Fitness and Exercise Strategies for Persons With Parkinson’s: Difference between revisions

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The aim of Lifestyle Medicine is to treat the underlying causes of disease rather than just addressing the symptoms.  This involves helping patients learn and adopt healthy behaviours. Lifestyle interventions have the potential to impact the prognosis of many chronic diseases, leading not only to better quality of life for many but also potentially reducing their costs to the healthcare system.<ref name=":4">Bodai B. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5638636/ Lifestyle Medicine: A Brief Review of Its Dramatic Impact on Health and Survival]. The Permanente Journal 2017;22(1).</ref> While a tendency to think of Lifestyle Medicine as being the domain of the physician is understandable, other providers such as dietitians, social workers, behavioural therapists and lifestyle coaches are also integral.<ref name=":4" /> It is also well within the scope of the physiotherapist, with diet and nutrition being key elements in many of the conditions managed by physiotherapists, with physiotherapists poised as experts in exercise and movement, and with prevention, health promotion, fitness and wellness being crucial aspects of physiotherapy care.<ref>Worman R. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7015533/ Lifestyle medicine: The role of the physical therapist]. The Permanente Journal. 2020;24:18.192.</ref>
The aim of Lifestyle Medicine is to treat the underlying causes of disease rather than just addressing the symptoms.  This involves helping patients learn and adopt healthy behaviours. Lifestyle interventions have the potential to impact the prognosis of many chronic diseases, leading not only to better quality of life for many but also potentially reducing their costs to the healthcare system.<ref name=":4">Bodai B. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5638636/ Lifestyle Medicine: A Brief Review of Its Dramatic Impact on Health and Survival]. The Permanente Journal 2017;22(1).</ref> While a tendency to think of Lifestyle Medicine as being the domain of the physician is understandable, other providers such as dietitians, social workers, behavioural therapists and lifestyle coaches are also integral.<ref name=":4" /> It is also well within the scope of the physiotherapist, with diet and nutrition being key elements in many of the conditions managed by physiotherapists, with physiotherapists poised as experts in exercise and movement, and with prevention, health promotion, fitness and wellness being crucial aspects of physiotherapy care.<ref>Worman R. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7015533/ Lifestyle medicine: The role of the physical therapist]. The Permanente Journal. 2020;24:18.192.</ref>


The focus of this module will be on discussing strategies for persons with Parkinson's related to '''fitness. T'''his topic will be discussed in terms of various categories including '''aerobic''' fitness, '''flexibility''', '''strength''', '''neuromotor''' function, '''leisure''', '''task-specific''' fitness, and '''mind-body''' fitness.
The focus of this module will be on discussing strategies for persons with Parkinson's related to '''fitness.''' This topic will be discussed in terms of various components including '''mind-body''', '''aerobic''', '''strength''', '''flexibility''', '''neuromotor''', '''task-specific''' and '''leisure''' fitness.
== Sub Heading 2 ==
[[File:Parkinsons Fitness Graphic.png|center|frame|Components of fitness]]


== Sub Heading 3 ==
== Mind-Body Fitness ==
A mind-body fitness regimen can include a variety of activities that combine body movement with mental focus. Practice of controlled breathing is often a feature.
 
* Yoga is one such practice involving assuming and holding various physical postures while performing coordinated, diaphragmatic breathing.<ref>Z Altug. Parkinson's Lifestyle Medicine - Fitness Strategies. Physioplus Course. 2022.</ref>There is evidence that yoga may help manage depression, reduce fall risk, and improve motor function in persons with Parkinson's.<ref>Sagarwala R, Nasrallah HA. The effects of yoga on depression and motor function in patients with Parkinson's disease: A review of controlled studies. Annals of Clinical Psychiatry. 2020; 32(3):209-215.</ref><ref>Van Puymbroeck M, Walter A, Hawkins BL, Sharp JL, Woschkolup K, Urrea-Mendoza E, et al. [https://www.hindawi.com/journals/ecam/2018/8516351/ Functional improvements in parkinson’s disease following a randomized trial of yoga]. Evidence-Based Complementary and Alternative Medicine. 2018;2018:1–8.</ref><ref>Kwok JYY, Kwan JCY, Auyeung M, Mok VCT, Lau CKY, Choi KC, et al. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6583059/ Effects of Mindfulness Yoga vs Stretching and Resistance Training Exercises on Anxiety and Depression for People With Parkinson Disease]. JAMA Neurology 2019;76(7):755.</ref>
* Traditional martial arts such as Tai chi and Karate may improve balance and fall prevention as well as quality of life.<ref>Gao Q, Leung A, Yang Y, Wei Q, Guan M, Jia C, et al. Effects of Tai Chi on balance and fall prevention in Parkinson’s disease: a randomized controlled trial. Clinical Rehabilitation 2014;28(8):748–53.</ref><ref>Fleisher JE, Sennott BJ, Myrick E, Niemet CJ, Lee M, Whitelock CM, et al. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7480843/ KICK OUT PD: Feasibility and quality of life in the pilot karate intervention to change kinematic outcomes in Parkinson’s Disease]. PLOS ONE 2020;15(9):e0237777.</ref> Tai chi, also known as shadow boxing, involves gentle, slow movements and stretching combined with controlled breathing and meditation. Karate, Japanese for "empty hand", employs the practice of stances along with kicking, striking, and defensive blocking movements with the extremities. Qigong is another style of Chinese martial art form combining gentle flowing exercises with mindfulness, and a particular form of qigong is Ba Duan Jin, meaning the "Eight Section Brocades". This uses a combination of eight movements with deep, slow breathing, and it is considered a form of medical qigong intended to improve health.<ref>Long L. Ba Duan Jin exercise, how to practice baduanjin [Internet]. China Educational Tours. China Educational Tours; 2021 [cited 2022Jan17]. Available from: https://www.chinaeducationaltours.com/guide/culture-qigong-ba-duan-jin.htm</ref>  There is evidence that qigong and Baduanjin qigong may improve gait and sleep quality in persons with Parkinson's.<ref>Wassom DJ, Lyons KE, Pahwa R, Liu W. Qigong exercise may improve sleep quality and gait performance in parkinson's disease: A pilot study. International Journal of Neuroscience. 2014;125(8):578–84.</ref><ref>Xiao C-M, Zhuang Y-C. Effect of health Baduanjin Qigong for mild to moderate Parkinson's disease. Geriatrics & Gerontology International 2016;16(8):911–9.</ref> (insert Youtube here)
*
 
