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Colin Hoobler: Exercise therapy helps combat Parkinson's effects, studies say

Wednesday August 17, 2011

OregonLive.com - Dear Colin: My dad is 61 and was diagnosed with Parkinson's disease in 2006. His medication helped initially, but not as much now and yields side effects. His balance is worsening, as is his strength and stamina. Can exercise help him? Thanks for any help you can provide.

It's more than likely exercise can help, but a little background first.

Parkinson's disease is a common neurological problem that is mainly the result of damage to an area of the brain that secretes dopamine, a neurotransmitter crucial for normal movement. Standard medical treatment involves drugs that either replace dopamine (Levodopa) and/or augment existing dopamine levels. One major problem with chronic use of these drugs, however, is their effectiveness declines over time while the risk of additional movement dysfunction increases (Neurology 1996).

There's exciting news, however. Studies on the use of exercise therapy in helping attenuate or even reverse Parkinson's symptoms have shown tremendous promise in its ability to stimulate dopamine production while protecting neurons that typically deteriorate in Parkinson's (Neuroscience 2003, Neurobiology of Disease 2003, Neurorehabilitation and Neural Repair 2005).

A compelling benefit of exercise therapy (as long as it's implemented correctly) is that it can be highly effective long-term and yields no side effects. However, its effectiveness largely depends on the willingness of the person with Parkinson's to commit to a therapy program.

Recently at the "Shake It Till We Make It" event at Pumpkin Ridge Golf Club, I had the privilege of meeting former Trail Blazers standout Brian Grant, an inspiring example of this commitment. Grant, diagnosed with Parkinson's in 2008, says, "Exercise is very important in dealing with PD, because when I'm not exercising I really notice (negative) changes in my body, especially my resting tremor." His website (poweringforward.org) is a resource for people with Parkinson's that includes research and insights on the disease.

Barney Hyde, a board member of the Brian Grant Foundation, was diagnosed with Parkinson's in 2005. He considers exercise essential, saying, "Exercise is tremendous. When I don't exercise, I pay a price in the form of increased stiffness and loss of balance."

As a board member, Hyde says the foundation seeks to provide not just answers to common questions on Parkinson's, but also to serve as a communication medium for people with Parkinson's so they don't feel alone.

Recent advances in exercise therapy for Parkinson's combine strengthening, gait training and coordination activities that people can do at home (Archives of Physical Medicine and Rehabilitation 2001). Research findings on exercise therapy for people with Parkinson's appear to be consistent with the experiences of Grant and Hyde, with studies showing significant improvements in gait speed, step length and ease of doing daily activities.

Self-assisted balance exercises that incorporate standing on different surfaces while closing the eyes (Movement Disorders 2000), as well as treadmill training have shown impressive results for people with Parkinson's (Advances in Neurology 1999). Strengthening the lower body (especially the thighs) seems to be a crucial part of rehab, but it must be continued for sustained results.

Even though there isn't a cure for Parkinson's yet, it's inspirational for all of us without the disease to watch those with it fight to maintain their health through hard work and maintaining a positive attitude.

Exercise again proves itself as the "universal" medication for people suffering from a wide variety of diseases, explaining why more and more physicians and physical therapists are using it as a viable treatment option.