course.
A few years down the road, Gilmour took over as the instructor.

The society currently operates the program in North Kildonan and Transcona, and is hoping to expand it to St. Boniface .

This October, the society will host an open house for the community that will help them assess whether there’s a need for it in southeast Winnipeg.

Parkinson’s disease is a neurological disorder that can cause tremors or shaking, slowness in movement, muscle stiffness and problems with balance.

Symptoms appear when the brain stops producing dopamine, a chemical that helps control movement.

Gilmour says that for many Parkinson’s patients, the automatic nature of movements like picking up a pen or brushing one’s teeth is lost.

"We have to consciously think of things now, because that part of the brain that reminds us is not working," she said.

That’s where exercise can make a huge difference, she added.

It stretches muscles that may not be getting the daily workout they did before a person acquired Parkinson’s, she explained.

And while exercising may not stop the disease’s progress completely, there’s evidence it can slow it down, she said.

"It only makes sense to me. If I use a muscle that is not being automatically used — that used to be — I won’t lose it," she said. "Maybe down the road, but not next year."

Howard Koks, CEO of Parkinson Society Manitoba, said most Parkinson’s patients have some level of awareness that exercise can help them — but like everyone else in the world when it comes to working out, there’s sometimes a gap between theory and practice.

"Everyone knows you should do it, but you don’t," he chuckled.

Gilmour said some people living in the St. Boniface area have been in touch to request their own exercise program, and Koks said the open house will help evaluate just how popular it may be.

Joan Ranick, for one, would be delighted to see a Movers And Shakers program start closer to home.

The Island Lakes resident drives to North Kildonan each week to take part in their class.

And while the drive isn’t too long, she said the class is also a good way to meet other people going through the same challenges with Parkinson’s.

At this point, Ranick said she doesn’t know anyone else in her area with the disease, but having the exercise class could change that.

Ranick, who was diagnosed with Parkinson’s five years ago, added that exercise has become a crucial part of her weekly routine.

"Like anything else, if you don’t use it, you lose it. But I think for Parkinson’s patients it’s especially important.

She said even with the exercise course, she struggles with things like projecting her voice.

"My husband is constantly reminding me to speak up," she said.

But Ranick added that with a disease like Parkinson’s that has no cure, knowing she is doing something to maintain her health is a good feeling.

"It’s kind of empowering to know you can still do some of these things," she said.

Gilmour said that’s the attitude she likes to see.

"We have a responsibility to do our best, no matter what life does to us," she said. "I’m not giving up."

 

 

Parkinson’s patients improve with innovative Waterloo program

Opied from The Northwest Parkinson’s Foundation Weekly News Update

Johanna Weidner

The Record - Bill Watson thought he was managing OK with Parkinson’s, at least until the Cambridge man joined a special exercise program designed to reduce symptoms of the debilitating disease.

Then he realized just how much better he was moving after just a few weeks.

“I noticed what I would call a fairly dramatic improvement,” said the 57-year-old. “I’m much more flexible. I’m much more capable in my movements.”

Best of all, he’s far more able to do the tasks of daily life, even something as basic as walking up and down the stairs of his home.

Watson is enlisted in the innovative exercise program developed at the Sun Life Financial Movement Disorders Research and Rehabilitation Centre at Wilfrid Laurier University.

The centre’s goal, explained director and associate professor Quincy Almeida, is using research and rehabilitation to immediately benefit Parkinson’s patients — to improve the lives of people like Watson.

Recently published research shows their specially designed exercises do just that. People with Parkinson’s disease who joined the 12-week program experienced significant improvements in skills affected by the neurological disease, such as walking, balance and co-ordination.

And when they were assessed again weeks later, those benefits lingered. The disease’s progression had been slowed.

“This is certainly a first for exercise rehabilitation,” Almeida said.

It’s perhaps the best hope for Parkinson’s patients as there has been little progress in combating the disease.

April is Parkinson’s disease awareness month. More than 100,000 Canadians have Parkinson’s disease, and people as young as 30 can be affected.

