Forced Exercise

Mr. A. is a 56-year-old man who was diagnosed with PD 8 months ago. He reports slowness with walking, a tendency to drag his left leg, and limited swinging of his left arm when he’s walking. His neurologist started him on 1 mg daily of Azilect, a drug that helps relieve tremors early in the course of the disease. Mr. A. works full time and does not currently exercise. He heard that exercise may be helpful for people with PD but doesn’t know which exercises are best for him and how much he should exercise.

Published studies of psychosocial factors or interventions associated to PDN were reviewed. This included a search of the following electronic databases, from 1946 to up to 10 August 2017: Medline, Embase, PsycInfo, Cinahl, Web of Science, ISRCTN registry, ClinicalTrials.gov registry, and EU Clinical Trials registry. Also, the reference lists of all included papers and of related published reviews (e.g., Eccleston et al., 2015) were screened to identify any additional eligible studies.

When exercise is initiated in the beginning of Parkinson’s disease the chances in prolonging this disease highly increase.

I have become very interested in a healthy lifestyle and been exercising more. It would be such an amazing gift which I would appreciate if you could buy me a heart rate monitor for my birthday. I have been doing research on heart rate monitors and on the other side is a list of five fitness band with heart rate monitoring.

PD is the second most common neurodegenerative disease featured pathologically by the progressive loss of dopaminergic neurons in the substantia nigra. The typical symptoms of PD include slowness of movements (bradykinesia), muscle stiffness (rigidity), tremor, and balance disturbance. Etiopathologically, PD is considered to be caused by the significant loss of dopaminergic neurons in the substantia nigra pars compacta and the subsequent dopamine depletion at the striatum. To date, there are only symptomatic treatments available for PD, particularly in the early stages of the disease. No therapy has been found that can cure or halt the progression of the disease.

Chung et al. (2013), Effectiveness of resistance training on muscle strength and physical function in people with Parkinson’s disease: a systematic review and meta-analysis . I chose this article most relevant because it is systemic peer review and quantitative in nature. In addition, the study selected seven databases (COCHRANE, CINAL, Scopus, Web of Science, ISI, Embase, MEdline ISI and Psycinfo) with full text and from 1946 to 2014. The randomized controlled trial investigating the effects of resistance training on muscle and fall prevention as physical functional activities. The systemic review result which support the hypothesis and demonstrate positive results. The moderate intensity, progressive resistance training 2-3 times per week to 10weeks result in significant strength, fall prevention(balance) and motor symptoms gains. The weakness of the study is they did not compare two kinds of resistive exercises which are more beneficial to improve condition, for instance-resisted static cycling, light weight lifting. I would like to use this article result in my clinical practice in patient with PD to improve muscle strength, balance and to prevent

Individuals who suffer from heart conditions, particularly adult and aged athletes are those who have had previously suffered from high blood pressure, experienced a heart attack or any other heart problems. Prescribed exercises for individuals within this group demonstrates low risk during participation and considerable health benefits. Health benefits through exercise reduces blood pressure levels, however in order to gain full benefits exercise must be linked with a balanced diet (low fat and low salt intake)

A majority of DBS studies have focused on the motor dysfunction seen in PD focusing therapies targeted towards the STN and GPi. Because these studies are well-covered and various literature reviews are already published, we will focus on other anatomical structures of interest. However, after one study conducted a three year follow-up on patients after DBS of the GPi and STN in advanced (also referred to as late-stage, or LSPD) PD, it was discovered that PD patients with STN DBS exhibited better off-phase motor improvement than GPi DBS patients4.

