These general exercises and suggestions are designed to assist a patient suffering from Parkinson's disease. They are ancillary to medical treatment and should be carried out in consultation with one's physician or neurologist. In certain conditions where other diseases are associated with parkinsonism, the physician may set to limit the intensity of the physical activity. However, more intensive physical therapy may be indicated and in some instances should be done under the direction of a physical therapist should the need arises.
STANDING
1. Stand ln front of a wall, facing it about 8" away. Raise arms and reach as high as possible toward the top of the wall. Lean toward the wall and stretch.
2. With your back to the wall, alternate raising legs as high as possible by bending the knee as if marching in place.
3. Holding on to something secure, squat down as far as possible, bending knees; then come up.
SITTING
1. Sitting in straight-back chair, place your arms behind the chair and bring your shoulders back as far as possible; raise your head up and look at the ceiling.
2. Sitting In the same chair, grip the ends of a broom or mop stick with both hands, try to raise it over your head until you get it behind your head. Keep head and shoulders as erect as possible.
3. Sitting in same chair, place one leg at a time on another chair and press the knee straight. Keep it there 15 minutes. Try both legs together.
4. Sitting in a chair, raise legs up from the knee alternately, as if stamping your feet.
LYING ON A FIRM BED OR FLOOR
1. Lie on the floor or bed, flat on your back; try to press your body to the floor as flat as possible. Move your head from right to left as far as possible. Make sure your head, shoulders, back, and knees touch the surface.
2. Lie on the floor or bed on your abdomen. Do the following one by one:
a. Put your hands behind back and look up to ceiling, trying to raise your chest off the floor.
b. Kick your legs alternately, as if swimming.
c. Turn your head from right to left.
FOR BETTER BALANCE
1. Stand with hands on hips, feet spread apart:
a. Practice marching in place
b. Practice raising leg straight out to the rear.
c. Practice raising leg out to the side.
d. Practice drawing a circle with the leg.
2. Standing with hands at side, feet spread apart:
a. Lean forward and back
b. Lean to both sides
c. Lean in a circular motion and reverse the motion
FOR WALKING
1. When walking, REMEMBER:
a. Take as large a step as possible
b. Raise your toes as you step forward, hitting ground with your heels
c. Keep legs apart and posture straight
d. Swing arms and look straight ahead - your feet know where the floor is located.
2. Collect a dozen magazines; lay them out in a straight line. Space them so that you can take as long a step as possible. Practice walking over these magazines without stepping on them.
3. For a better swing to arms, walk holding a rolled magazine in each hand; keep elbows straight.
4. Practice walking sideways, backwards, and take big steps.
FOR TURNING
1. When practicing turning:
a. Keep feet spread-apart and head high
b. Use small steps; rock front side to side
c. Raise legs from the knees
2. If you feel glued to the floor:
a. Raise your head, relax back on your heels and raise your toes
b. Rock from side to side, bend knees slightly and straighten up and lift your toes
c. It sometimes helps if the arms are raised in a sudden short motion
FOR GETTING IN AND OUT OF A CHAIR
1. If you become glued a few steps before you reach the chair, try this: Don't aim for the chair but some object past it. Pass the chair as closely as possible and as you go by it sit down.
2. To sit down, bend forward as far as possible and sit down slowly. Get close to the chair. Do not fall into the chair.
3. To get up, move to the edge of the chair, bend forward and push up vigorously using your arms; try to count 1 2 3 GO! If you have a favorite armchair, raise the back legs with 4" blocks. This will help you to get up easily. Don't let people drag you up by your arms, but help you by pulling you under your arms, or with a slight push on your back.
FOR GETTING OUT OF BED
1. Place blocks under the legs of the head of the bed. This will elevate the head of the bed, & make it easier for you to sit up and swing the legs off the bed.
2. A knotted rope tied to the foot of the bed can help you to pull yourself up.
3. To get to a sitting position, shift the body down and rock yourself by vigorously, throwing your arms and legs toward the side of the bed.
FOR USING YOUR ARMS AND HANDS
1. Practice buttoning and unbuttoning your clothes; practice cutting food and writing. Squeeze a ball or work with "Silly Putty." Keep your fingers busy many times a day. Tear paper; take coins out of the pocket; play the piano.
2. Always try to dress yourself completely. Use shoehorns, elastic laces, or extra-long shoelaces to get a better grip. Dress in the most relaxed and comfortable position, sitting or standing, but make sure you are in a safe position.