== Aerobic Fitness ==
 
== Strength ==
 
== Flexibility ==
 
== Neuromotor Function ==
 
== Task-Specific Circuit Training ==
 
== Leisure ==


== Resources  ==
== Resources  ==

Revision as of 02:05, 18 January 2022

Original Editor - Thomas Longbottom based on the course by Z Altug

Top Contributors - Thomas Longbottom, Stacy Schiurring, Kim Jackson, Jess Bell and Lucinda hampton  

Introduction[edit | edit source]

Approximately 10 million people around the world are currently living with Parkinson’s Disease.[1] Meta-analysis of worldwide data reveals that the prevalence of Parkinson’s Disease increases with age, quadrupling from a level of almost 0.5%  in the seventh decade of life to approximately 2% for those over the age of 80.[2] Other sources report that Parkinson's affects 1.5-2% of the population over the age of 60.[3] Parkinson’s is associated with the loss of dopamine-producing neurons in the substantia nigra of the midbrain, and it is typified clinically by resting tremor, rigidity, and bradykinesia along with a number of non-motor features such as anosmia, sleep behaviour disorder, depression, autonomic dysfunction, and cognitive dysfunction.[4] The aetiology of this disease is not fully understood, but there is some combination of environmental and genetic factors presumed to be causative.[4] Among these are various lifestyle factors such as tobacco use, dietary intake, and physical activity.[5][6]

According to the Lifestyle Medicine Handbook, Lifestyle Medicine involves the use of evidence-based lifestyle therapeutic approaches to treat, reverse, and prevent lifestyle-related chronic disease.[7] These include:

  1. A predominantly whole food, plant-based diet
  2. Regular physical activity
  3. Adequate sleep
  4. Stress management
  5. Social connections
  6. Avoidance of risky substance abuse[7]


The aim of Lifestyle Medicine is to treat the underlying causes of disease rather than just addressing the symptoms. This involves helping patients learn and adopt healthy behaviours. Lifestyle interventions have the potential to impact the prognosis of many chronic diseases, leading not only to better quality of life for many but also potentially reducing their costs to the healthcare system.[8] While a tendency to think of Lifestyle Medicine as being the domain of the physician is understandable, other providers such as dietitians, social workers, behavioural therapists and lifestyle coaches are also integral.[8] It is also well within the scope of the physiotherapist, with diet and nutrition being key elements in many of the conditions managed by physiotherapists, with physiotherapists poised as experts in exercise and movement, and with prevention, health promotion, fitness and wellness being crucial aspects of physiotherapy care.[9]

The focus of this module will be on discussing strategies for persons with Parkinson's related to fitness. This topic will be discussed in terms of various components including mind-body, aerobic, strength, flexibility, neuromotor, task-specific and leisure fitness.

Components of fitness

Mind-Body Fitness[edit | edit source]

A mind-body fitness regimen can include a variety of activities that combine body movement with mental focus. Practice of controlled breathing is often a feature.

