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Parkinson's Disease

What is Parkinson’s?
It is a progressive neurological disease that affects the substantia nigra in the brain. What does this mean? There is a center in your brain that produces a chemical called dopamine. This chemical is used in the body to produce purposeful, smooth movement. For example when you reach for a cup of coffee your hand does not shake. In someone who has Parkinson’s their hands shake as they do not have the motor control from the missing dopamine.

How many people are diagnosed with Parkinson’s?
Believe it or not 60,000 people are diagnosed with this disease every year. This disease affects 1 million Americans. How does Parkinson’s get diagnosed? There is not one specific test that diagnosis Parkinson’s. Most people who are diagnosed have noticed a change in their movement for quite some time before they tell the doctor their symptoms. Usually people start to notice 3 things: slowed movement (bradykinesia), tremor, and rigidity. The doctor may perform some clinical tests such as an MRI to verify a change in the brain. They may also prescribe Levodopa which is the clinical form of dopamine to help replace what is missing in the body. If the person responds to the medication, this is a positive finding for having Parkinson’s.

How do we treat Parkinson’s?
There is no cure for Parkinson’s; however there are some treatment options to help with the symptoms of the disease. One treatment option is taking medication. As stated above, taking Levodopa and other meds may help hide the symptoms of Parkinson’s. Another treatment option for those that have a significant tremor is a deep brain stimulator. The stimulator is inserted surgically behind an ear, which connects to a certain part of the brain to help control motor symptoms.

Another treatment option, which I find fascinating, is exercise. There are clinical studies which are starting to prove that exercise actually helps restore the parts of the brain which are affected by Parkinson’s. This is called neuroplasticity. These studies have found that early exercise resulted in no behavioral impairment and attenuated dopamine loss. Lack of exercise resulted in behavioral asymmetry and dopamine loss. Exercise may also initiate a cascade of cellular events responsible for protecting vulnerable neurons. Isn’t this great? This is “sit on the edge of your seat” exciting!

Who can help provide the amount of exercise needed for Parkinson’s? A physical therapist is a highly trained professional who can help a person with Parkinson’s start out in the right direction. A therapist who is trained in treating Parkinson’s would be even better. There is one program which is proving to be the most beneficial for these people and it is called the LSVT BIG Program. It is specifically geared towards the Parkinson’s population. It started with speech therapists who realized people with Parkinson’s spoke very softly, so they created exercises to make them Louder. This was a huge success with huge outcomes. Then a couple physical therapists tagged along and created exercises to get Parkinson’s patients moving Bigger. This program has also had huge success.

Why does the program work better than regular physical therapy? This program’s foundation is built on increasing neuroplasticity. There are key principles to increasing new growth in the brain: intensity, complexity, repetition, salience, timing, and specificity. No other program addresses these components better than the LSVT program. New research which compared LSVT to regular physical therapy showed better long term retention in movement with those who participated in the LSVT program.
What can a person with Parkinson’s expect in this program? Four weeks of intense physical therapy to help re-learn what has been lost. This program can be modified for those with advanced stages of Parkinson’s and for those who have just been diagnosed. I have been certified in this program for 3 years and every patient that graduates has seen success.

Exercise is medicine. This is a mantra those with Parkinson’s should say to themselves every day to help avoid the negative impact of Parkinson’s on the body.

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