3. To keep elbows straight and shoulders loose, install a pulley in doorway, place a chair under it or slightly in front. Stretch your arms and shoulders in all directions. By working the pulley when seated, you can get a more vigorous pull.
FOR GREATER SAFETY IN BATHTUB AND TOILET
If it is difficult to sit down in a bathtub, try the following:
1. Place a bench, stool or chair inside the tub; have the legs sawed off to tub height. Sit on the chair and soap yourself. Use shower to rinse, or rubber shower extension.
2. Bathtub grab bars are available. Purchase only those that attach securely.
3. Raised toilet seats are commercially available.
4. Toilet armrest for getting on and off the toilet are available.
FOR SPEECH, FACE AND CHEWING DIFFICULTIES
1. Practice singing and reading aloud with forceful lip movements. Talk into a tape recorder, if one is available.
2. Practice making faces in front of a mirror. Recite the alphabet and count numbers with exaggerated facial motions. Massage your face with vigor when washing and bathing.
3. When chewing food, chew hard and move the food around; avoid swallowing large lumps.
Wednesday, December 30, 2009
Ten Basic Exercises for Patients with Parkinson's Disease
The maintenance of normal muscle tone and function is an important aspect of the treatment of parkinsonism. In part, medication administered for the illness achieves this goal. However, to realize the full benefit of the medication, daily exercise and activity are essential. Here is an outline of some of the exercises capable of maintaining muscle power and tone and preventing deformities of the limbs and spine. Their daily performance has proved most beneficial to patients with this illness.
TEN BASIC EXERCISES FOR THE PARKINSON PATIENT
1. Bring the toes up with every step you take. In Parkinson's disease, "you never make a move", without lifting the toes.
2. Spread the legs (10 inches) when walking or turning, to provide a wide base, a better stance, and to prevent falling. It may not look "beautiful," but neither does falling.
3. For greater safety in turning, use small steps, with feet widely separated. Never cross one leg over the other when turning. Practice walking a few yards and turn. Walk in the opposite direction and turn. Do so fifteen minutes a day.
4. Practice walking into tight corners of a room, to overcome fear of close places.
5. To insure good body balance, practice rapid excursions of the body. Backward, forward and to the right and left, five minutes, several times a day. Don't look for a wall when you think you are falling. It may not be there. Your body will always be there to protect you, if you will practice balance daily.
6. When the legs feel frozen or "glued" to the floor, a lift of the toes eliminates muscle spasm and the fear of falling. You are free to walk again.
7. Swing the arms freely when walking. It helps to take body weight off the legs, lessens fatigue, and loosens the arms and shoulders.
8. If getting out of a chair is difficult, rise with "lightning speed," to overcome the "pull of gravity." Sitting down should be done slow, with body bent sharply forward, until one touches the seat. Practice this at least a dozen times a day.
9. If the body lists to one side, carry a shopping bag loaded with books or other weights in the opposite hand to decrease the bend.
10. Any task that is difficult, such as buttoning a shirt. or getting out of bed, if practiced 20 times it day, becomes easier the 21st time.
TEN BASIC EXERCISES FOR THE PARKINSON PATIENT
1. Bring the toes up with every step you take. In Parkinson's disease, "you never make a move", without lifting the toes.
2. Spread the legs (10 inches) when walking or turning, to provide a wide base, a better stance, and to prevent falling. It may not look "beautiful," but neither does falling.
3. For greater safety in turning, use small steps, with feet widely separated. Never cross one leg over the other when turning. Practice walking a few yards and turn. Walk in the opposite direction and turn. Do so fifteen minutes a day.
4. Practice walking into tight corners of a room, to overcome fear of close places.
5. To insure good body balance, practice rapid excursions of the body. Backward, forward and to the right and left, five minutes, several times a day. Don't look for a wall when you think you are falling. It may not be there. Your body will always be there to protect you, if you will practice balance daily.
6. When the legs feel frozen or "glued" to the floor, a lift of the toes eliminates muscle spasm and the fear of falling. You are free to walk again.
7. Swing the arms freely when walking. It helps to take body weight off the legs, lessens fatigue, and loosens the arms and shoulders.
8. If getting out of a chair is difficult, rise with "lightning speed," to overcome the "pull of gravity." Sitting down should be done slow, with body bent sharply forward, until one touches the seat. Practice this at least a dozen times a day.
9. If the body lists to one side, carry a shopping bag loaded with books or other weights in the opposite hand to decrease the bend.
10. Any task that is difficult, such as buttoning a shirt. or getting out of bed, if practiced 20 times it day, becomes easier the 21st time.
