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Parkinson's Disease and Exercise

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How does Parkinson's Disease affects the body?

Parkinson's Disease disrupts the brain's delicate balance, primarily affecting the production of dopamine. 

As dopamine levels decline, individuals may experience:

  • Reduced control of voluntary movements: Difficulty initiating and executing actions.
  • Freezing: Episodes of sudden immobility.
  • Tremors: Involuntary shaking, often in the hands and limbs.
  • Joint rigidity: Stiffness and resistance to movement.
  • Reduced speech capacity: Soft, slurred, or rapid speech.
  • Increased falls risk: Impaired balance and coordination.

The Stages of Parkinson's Disease

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Common signs include:
  • Mild tremors: Usually beginning in one hand, often at rest.
  • Unilateral motor symptoms: Stiffness or rigidity, particularly in the limbs on one side of the body.
  • Changes in gait: Shuffling gait and slowed movement.
  • Facial expression changes: A mask-like appearance with reduced blinking and decreased facial expression.
While these early symptoms may not significantly impact daily activities, they can progressively worsen over time.
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Individuals may experience:

  • Bilateral motor symptoms: Stiffness and rigidity affecting both sides of the body.
  • Slower movement: Difficulty initiating and completing movements.
  • Speech changes: Soft, slurred, or hesitant speech.
  • Increased challenges with daily activities: Tasks like dressing, bathing, and eating may become more difficult.
  • Emotional changes: Anxiety and depression can arise as individuals cope with the progression of the disease.

While people in Stage 2 can often maintain independence, they may require assistive devices or modifications to their environment to support their daily routines.

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Common symptoms include:

  • Balance issues: Increased risk of falls.
  • Slower movement: Difficulty initiating and completing movements.
  • Festination: Short, rapid steps with a shuffling gait.
  • Fine motor difficulties: Challenges with tasks like buttoning clothes, writing, and eating.
  • Micrographia: Smaller and smaller handwriting.

While individuals in Stage 3 can often maintain independence, they may require assistive devices and support with daily activities.

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Common challenges include:

  • Impaired mobility: Difficulty walking, standing, and transferring.
  • Difficulty with self-care: Challenges with dressing, bathing, and personal hygiene.
  • Swallowing difficulties: Increased risk of choking and aspiration pneumonia.
  • Speech impairment: Very soft, mumbled, or unintelligible speech.

At this stage, individuals often require significant assistance with activities of daily living and may need to consider alternative living arrangements, such as assisted living or nursing home care.

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Key characteristics of Stage 5 include:

  • Severe motor impairment: Significant difficulty with movement, including walking and standing.
  • Cognitive decline: Hallucinations, delusions, and dementia may develop.
  • Reduced quality of life: Significant challenges with activities of daily living, communication, and overall well-being.

As the disease progresses, individuals may require specialized care to manage their symptoms and maintain comfort.

Core Principles of Parkinson's Disease Treatment

Amplitude:
Bigger is Better

Parkinson's Disease disrupts the brain's ability to produce and utilise dopamine, a neurotransmitter essential for smooth, coordinated movement. As a result, individuals with Parkinson's Disease may experience difficulties initiating and executing movements.

The Amplitude Principle

How It Works:

  1. Overproduction Cue: The individual is instructed to perform a movement with greater force and amplitude than typically required.
  2. Brain Response: The brain, perceiving the increased demand, attempts to compensate by releasing more dopamine.
  3. Improved Movement: As a result, the individual's movement becomes smoother and more coordinated.

Maximum
Effort

By increasing heart rate and blood flow, cardio workouts deliver a multitude of benefits to the brain:

  • Enhanced Brain Oxygenation: Increased blood flow carries vital oxygen to the brain, nourishing neurons and improving cognitive function.
  • Neurogenesis: Regular cardio exercise can stimulate the growth of new brain cells, particularly in areas affected by Parkinson's Disease.
  • Neurotransmitter Boost: Cardio activities can elevate levels of neurotransmitters like dopamine, which play a crucial role in motor control and mood regulation.
  • Improved Cognitive Function: Regular physical activity can enhance memory, attention, and problem-solving skills.

Retain Range of Motion (ROM)

Regular exercise and stretching can help maintain flexibility and prevent muscle stiffness.

Regular stretching and mobility exercises are essential for individuals with Parkinson's Disease for several reasons:

  • Improved Posture: Stretching can help counteract the effects of muscle tightness and promote better posture.
  • Increased Range of Motion: Regular stretching can help maintain flexibility and prevent joint stiffness.
  • Reduced Fall Risk: Improved balance and coordination, achieved through stretching and mobility exercises, can significantly reduce the risk of falls.
  • Enhanced Quality of Life: By maintaining mobility, individuals with Parkinson's Disease can enjoy greater independence and a better quality of life.

Nutrition and Parkinson's Disease:
A Powerful Partnership

The Role of
Nutrition & Dietetics

While there's no cure for Parkinson's Disease, nutrition plays a crucial role in managing symptoms and potentially slowing disease progression. A well-balanced diet can:

  • Protect Brain Cells: Certain nutrients, like omega-3 fatty acids and antioxidants, can help protect brain cells from damage.
  • Reduce Inflammation: A diet rich in anti-inflammatory foods can help reduce inflammation in the brain, which may contribute to Parkinson's Disease progression.
  • Improve Overall Health: A healthy diet can boost energy levels, strengthen the immune system, and improve overall well-being.

Why You Need a Dietitian's Help ?
Our accredited dietitians can provide personalised nutrition advice to help you manage Parkinson's Disease. They can:

  • Create a Tailored Meal Plan: Develop a meal plan that meets your specific dietary needs and preferences, while considering any swallowing difficulties or other challenges.
  • Address Nutritional Deficiencies: Identify and address any nutrient deficiencies that may be contributing to Parkinson's Disease symptoms.
  • Manage Weight: Help you maintain a healthy weight, as obesity can exacerbate certain health conditions.
  • Provide Education and Support: Offer guidance on food choices, cooking techniques, and label reading to help you make informed decisions.

Key Dietary Tips for People with Parkinson's Disease

  • Include Neuroprotective Foods:
    • Omega-3 fatty acids (fish, flaxseed, chia seeds)
    • Antioxidants (fruits, vegetables, berries)
    • Vitamin D (fortified dairy products, fatty fish)
    • Vitamin E (nuts, seeds, vegetable oils)
    • B Vitamins (whole grains, legumes, meat)
  • Limit Processed Foods and Sugary Drinks:
    • These can contribute to inflammation and weight gain.
  • Stay Hydrated:
    • Dehydration can worsen constipation, a common issue for people with Parkinson's Disease.
  • Monitor Sodium Intake:
    • Excessive sodium intake can lead to fluid retention and worsen symptoms.
  • Consider a Mediterranean Diet:
    • This diet is rich in fruits, vegetables, whole grains, and healthy fats, which can benefit brain health.

By working closely with a registered dietitian, you can optimise your diet and improve your overall well-being.

"Exercise physiology offers a roadmap to navigate the challenges of Parkinson's Disease, providing a framework for tailored movement that can significantly enhance physical and mental well-being."

If you are in stages 1 or 2 of Parkinson's Disease, book in with our clinicians who are experts in this area.

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Kane Carstens

Exercise Physiologist

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Sarah Davey

Exercise Physiologist

The Allied Health Team is here to help. Start your journey with us!