Exercise is Medicine-Especially for Parkinson’s Disease

What do you think of when you hear the term “Parkinson’s Disease”? Do you think of hand tremors? Do you picture an elderly person, perhaps a grandfather? Although hand tremors are a common symptom of Parkinson’s, and the disease is more likely to affect people 60 and older, there is much more to PD than you may realize.

Parkinson’s disease (PD) is a neurodegenerative disorder that affects predominately dopamine-producing (“dopaminergic”) neurons in a specific area of the brain called substantia nigra. Symptoms generally develop slowly over years. The progression of symptoms is different from one person to another. People with PD may experience tremors, mainly at rest. Slowness of movements (bradykinesia). limb rigidity, gait and balance problems are also symptoms of PD. Non-motor symptoms can include apathy, depression, constipation, sleep behavior disorders, loss of sense of smell, and cognitive impairment.

According to the Michael J Fox Foundation for Parkinson’s Research, while the average age at onset is 60, people have been diagnosed as young as 18. There is no objective test, or biomarker, for Parkinson’s disease, so the rate of misdiagnosis can be relatively high. Estimates of the number of people living with the disease therefore vary, but research indicates that at least one million people in the United States, and more than five million worldwide, have Parkinson’s disease. That is more than the combined number of people diagnosed with multiple sclerosis, muscular dystrophy and Lou Gehrig’s disease (or Amyotrophic Lateral Sclerosis).

Although there is no cure for the disease and the exact cause is unknown, we do know both environmental and genetic factors play a role. Research is ongoing to learn more about the disease, treatments, and someday a cure. Current medications help to manage symptoms. Surgery, known as Deep Brain Stimulation, can help to reduce tremors. Another way to manage symptoms is through exercise. Although more research is needed on how exercise reduces symptoms, or if it actually slows the progression of the disease, we do know that exercise is good for everyone for a variety of reasons.

Exercise can improve daily function such as getting out of bed, standing up from a chair, or dressing oneself. Exercise also improves balance. As a matter of fact, it is the only thing that can improve balance. Medications do not help, and often can increase balance problems. Exercise improves strength which we need for daily activities such as carrying groceries or picking up children or grandchildren. Exercise improves endurance. Exercise improves flexibility. It is difficult to bend down to tie your shoes or reach around for the seat belt in your car without it. We also know that regular exercise helps to lower blood pressure, reduce blood glucose levels in those with diabetes, improve mood to reduce depression and anxiety, and improve sleep.

These improvements will not just help those with Parkinson’s, but almost all of us. So why wouldn’t we prescribe exercise? Prescription medications are necessary, but exercise is medicine as well…without side effects. This time of year, exercise becomes a priority for many Americans as they make New Year’s Resolutions. For people with PD, exercise isn’t just a resolution. It is a necessity. I once heard a Neurologist say, “If I had PD and had to leave my career, my job would be to exercise every day.” That is how important exercise is to those with Parkinson’s Disease, and why we say Exercise IS Medicine.

 

 

How To Start 2016 Out Right

Here we are, another January and another chance to set goals for the new year.  As much as I and others talk about skipping resolutions because they just don’t work, I see so many posts on social media from friends and even former clients about their resolutions to eat healthy, exercise more, stress less, etc.  It seems we can’t get out of the mindset or the habit of making resolutions in January.

What if this year, we change that mindset or habit along with the idea that we have to achieve some level of perfection when it comes to eating right and exercising?  What if we start 2016 by throwing out the idea that we have to join a gym, or commit to some brutal exercise class or program that we don’t really like and we know we won’t be doing a year from now in 2017?

This year, let’s resolve to have balance in our life.  Let’s think of exercise in terms of movement.  Let’s think of “diet” in terms of fueling our body instead of depriving ourselves or giving in to emotional eating.  Let’s think of HEALTH.

Many of us have sedentary jobs, families at home, older parents to take care of, financial stresses, or a number of other commitments that will take priority over the $60 a month gym membership.  Instead of stressing ourselves over the fact that we are “donating” $60 a month because we can’t get to the gym every day, how about we take a walk every day?  It may be on our lunch break, it may be in the morning before everyone is awake and the day has started, it may be at the end of the day to relieve stress.  Is the weather bad where you live?  Find an indoor track, or create a walking path in your house.  Yes, walk in your house.  Put on headphones with your favorite music and walk for 10 minutes.  So what if the dog or the kids are making faces at you!  You’re moving and improving your health.