Friday, December 11, 2009
Senate Bill 979 on Parkinson's Disease in the Philippines
In the First Regular Session of the Fourteenth Congress of the Republic of the Philippines, Senator Manny Villar introduced Senate Bill 979, which was received by the Office of the Secretary of the Senate on July 4, 2007 at 10:04 AM. This senate bill is the Parkinson's Disease Public Awareness and Education Act. It has been pending in the Committee on Health and Demography headed by Senator Loren Legarda since September 5, 2007. I am reproducing the said bill filed verbatim with this explanatory note from the distinguished Senator.
"Parkinson's disease is a debilitating, painful,and incurable neurological disorder of unknown origin that disrupts and can end the lives of those who suffer from it.
Parkinson's disease causes diverse symptoms, including rigidity,slowness of movement,poor balance and tremors, which lead to impaired ability to walk, speak, swallow,and even breathe, so that the end result can be a clear mind trapped inside a body that has lost its ability to function. The visible symptoms of Parkinson's disease are often mistaken to be a normal part of the aging process.
It has been estimated that thousands of Filipinos have been diagnosed with Parkinson's disease, there are more diagnosed nationally each year, and most of them have never seen a neurologist.
The bill shall include programs such as development of a public education and outreach campaign to promote Parkinson's disease awareness and education, including, but not limited to, the cause and nature of the disease, diagnostic procedures and appropriate indications for their use, lifestyle issues relating to how a person copes with Parkinson's disease, environmental safety and injury prevention and availability of Parkinson's disease diagnostic and treatment services in the community."
"Parkinson's disease is a debilitating, painful,and incurable neurological disorder of unknown origin that disrupts and can end the lives of those who suffer from it.
Parkinson's disease causes diverse symptoms, including rigidity,slowness of movement,poor balance and tremors, which lead to impaired ability to walk, speak, swallow,and even breathe, so that the end result can be a clear mind trapped inside a body that has lost its ability to function. The visible symptoms of Parkinson's disease are often mistaken to be a normal part of the aging process.
It has been estimated that thousands of Filipinos have been diagnosed with Parkinson's disease, there are more diagnosed nationally each year, and most of them have never seen a neurologist.
The bill shall include programs such as development of a public education and outreach campaign to promote Parkinson's disease awareness and education, including, but not limited to, the cause and nature of the disease, diagnostic procedures and appropriate indications for their use, lifestyle issues relating to how a person copes with Parkinson's disease, environmental safety and injury prevention and availability of Parkinson's disease diagnostic and treatment services in the community."
Monday, November 30, 2009
My Brother has Parkinson's Disease
Parkinson's disease involves a breakdown of the nerve cells in the motor area of the brain. As the cells break down, there is a shortage of dopamine. Dopamine is a neurotransmitter, or chemical that carries messages to the body. When there is a shortage of dopamine, the messages that regulate movement aren't sent properly.
The cause of Parkinson's disease is not known. There may be a hereditary tendency to the disease that is worsened by factors in the environment. Some people with Parkinson's disease have an abnormality on chromosome 4. I have yet to find a relative afflicted with the same disease.
There is evidence that Parkinson's disease may be caused by a defect in the body's normal methods for breaking down protein. This defect allows debris to build up in the brain and damage brain cells. The defect may be caused by one or more of the following factors:
- an environmental toxin, such as pesticides
- a gene defect, such as the abnormality on chromosome 4
- a viral infection.
All I can remember about my brother's past medical history is that he had seizures and was diagosed to have encephalitis/meningitis when he was less than a year old.
The symptoms of Parkinson's disease usually begin at about age 60. It is most common in people in their 70s and 80s. Parkinson's disease is twice as frequent in men than in women. Preliminary research suggests that estrogen, a female hormone, may protect against Parkinson's disease.
However, my brother presented the symptoms of Parkinson's disease at the age of 35, initially seen as tremors of the right hand which progressively involved the forearm and then the upper arm later on.
There is no cure for Parkinson's disease. The major goal of treatment is to prevent deterioration. Symptoms can usually be well controlled for several years in the early stages of the disease.
Early in the disease, medications are used. One of the most common medicines is a combination of levodopa and carbidopa. Although this combination is effective, it tends to work less and less over time. Other medications used to treat Parkinson's disease include the following:
- amantadine
- pergolide
- pramipexole
- ropinirole
- selegiline
My brother was intially started on levodopamine and pramipexole with note of decrease in the tremors through time.
Another treatment is surgery. Surgery can include removal of a tiny part of the brain. Another approach is deep brain stimulation with electricity. This is not an option for my brother right now.