Acupuncture has been used as an implemented complementary therapy to lessen the motor and non-motor symptoms associated with PD. Massage therapy has been reported as a complementary therapy for PD. It purportedly assists in posture and with stiffness that is associated with the disease process. Patients have reported that the speed of their gait improves after massage therapy is implemented (Paterson, Allen, Browning, Barlow, & Ewings, 2005). However, research has demonstrated that although it may have a beneficial impact on the patient’s mood and, subjectively, their quality of life, there is no scientific evidence that this would have any type of long term benefit for their illness progression (Craig, Haber, & Junco,

James et al. (2007) noticed exercise has showed similar effect like antidepressant medication in reducing symptoms of depression in over 156 older MDD patients in his research study. They used graded treadmill exercise testing to check the fitness levels of all the patients before treatment . Researchers compared the effect of exercise on the symptoms of patient’s depression by involving participants in 4 groups .One group is under supervision and the other group involved in a home based program. The other two groups were under antidepressant medications Both exercise groups participated in 30minutes aerobic session such as walking or jogging on a treadmill including 10mins warm up at the beginning and 5 mins cool down at the end. james also mentioned that all the participants were monitored 3 times during their exercise session by checking their heart rates manually via radial pulses, along with ratings of perceived exertion and the home-based exercise group have been followed up by an exerxise physiologist monthly and taking feedback via phone calls every week in the first month and therafter

In this study, “Group A received PT and medication therapy (MT) for 6 weeks, followed by MT only for the second 6 weeks. Group B received only MT for the first 6 weeks and PT and MT for the second 6 weeks(5)”. This study helps show how physical therapy can be applied to many different types of medical fields for any type of recovery. In the conclusion of the study, it stated, “People with Parkinson’s disease derive benefits in the short term from the physical therapy group treatment, in addition to their medical therapy, for quality of life related to mobility, long-term benefits were found in the study, and the total scores but varied between groups(5)”. In simpler terms the patients that received physical therapy and medical therapy at the same time opposed to those who only received the medical side showed much more improvement in the recovery and wellness process. Provided this, it is clear that physical therapy can and is playing a large part in many different medical

Functional neuroimaging study using PET or blood oxygen level-dependent functional MRI frequently demonstrated increased activation in the cerebellum in patients with PD during performance of various upper limb movements (Rascol et al., 1997; Catalan et al., 1999; Wu and Hallett, 2005; Yu et al., 2007; Wu et al.,

In the article, “How to Prevent Injuries During Exercises” by Astrid Bidanec, she explains the necessary steps to take action during exercising. She discusses the importance of a warmup and a cool down, but specifically cooling down the muscles worked by stretching the muscles that were used during the work out. Hydrating before and during exercises, as well as eating nutritional foods before and after are also very important. She compares not drinking water before and during exercises as serious as driving on an “empty tank of gas.” Rest plays a big factor, too. Motivation will keep a person going hard even when the body is tired, but Bidanec discusses the importance of having a rest day in between the weekly exercise routine, and knowing

The decreased physical activities and range of motion are a significant concern in Parkinson’s disease patients. Physical Therapy has been shown to benefit Parkinson’s patients, improving the quality of life. According to the data by Gisbert and Schenkman, research shows that Physical Therapy has a positive short term effect on people with Parkinson’s disease. Exercises such as 2- and 6-minute walk tests, walking speed, step length, Timed "Up & Go" Test (TUG), Functional Reach Test (FRT), have all showed positive results for PD patients. All these exercises relate to Physical Therapy and are based off its principles. One patient in the study said he was able to walk up and down a flight of stairs without help because he had strengthened his

This MOT will focus on initiation of pharmacological management of depression in PD patients without dementia. Brown R.G. et al. concluded that depression in PD can present as either “anxious-depressed” or “depressed” (Brown R.G., et al. 2011). There has been no clear guideline for management of depression in PD. There have not been many large, reliable trials that investigate anti-depressant properties of current PD medications. Currently, dopaminergic drug especially ropinirole has been shown to improve patient’s anti-depression over 24-week period in a double-blind trial (Pahwa R., et al. 2007 cited in Gallagher D.A., et al. 2008). Pramiprexole has also shown to improve depression in two studies. (Corrigan M.H. et al. 2000, Rektorova