Do you spend at least 5 minutes before you go to bed checking your phone, email, or Facebook?  Shut off the electronics, and spend that 5 minutes stretching or doing yoga instead.  It will reduce stress, relax your mind and body, and help you to sleep better.  You’re moving and improving your health.

Are you an all day coffee or soda drinker?  Follow each cup of coffee or can of soda with a glass of water.  You may find that you start drinking just the water and cutting back on the soda.  You’re improving your health.

Will you be perfect at these changes?  Of course not, but you will start thinking differently.  Instead of not being aware of how much you haven’t moved, you will begin to think, “I haven’t gone for my walk today”.  That awareness is improvement.  Will something such as illness or work deadlines get you off track? You can count on it!  However, you will start your routine again as soon as you can and not feel defeated or give up. Will you have too much dessert or too much wine?  Probably, but it isn’t the end of the world or the end of your health goals.  Just get back on track.

A healthy lifestyle isn’t about perfection.  It is about making small changes, awareness, and letting go of ideals that never really worked. Start today by looking for opportunities to move.  Walk to your co-worker’s desk instead of emailing her.  March in place tonight while you are watching the news.  Drink one more glass of water than you did yesterday.  Start 2016 out right, but in a way that you don’t have to start all over again in 2017.

The Costs Of Health

Many of you have made your health a priority if you are reading this blog.  However, there are many more who are still contemplating making positive changes to your lifestyle, perhaps you just don’t know where to start.

One of the comments that I hear frequently is that it is too expensive to join a gym or work with a personal trainer.  I completely understand in this economy that we want to be cautious of how we spend our money. However, I want to make a few cost comparisons and break down these costs for you.

On average in my location, many gyms charge around $40-$50 per month for a membership.  Personal training can cost from $30 to $70 per session. That may sound expensive.

However, most of us do not think twice at buying a carryout pizza once a week.  The average cost per month for a carry out pizza is $48 if you order one pizza per week.

Perhaps a sit-down restaurant is more your style. Expect to spend a minimum of $40 per week for
two people to eat out.  Average cost per month, $160.

To get a little more serious, let’s look at the cost of medications for high cholesterol. One medication sells for $75 for a 30 day supply.  It is easy to spend at minimum $100 per month on prescriptions for many conditions which are preventable through exercise and a healthy diet.

Now, I am not saying these medications are bad or one should not take them if needed.
However, they are costly.  $40 per month for a gym membership or $30 to improve your health with a personal trainer does not sound like much when looking at these cost comparisons.

Better yet, exercise doesn’t have to cost anything. Simple exercises such as walking, biking, or doing
bodyweight exercises in your home are free and can benefit both your body and your brain.

You will pay for your health one way or another. You will either pay high insurance and medical costs, or pay for a healthier lifestyle. Make wise decisions and invest in your health.

Morning Energizers

Do you ever find yourself waking up with tightness in your back, legs or shoulders? If you struggle some mornings just to get your body out of bed, try these six stretches to wake up the muscles and get the blood flowing.

The simplest stretch is to lie on your back on the bed or on the floor, point the toes and reach the arms above the head. This is a good stretch to lengthen the spine and stretch the muscles from head to toe.

Next, pull the knees in toward the chest with the hands and hold for 10 to 15 seconds to stretch the lower back.

Release the stretch and lie with the knees bent, feet flat. Tuck the belly in, slightly lifting the pelvis. Then lift the lower back slightly, pressing the pelvis into the bed for pelvic tilts. Perform five sets.

In the same position, lift the hips off the bed or floor, keeping the abdominals contracted for a glute bridge. Hold the stretch for 10 to 15 seconds.

Next, extend the legs and lift the legs and shoulders off the floor or bed, keeping the abdominals contracted for a modified Pilates 100 stretch. Hold for 3 to 5 seconds and repeat.

Finally, perform the Cobra stretch lying on your stomach. Place the hands next to the shoulders and lift the upper body, allowing the hips to remain on the floor or bed. Hold for 10 to 15 seconds.

These stretches will energize your body and get you moving a little easier in the morning!Image

Exercise, Parkinson’s Disease and Hope

We all know the benefits of exercise. Exercise can help a person lose or maintain weight, gain lean muscle, lower blood pressure, control blood glucose, lower cholesterol, strengthen bones and joints, give a person the functional strength needed for daily activities, improve mood, reduce depression….I could go on and on.