People may need other treatments to deal with the many problems associated with the disease. If dementia is present, close monitoring may be needed. Treatment with antidepressants, antipsychotic medications, or sedatives can also help relieve some symptoms. Physical and occupational therapy, as well as speech therapy may help. The use of a service dog and in-home care may be needed.
Other medications may be used in late-stage Parkinson's disease to control symptoms. Medicines can be helpful when there are problems with bladder control, for example. Men with Parkinson's disease may be given medications for erectile dysfunction.
Researchers continue to test new treatments for Parkinson's disease. Implanting fetal cells into the brain of people with Parkinson's disease was recently tried and failed. In some people, the treatment caused severe problems with movement.
Medications used to treat Parkinson's disease may cause abnormal body movements. Other side effects include nausea, drowsiness, confusion, and dry mouth which were all experienced by my brother that he needs to take other medications to counteract the side effects of the drugs.
Surgery may cause difficulty with speech or paralysis on one side of the body.
Deep brain stimulation usually requires more than one operation. There is also a risk of bleeding, infection, or allergic reaction to anesthesia.
People with Parkinson's disease need treatment for life. Hence, this can be a big financial burden for every member of the family.
A family member or caregiver is important when it comes to monitoring Parkinson's disease. They can give the healthcare provider day-to-day input on benefits and side effects of treatment. Any new or worsening symptoms should be reported to the healthcare provider.
The cause of Parkinson's disease is not known. There may be a hereditary tendency to the disease that is worsened by factors in the environment. Some people with Parkinson's disease have an abnormality on chromosome 4. I have yet to find a relative afflicted with the same disease.
There is evidence that Parkinson's disease may be caused by a defect in the body's normal methods for breaking down protein. This defect allows debris to build up in the brain and damage brain cells. The defect may be caused by one or more of the following factors:
- an environmental toxin, such as pesticides
- a gene defect, such as the abnormality on chromosome 4
- a viral infection.
All I can remember about my brother's past medical history is that he had seizures and was diagosed to have encephalitis/meningitis when he was less than a year old.
The symptoms of Parkinson's disease usually begin at about age 60. It is most common in people in their 70s and 80s. Parkinson's disease is twice as frequent in men than in women. Preliminary research suggests that estrogen, a female hormone, may protect against Parkinson's disease.
However, my brother presented the symptoms of Parkinson's disease at the age of 35, initially seen as tremors of the right hand which progressively involved the forearm and then the upper arm later on.
There is no cure for Parkinson's disease. The major goal of treatment is to prevent deterioration. Symptoms can usually be well controlled for several years in the early stages of the disease.
Early in the disease, medications are used. One of the most common medicines is a combination of levodopa and carbidopa. Although this combination is effective, it tends to work less and less over time. Other medications used to treat Parkinson's disease include the following:
- amantadine
- pergolide
- pramipexole
- ropinirole
- selegiline
My brother was intially started on levodopamine and pramipexole with note of decrease in the tremors through time.
Another treatment is surgery. Surgery can include removal of a tiny part of the brain. Another approach is deep brain stimulation with electricity. This is not an option for my brother right now.
People may need other treatments to deal with the many problems associated with the disease. If dementia is present, close monitoring may be needed. Treatment with antidepressants, antipsychotic medications, or sedatives can also help relieve some symptoms. Physical and occupational therapy, as well as speech therapy may help. The use of a service dog and in-home care may be needed.
Other medications may be used in late-stage Parkinson's disease to control symptoms. Medicines can be helpful when there are problems with bladder control, for example. Men with Parkinson's disease may be given medications for erectile dysfunction.
Researchers continue to test new treatments for Parkinson's disease. Implanting fetal cells into the brain of people with Parkinson's disease was recently tried and failed. In some people, the treatment caused severe problems with movement.
Medications used to treat Parkinson's disease may cause abnormal body movements. Other side effects include nausea, drowsiness, confusion, and dry mouth which were all experienced by my brother that he needs to take other medications to counteract the side effects of the drugs.
Surgery may cause difficulty with speech or paralysis on one side of the body.
Deep brain stimulation usually requires more than one operation. There is also a risk of bleeding, infection, or allergic reaction to anesthesia.
People with Parkinson's disease need treatment for life. Hence, this can be a big financial burden for every member of the family.
A family member or caregiver is important when it comes to monitoring Parkinson's disease. They can give the healthcare provider day-to-day input on benefits and side effects of treatment. Any new or worsening symptoms should be reported to the healthcare provider.
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