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Physiotherapy management for Parkinson’s Disease

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Research has shown that regular exercise benefits people with Parkinson’s disease. Exercise reduces stiffness and improves mobility, posture, balance and gait. Aerobic exercise increases oxygen delivery and neurotransmitters to keep our heart, lungs, and nervous system healthy. General exercise may also reduce depression. Learning-based memory exercises can also help keep our memory sharp. It is also important to keep variety in exercise activities, because individuals with Parkinson’s disease often have difficulty in shifting from one activity to another or in performing two activities at the same time. Exercises that require balance and preparatory adjustment of the body are also important along with rhythmic activities such as dancing, skipping and cycling can maintain the ability to perform reciprocal movements. Finally, exercises that promote attention and learning are beneficial.

Exercises that require large, rhythmical movements through a full range of motion have been shown to decrease rigidity. For example, in a program of aerobic exercise using music, there was a reduction in rigidity in 9 out of 10 participants immediately after the exercise program. Exercises to decrease stiffness are:
  • Large, rhythmical movements
  • Rotating the trunk
  • Vibration, rocking and swinging
  • Other considerations to decrease stiffness:
  • Avoiding tremors (e.g. touching the limb that is shaking to quiet the movement) can also decrease tension
  • Decreasing stress in one’s life – having fun, thinking positively about planning and
  • carrying out challenging, socially engaging and learning-based activities
  • Cooling or warming the tense extremity can sometimes be helpful.

The exercise guidelines for people with Parkinson’s disease are no different from those without the
disease (i.e. 4-5 times a week for at least 30-40 minutes). This assumes that your heart is beating at 70 to 80% of maximum (220 – your age times 70 or 80%).
Make the exercise time fun:
 
  • Engage in group exercise, movement or dancing classes. For many, participating in activities
  • with other people, can be more stimulating and increase compliance.
  • Stay active and integrate exercise into your usual day:
  • Walk whenever possible instead of driving
  • Climb the stairs instead of taking the elevator
  • Take regular 5 minutes breaks every 30 minutes (lifting the arms up over your head,
  • performing wall glides, breathing diaphragmatically, getting up to get a glass of water, or
  • putting TheraBand on chairs to work on some strengthening
  • Avoid long periods of time watching TV and or using a computer


 

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