I have been a certified personal trainer for 15 years. Before I began a career in fitness, I worked in healthcare in Orthopedics, Physical Therapy, and Occupational Therapy. I have seen what exercise can do for a person and what the lack of exercise results in. As a personal trainer, I specialize in working with individuals with chronic conditions and older adults. My clients range from post-physical rehabilitation, to post-stroke, cardiac rehab, diabetes, MS, and Parkinson’s disease. A few years ago I began to read studies about the benefits of exercise for individuals with Parkinson’s disease. Since my dad died from complications due to PD, I was very interested in pursuing more information. I became certified as a Delay the Disease Exercise for Parkinson’s instructor, started a local class, then later took over another area class after the instructor moved out of state.

Now, it seems as if you line up ten physicians, including neurologists, and ask them if exercise is beneficial for Parkinson’s Disease, you will likely get ten different answers. Many have done their own research and while they may say they do not have scientific evidence on exercise and PD, I haven’t heard anyone recommend NOT to exercise. The debate seems to be over if exercise can change the brain which would make an impact on Parkinson’s Disease symptoms.

According to the Parkinson’s Disease Foundation, neurons – the brain cells that produce the chemical transmitter dopamine are damaged and lost in Parkinson’s. There is a lag between the time when the loss of neurons begins and the time when Parkinson’s motor symptoms, such as tremors or slowness of movement begin to show. It is estimated that by the time most people are diagnosed, nearly 80 percent of their dopamine neurons are gone.

The good news is that the brain is actually changing, compensating for the loss of dopamine neurons. Scientists call this ability to change and compensate “exercise-dependent neuroplasticity”. The belief is that exercise may contribute to neuroplasticity by helping the brain to maintain old connections, form new ones, and restore lost ones. Research done by Giselle M. Petzinger, M.D., Assistant Professor in the Department of Neurology, Movement Disorders Division at USC, along with other research shows intense, specific and complex exercise improves walking and other motor skills in people with Parkinson’s.

I am not a neurologist or a physician, nor do I claim to have the knowledge they have. I have not spent hours doing research on the brain. However, I do know what many of my participants and clients with Parkinson’s disease have experienced from exercise. Many have seen their balance improved, their gait has improved, their range of motion and flexibility has improved, and their ability to get up out of chair has improved. Just as important, I see improvements in their mood, confidence, anxiety levels, and their outlook on life.

You see, there is no cure for Parkinson’s disease. Some, like my dad, hear that and they sit in a chair and wait to die. However, many, many more want to fight as long as they possibly can. They want to stay active and be able to complete their activities of daily living. I recently heard someone say, “Parkinson’s is not a death sentence, it’s a life sentence”. I don’t expect exercise to cure PD, but it does help just as it helps many other diseases. I once had a neurologist, who was not keen on my presentation of the Parkinson’s exercise program (his research showed no results with exercise on Parkinson’s disease) tell me, you don’t want to give people false hope. I don’t see it as false hope, I see hope. I see helping people to find a bright spot in their day and celebrate improvements regardless of how small. I see caregivers who come to class and help their loved ones with the exercises and even do the exercises themselves.  I see people who had never met, getting to know each other and sharing their experiences.  If something as simple as exercise can give hope and help you walk through life a bit better, why wouldn’t you do it?

 

Kris Cameron, B.S.

American Council on Exercise Certified Personal Trainer

Delay the Disease Certified Instructor

Arthritis Foundation Certified Instructor

YMCA Active Older Adults Certified Instructor

Take A Walk!

If you are thinking of starting an exercise program but not sure which form of exercise is right for you, walking may be the answer. Walking is one of the easiest forms of exercise for most individuals and presents the lowest risk of injury. All you need are comfortable clothes and supportive shoes. Walking can result in numerous health benefits including lower blood pressure, improved cholesterol levels and increased energy. According to the American Council on Exercise, an eight-year study of 13,000 people found that those who walked 30 minutes a day had a significantly lower risk of premature death than those who rarely exercised. In addition, research has shown that regular walking can decrease total and intra-abdominal fat and reduce your risk of developing diabetes or breast cancer.