Parkinson’s is a neurodegenerative disease where cells producing the chemical that carries signals controlling movement between nerves in the brain die. The most common symptoms are tremor, slowness and stiffness, impaired balance and rigidity of the muscles. Other symptoms include fatigue, soft speech, stooped posture and sleep disturbances.

Almeida will share the centre’s latest research at a public talk on April 9 on the Laurier campus.

The idea for the exercise program came from earlier research that lead the centre’s experts to look differently at a severe symptom of Parkinson’s. Freezing is when a person can’t move from where they’re standing.

“Their feet literally feel like they’re stuck to the ground and they can’t lift them,” Almeida said.

It was thought the impairment was caused by the brain not properly sending signals to the body to move. The centre’s findings, which will be published this month in another journal, suggest the problem could be caused by sensory and perceptual issues.

“This freezing may not actually be a problem in the brain,” Almeida said.

That’s how they got the idea to design a rehabilitation program that tackles sensory perception to help Parkinson’s patients with movement difficulties — “exercise that helps you co-ordinate how your limbs are moving,” he said.

Basically, the patients perform specific exercises with their eyes closed to retrain their body how to do certain movements. One group in the study did the exercises with their eyes closed and the other with open eyes.

“The group that had done everything with their eyes closed was much better off,” Almeida said.

Certainly Watson noticed how movements, such as lunges were far more difficult when he closed his eyes. His body had to figure out how to do the movement when it could no longer depend on visual cues.

Participants didn’t just improve in those practised movements, but also in functional measures of how they do in daily activities. For instance, researchers measured the time it took a person to stand up from a chair, take a few steps and then back to the chair. That’s simple for an average person, but a challenging set of movements for someone suffering with Parkinson’s.

Researchers also studied strength training exercises and found that while benefits came with strengthening exercises for Parkinson’s, they were temporary. Many types of exercise have been attempted with Parkinson’s patients, most having no measurable effect on the disease’s symptoms, Almeida said.

Today’s medication can only mask symptoms to help people function better in daily life. The centre’s purpose is finding rehabilitation techniques that are scientifically proven, and then sharing that information across the country to help Parkinson’s patients enjoy a better quality of life.

“Our goal was to find something that people would eventually be able to do in their home.”

 

Not by John Pepper:

The statement in the penultimate paragraph is not correct. All but one type of medication only mask symptoms. The only type that does not mask symptoms but does affect the progression of Parkinson’s disease is the MAO-b inhibitors, namely Azilect, Eldepryl and Parkyline.

 

   

Parkinson's no match for Jill

Copied from The Northwest Parkinson’s Foundation News Update

EUGENE BENSON

Moone Valley Weekly - AFTER almost 50 years of calisthenics, Jill Joss says it's keeping her young.

The 70-year-old is dealing with Parkinson's Disease but refuses to let it interfere with her love for the exercise routines.

The Avondale Heights resident continues to "bring out the best" in hundreds of children from across Melbourne's north and western suburbs at her training school, Avonde.

Her reputation is still bringing students from as far as Ocean Grove, Bacchus March and Sunbury.

And it's just what the doctor ordered.

"Mr doctor says I should never give it up as it's keeping me strong and fit despite the Parkinson's,"

 

Mrs Joss says.

 

"What I always say is, 'I've got Parkinson's, it hasn't got me'."

Calisthenics is a mixture of gymnastics, figure marching, jazz dancing and ballet.

There are 200 calisthenics clubs Australia-wide and Avonde is standing out from the crowd, with its students regularly winning at the highest level of competition.

Last year, the school took home two first and two runners-up awards from the elite-level Ballarat Royal South Street Competition.

Mrs Joss says she loves being involved with teaching, and seeing her students' hard work pay off is a thrill that's hard to beat.

"It's fun and fitness and an art form, but it's classified as a sport so you're a teacher and a coach.”

"And it's great because anyone can do it from three to 93."