Symposium Panelists to Parkinson's Disease Patients: Exercise Various Options to Fight Back
Thursday, October 13th, 2016
At a recent symposium in Atlanta, the National Parkinson Foundation (NPF) and PD Gladiators presented a variety of exercise programs, ranging from Tai Chi to dancing to non-contact boxing, as proven means to combat progression of the degenerative illness. A panel of nationally recognized medical, therapy and research experts spoke before an audience of nearly two hundred patients, spouses, and care givers, and interactive demonstrations of each option followed. Over 13,000 people in metro Atlanta are Parkinson’s patients.
Dr. Jorge Juncos, MD, Associate Professor of Neurology at Emory University School of Medicine and a Movement Disorder Specialist at the Emory Clinic, explained why people with Parkinson’s disease should exercise. “The cardio-respiratory function and neuromuscular effect of exercise in terms of fitness, stamina, strength, and balance is a major benefit in Parkinson’s disease because one of the things Parkinson’s does, it tends to worsen all of these areas of your life as the secondary outcome of the bradykinesia, the rigidity, the decreased motivation, the fatigue. Those problems have little to do with the dopamine deficiency directly. When you replace dopamine, you’re not addressing any of those directly.” The protective effect of exercise only, however, can actually slow the progression of the symptoms, and, in some cases, has been known to halt the disease itself, effects that medications have not been able to accomplish.
Juncos continued, “We have enough evidence to support what I’m saying now from a large data base. When you exercise, you improve your goal-directed motor learning.”
Dr. Fernando Cubillos, NPF Director of Research Programs, substantiated these data by describing the Parkinson’s Outcomes Project, the largest clinical study of its kind, which includes 8,600 patients currently in 23 clinics. The ongoing data collection, begun in 2009, includes demographics, interventions, caregiver burden, and social data. Answers to questionnaires break down before and after results of exercise, structured versus unstructured, starting dates, early and later, the types of exercises and the intensity.
The role of a physical therapist for designing exercise routines was addressed by Dr. Amy Morse DPT. “The therapist targets the individual impairment for quality and efficiency of movement in everyday life,” said Dr. Morse. She listed five goals of a physical therapy session: address the functional impairment; teach the patient how to think and move differently; establish an individual regular exercise program to do at home; incorporate neuroplasticity principles; and, educate the patient to empower him or her self.
Dr. Joe Nocera, Assistant Professor of Neurology at Emory University school of Medicine, answered the universal question of Parkinson’s sufferers: what is the best exercise for me? “It depends upon the person’s age and the progression of the disease in the individual.” Then he suggested the following: for aerobics, spinning, walking, or jogging; for muscle strength, a program called “Ageless Grace;” for balance, tai chi; for flexibility, yoga. As for the amount of exercise, “Two and a half hours of moderate exercise or one and a quarter hour of vigorous exercise per week,” said Nocera.
The hottest exercise for combating the disease, according to Dr. Morse, is non-contact boxing training, specially adapted for people with Parkinson’s. It provides a better quality of life for both short term and long term improvement. Not only is it a vigorous aerobic exercise, its actions encompass spinal extension, strength, balance coordination, and mental intent. Former professional welterweight boxer, Paul Delgado, who trained at Rock Steady Boxing, the non-profit organization that developed this special boxing regimen, described the program’s elements. “We do calisthenics, punch combinations, shadow boxing, stretching and we focus on multi-tasking. We even have a few members who drive an hour and a half to participate.”
PD Gladiators, a local non-profit, was co-founded two years ago by former attorney-turned novelist, Larry Kahn. He is responsible for encouraging Delgado to organize the Boxing for PD class at Delgado’s gym, as well as creating a network of over 50 dance, yoga, tai chi and general fitness classes adapted for people with PD held throughout metro Atlanta by independent fitness instructors, including the YMCA of Metro Atlanta. Kahn, who has Parkinson’s, said, “The mission of PD Gladiators is to focus the attention of people with PD and the medical community on the role of exercise in slowing the progression of PD and to make community-based exercise programs available to people with PD and their care partners.
“We hope that by demonstrating the value of vigorous exercise and community-based programs to practicing neurologists, they will spark an increase in participation in the PD community by people with Parkinson’s, leading to a more robust exercise/physical therapy infrastructure, a freer flow of information among Parkinson’s patients through increased social interactions, and greater participation in clinical trials.”
Kahn also noted, “Our job is to create a branded network in the Atlanta area to make it easy for patients and doctors to take advantage of the variety of exercise classes available to formulate a safe, effective and sustainable exercise routine.”
As a co-sponsor of the symposium, PD Gladiators’ Kahn speculated that this was probably the first time an event of this kind has been held in the U.S. with such a combination of presentations on exercise and PD by Parkinson’s experts and program demonstrations moderated by the experts. For more information about PD Gladiators, please visit www.pdgladiators.org.
The other co-sponsor of the symposium, Moving Day®, an arm of the NPF, will be promoting a Walk for Parkinson’s on October 23, 2016 in Centennial Olympic Park. Moving Day events have attracted over 80,000 participants and have raised over $8 million to fund cutting edge research and provide local services and programs for patients. The Atlanta walk is in its fourth year, and is one of twenty in markets across the U.S. For more information, visit www.npfmovingday.org or call 1-800-4PD-INFO.