  • Yoga is one such practice involving assuming and holding various physical postures while performing coordinated, diaphragmatic breathing.[10]There is evidence that yoga may help manage depression, reduce fall risk, and improve motor function in persons with Parkinson's.[11][12][13]
  • Traditional martial arts such as Tai chi and Karate may improve balance and fall prevention as well as quality of life.[14][15] Tai chi, also known as shadow boxing, involves gentle, slow movements and stretching combined with controlled breathing and meditation. Karate, Japanese for "empty hand", employs the practice of stances along with kicking, striking, and defensive blocking movements with the extremities. Qigong is another style of Chinese martial art form combining gentle flowing exercises with mindfulness, and a particular form of qigong is Ba Duan Jin, meaning the "Eight Section Brocades". This uses a combination of eight movements with deep, slow breathing, and it is considered a form of medical qigong intended to improve health.[16] There is evidence that qigong and Baduanjin qigong may improve gait and sleep quality in persons with Parkinson's.[17][18] (insert Youtube here)

Aerobic Fitness[edit | edit source]

Strength[edit | edit source]

Flexibility[edit | edit source]

Neuromotor Function[edit | edit source]

Task-Specific Circuit Training[edit | edit source]

Leisure[edit | edit source]

Resources[edit | edit source]

  • bulleted list
  • x

or

  1. numbered list
  2. x

References[edit | edit source]

  1. ↑ Statistics [Internet]. Parkinson's Foundation. [cited 2021Dec28]. Available from: https://www.parkinson.org/Understanding-Parkinsons/Statistics
  2. ↑ Pringsheim T, Jette N, Frolkis A, Steeves TDL. The prevalence of Parkinson's disease: A systematic review and meta-analysis. Movement Disorders 2014;29(13):1583–90.
  3. ↑ Venes D, Taber CW. Taber's Cyclopedic Medical Dictionary. Philadelphia, PA: F.A. Davis; 2021.
  4. ↑ 4.0 4.1 Simon DK, Tanner CM, Brundin P. Parkinson Disease Epidemiology, Pathology, Genetics, and Pathophysiology. Clinics in Geriatric Medicine 2020;36(1):1–2.
  5. ↑ Ritz B, Ascherio A, Checkoway H, Marder KS, Nelson LM, Rocca WA, et al.. Pooled Analysis of Tobacco Use and Risk of Parkinson Disease. Archives of Neurology [Internet] 2007;64(7):990.
  6. ↑ Paul KC, Chuang Y, Shih I, Keener A, Bordelon Y, Bronstein JM, et al.. The association between lifestyle factors and Parkinson's disease progression and mortality. Movement Disorders 2019;34(1):58–66.
  7. ↑ 7.0 7.1 Frates B, Bonnet JP, Joseph R, Peterson JA. Lifestyle Medicine Handbook: An introduction to the power of Healthy Habits. Monterey, CA: Healthy Learning; 2021.
  8. ↑ 8.0 8.1 Bodai B. Lifestyle Medicine: A Brief Review of Its Dramatic Impact on Health and Survival. The Permanente Journal 2017;22(1).
  9. ↑ Worman R. Lifestyle medicine: The role of the physical therapist. The Permanente Journal. 2020;24:18.192.
  10. ↑ Z Altug. Parkinson's Lifestyle Medicine - Fitness Strategies. Physioplus Course. 2022.
  11. ↑ Sagarwala R, Nasrallah HA. The effects of yoga on depression and motor function in patients with Parkinson's disease: A review of controlled studies. Annals of Clinical Psychiatry. 2020; 32(3):209-215.
  12. ↑ Van Puymbroeck M, Walter A, Hawkins BL, Sharp JL, Woschkolup K, Urrea-Mendoza E, et al. Functional improvements in parkinson’s disease following a randomized trial of yoga. Evidence-Based Complementary and Alternative Medicine. 2018;2018:1–8.
  13. ↑ Kwok JYY, Kwan JCY, Auyeung M, Mok VCT, Lau CKY, Choi KC, et al. Effects of Mindfulness Yoga vs Stretching and Resistance Training Exercises on Anxiety and Depression for People With Parkinson Disease. JAMA Neurology 2019;76(7):755.
  14. ↑ Gao Q, Leung A, Yang Y, Wei Q, Guan M, Jia C, et al. Effects of Tai Chi on balance and fall prevention in Parkinson’s disease: a randomized controlled trial. Clinical Rehabilitation 2014;28(8):748–53.
  15. ↑ Fleisher JE, Sennott BJ, Myrick E, Niemet CJ, Lee M, Whitelock CM, et al. KICK OUT PD: Feasibility and quality of life in the pilot karate intervention to change kinematic outcomes in Parkinson’s Disease. PLOS ONE 2020;15(9):e0237777.
  16. ↑ Long L. Ba Duan Jin exercise, how to practice baduanjin [Internet]. China Educational Tours. China Educational Tours; 2021 [cited 2022Jan17]. Available from: https://www.chinaeducationaltours.com/guide/culture-qigong-ba-duan-jin.htm
  17. ↑ Wassom DJ, Lyons KE, Pahwa R, Liu W. Qigong exercise may improve sleep quality and gait performance in parkinson's disease: A pilot study. International Journal of Neuroscience. 2014;125(8):578–84.
  18. ↑ Xiao C-M, Zhuang Y-C. Effect of health Baduanjin Qigong for mild to moderate Parkinson's disease. Geriatrics & Gerontology International 2016;16(8):911–9.
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