Parkinson’s Disease will be diagnosed in approximately 50,000 to 60,000 American’s each year.  Parkinson’s Disease is a movement disorder affecting nearly 2 million people in this country.  It is difficult to diagnose, is often misdiagnosed or remains undiagnosed particularly in the elder population because early symptoms will mimic normal aging.  This information and much more can be found on the website of the National Institute of Neurological Disorders and Stroke (NINDS).

What is Parkinson’s?  According to Wikipedia “it is a degenerative disease of the central nervous system that impairs the sufferer’s motor skills and speech.”  The brain loses its ability to produce dopamine, the chemical that allows the brain to talk with the rest of the body.  The portion of the brain specifically affected is the substantia nigra and the central nervous system.

Some of the symptoms of Parkinson’s include:  tremor, or “pill-rolling”, bradykinesia or slowness of movement, rigidity and stiffness of the muscles and muscle cramps, change in gait (slowness, shuffling, festination or a speedup of gait until the person cannot stop and falls), freezing that occurs in tight places like doorways or cluttered areas, hypophonia (soft speech), drooling, and the mask or lack of facial expression.  These are a few symptoms.  There are many more that affect people with Parkinson’s.  A complete listing of all symptoms can be found on NINDS, or the Parkinson’s Foundation website.

How did I first get involved with Parkinson’s Disease?  We have an excellent local support group that is sponsored by Northeast Health and administered by Suzanne Miller, R.N. B.S.N., C.C.M. Health Services Coordinator of Quarry Hill.  She and I have known one another for sometime, and she knows that I have been teaching T’ai Chi for nearly 20 years.  She asked me to come to demonstrate and talk about the benefits of T’ai Chi exercise for Parkinson’s.  I strongly believe in the benefits of T’ai Chi for supporting the immune system, building lower body strength, improving balance, and helping to deal with stressful situations.  I went on the internet to find several articles supporting the practice of T’ai Chi for the benefit of Parkinson’s specifically.  I gave my lecture and demonstration at the meeting, and stayed for the rest of the breakout session and met with several of the people who have Parkinson’s.  A number of the participants began coming to me for personal training.  In order to better serve this population, I began learning as much as I could about this chronic, progressive disease.  Mayo Clinical has done studies concerning the benefits of T’ai Chi for Parkinson’s.  Cleveland Clinic, Jacksonville Univ., The American Parkinson’s and Movement Disorders Center and others recommend T’ai Chi or similar exercise.  More information is available on their websites or through The American Parkinson’s Disease Association.

As a result of my professional relationship with several people who have Parkinson’s, I developed an idea for a class to accommodate more people. It also gives the people I am training once a week an additional day of exercise that is specific to their disease and affordable.

Our program is entitled New Pathways for Parkinson’s.  The relevance of the title is that the exercises aid in developing new neurological pathways. We have been successful enough with our program that we now have the endorsement of the local neurological group, Pen Bay Neurology and the support group from Northeast Health.

The class uses music appropriate to the age group of the participants.  Music has been shown to be helpful in moving more rhythmically.  The Center for Neurologic Study states “Just as running water does not freeze, so moving muscles do not freeze.” 

Our program begins each week with dance steps.  Sometimes the steps are from Swing, sometimes from Tango, and sometimes from aerobics dance movements.  We also occasionally utilize “Brain Gym” movements.  We go from dance steps to walking balance exercises based on Qigong movements or simple walks such as high knees or “Wooden Soldier”, attempting to swing the opposite arm to leg.  This can be quite challenging because gait is a major symptom.  Parkinson’s generally affects one side of the body more than the other and it is common to see people not picking up their feet to walk.  It is important to have people make a conscious effort to pick up rather than shuffle their feet.  In addition to gait, we work on posture and alignment.

Rest is built into the exercise program.  After the opening portion everyone is encouraged to sit, have some water, and get prepared for the exercises to follow.  Pacing the program is important.  Fatigue is a symptom of Parkinson’s; it can also be a side effect of some of the medications being taken.  Orthostatic hypotension can happen as a result of the disease or as a side effect of some of the medications taken as well.  It is helpful to know if anyone participating has this problem because they can pass out without much notice. We make note of the weather and record the exercises performed on an exercise sheet.  The weather appears to have a direct relationship to how people are feeling.

Everyone who participates in our program has provided a health history with their medications and has notified and received approval from their neurologist to participate.

The next section of the exercise program changes weekly or bi-weekly.  Courses are set up throughout a large, open, well-lit room.  The courses utilize agility poles, cones, balance pods, balance disks, rubber mat ladders, rubber mat drills, and hurtles so participants perform turns, high steps, and patterns sometimes on destabilized surfaces.  As the disease progresses, these tasks become increasingly difficult.  They record information on an exercise sheet.  This task challenges short-term memory.

Participants perform squats, abduction, and calf raises on either a Bosu Balance Trainer or a balance disk.  They do pushups against the wall.  While sitting on stability balls, use tubing to perform rowing exercises for their latissimus dorsi and press backs to strengthen triceps.   We use 10” rubber balls, again while sitting on the stability balls, to work on reaction time. This has to be one of the most fun exercises.  Everyone is throwing the balls back and forth to one another.  Sometimes one person will have more than one ball coming at them.  Everyone laughs a lot during this activity.  This activity definitely helps the reflexes. After all of the exercises have been performed participants go through a series of stretches for the upper and lower body.  We always take this time to yell out the vowels and numbers (sometimes numbers in foreign languages just for fun) and exercise the vocal cords and lungs. 

Toward the end “Chi Balls” are used to work on flexibility particularly torso turns, reaching exercises to further elongate the muscles of the back and neck.   At the end

Qigong breathing exercises are performed, a short “Zen” story is read and neck rubs are given to everyone.  It is a very full hour.  Everyone says how much better they feel after the class than before they came.

This work is rewarding.  It requires a lot of energy and a sense of fun.  The class is kept quite affordable so the people who need the class can easily attend.  The equipment investment is $2,500. to $3,000.  I am presently working on a DVD and workbook to begin training others to use the program.  It works well with aging populations in general.  One participant is a stroke recovery person.  I can see the program working for other neurological movement disorders such as MS.

Usually at the end of the program, participants go to lunch together.  They have become a supportive family for one another. Exercising twice a week has made a huge difference in their lives.