Whether the walk is around the block, in the mall or on the track, start slowly if you are new to exercise. An easy 10 minute walk is all it takes to get started. Walk at a “conversation pace”, which means to walk at a pace where breathing is increased but you can carry on a conversation. Do this every day to get into a routine. As the walk becomes easier, add 5 more minutes of walking time. Experts recommend at least 30 minutes of exercise for health benefits. Set this as your goal and work toward increasing the amount of time that you walk. You can also split up the time in 10 to 15 minute increments throughout the day. For example, take a 15 minute walk in the morning and a 15 minute walk in the evening to accumulate 30 minutes.

 If you need a little extra motivation as you progress in a walking program, try using a pedometer throughout the day. 10,000 steps is the recommended daily guideline, which is approximately 5 miles. A sedentary person may only average 1,000 to 3,000 steps per day. There are many ways to get walking time in such as planning a walk with your family or friends on a trail, parking further away from the store, taking the dog for regular walks, taking a “walking break/lunch” at work, or using the stairs instead of the elevator to increase activity. Whatever you choose, set your goal and stick with it!

Stop The Fitness Insanity!

I admit I am not much of a TV watcher.  I don’t have cable, I watch a lot of PBS, and my favorite series is a British TV program that I watch through Netflix.  If you ask me if I’ve watched this week’s episode of some new series or reality program, I may not know what you are talking about.  I thoroughly despise (yes, that’s a strong word) reality shows.  I think they are part of the downfall of our society (hey, I’m being honest).  However, I have in my cable days viewed enough of these programs to know that I don’t like the Biggest Loser.  Yes, the stories are motivational and touching.  Yes, I have shed tears when a participant has overcome incredible odds to change their health and weight.  However, I can’t stand what the show is doing to the business of personal training and to the hopes of average people who can’t spend months at the Biggest Loser camp. If you are my personal training client, you know I’m not a screamer.  I don’t criticize you because you can’t flip a 200 pound tractor tire (and I won’t make you do that anyway).  I don’t yell at you that you are lazy or unmotivated.  I don’t have you do plyometric jumps if you have problems with your knees.  I don’t make you run sprints if I know your body can’t handle it.  If you want that, there are trainers out there you can call.  I try to be patient and understanding, but motivate you at the same time.  I want you to continue to exercise and have a healthy lifestyle on your own, so I have to teach you.  Maybe I should be considered a teacher instead of a trainer.

Here are my issues with the Biggest Loser.  The trainers act more like Marine Drill Sargeants.  They want to beat you down mentally to get you to do what you need to do.  The trainers have participants do very unsafe exercises.  If you are 65 years old and have problems with your hip, you shouldn’t jump on and off a 2 foot plyo-box.  The participants are living at a camp, not in real life.  Their meals are planned and prepared, they workout for hours each day, they basically have someone watching them and holding their hands 24 hours a day.  They don’t go to work, pick up kids from school, change their plans because the kid puked in their bed in the middle of the night, make dinner for a picky family, run from work, to the grocery store, to home to make dinner, to baseball practice, then back home to help with homework before getting their kids to bed at a decent time, then clean up after the dog who pooped on the floor….you get the idea.  Their 5-10 pound a week weight loss is not realistic, nor sustainable.  Safe, sustainable weight loss is anywhere from 1/2 lb to 2 lbs per week.  Sure you can drop a lot with some crazy diet and even crazier workouts.  But I can guarantee that you will put that much, plus some back on within a year of stopping the crazy diet and workouts.

Unfortunately, there are trainers who will train like this and clients who expect to be trained the same way.  I’m sad to say that my industry is not regulated.  TV trainers aren’t always certified trainers.  There isn’t the same accreditation that say a college has to be able to give you a certification.  There are some trainers who received their certification with an online quiz and base their training on their own workouts (or the Biggest Loser).

Good health, if you don’t have it, is a process and you have to be patient.  Here is the reality check:  You didn’t gain the weight in one day and you won’t lose it all in one week.  My workouts alone will not change your body completely if you don’t change the way you eat.  Exercising once a week will not help you to lose weight if you don’t do anything the other 6 days.  Flipping tractor tires and pushing cars will not be a friendly activity for your back.  These fad workouts, fad diets, and reality shows are not reality. 

We should all be in this for a healthier lifestyle.  Weight loss is great, lowering blood pressure is fantastic, having more energy is a great goal, being able to carry your groceries or your kids up the steps is fabulous.  So you won’t look like a celebrity, who wants to?  Wouldn’t you rather be happy and healthy and be there for your family?  Our reality (REAL reality) is not what is seen on TV.  Be a smart media consumer and stop the insanity!