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Dr. Okun

Post of the Week: Exercise, Use it or Lose it in Parkinson's Disease

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Dear Forum Members,

 

In a recent review article, Archer et. al. espouse the view that because of accumulating evidence supporting the positive effects of exercise PD patients should take notice. They have advocated the use it or lose it principle. Of course we need more research but certainly there are benefits to general health and PD from exercise. Here is the abstract:

 

Acta Neurol Scand. 2010 May 17. doi: 10.1111/j.1600-0404.2010.01360.x. [Epub ahead of print]

Exercise alleviates Parkinsonism: clinical and laboratory evidence.

Archer T, Fredriksson A, Johansson B.

 

Department of Psychology, University of Gothenburg, Gothenburg, Sweden Department of Neuroscience Psychiatry Ulleråker, University Hospital, Uppsala, Sweden.

Abstract

Archer T, Fredriksson A, Johansson B. Exercise alleviates Parkinsonism: clinical and laboratory evidence.
Acta Neurol Scand: DOI: 10.1111/j.1600-0404.2010.01360.x.
© 2010 John Wiley & Sons A/S. The present review examines the putative benefits for individuals afflicted with Parkinsonism, whether in the clinical setting or in the animal laboratory, accruing from different exercise regimes. The tendency for patients with Parkinson's disease (PD) to express either normal or reduced exercise capacity appears regulated by factors such as fatigue, quality-of-life and disorder severity. The associations between physical exercise and risk for PD, the effects of exercise on idiopathic Parkinsonism and quality-of-life, the effects of exercise on animal laboratory models of Parkinsonism and dopamine (DA) loss following neurotoxic insults, and the effects of exercise on the DA precursor, l-Dopa, efficacy are examined. It would appear to be case that in view of the particular responsiveness of the dopaminergic neurons to exercise, the principle of 'use it or lose' may be of special applicability among PD patients.

 

© 2010 John Wiley & Sons A/S.

PMID: 21108623 [PubMed - as supplied by publisher]

 

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Dear Dr Okun,

 

Thank you for posting this article. Personally speaking, it requires quite an effort to sustain exercise over a period of time and regular reminders and encouragements such as this are a big help.

 

kind regards

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I would heartily recommend regular exercise. I've exercised regularly for many years. But my exercise went down dramatically a few years ago, before I was diagnosed. Once I got my medications adjusted well (which took almost two years), I was able to exercise a lot more (instead of fifteen minutes twice a week, I now do 30-40 minutes every day). The more I exercise, the better I do - more energy, longer on times. And the more energy I have, the easier it is to exercise. So I've gone from a downward spiral (little energy, little exercise, less energy, even less exercise...) to an upward one. I've gone from feeling like a semi-invalid to almost back to my old active self.

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We recommend that each person with PD see a physical therapist to be evaluated for safety of an exercise program. There are a wide range of choices. In people with severe gait and balance problems exercise must be performed with the assistance of someone to avoid falls and injury. Many people with balance problems do supervised exercise on a recumbent stationary bike (seated and supervised).

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Fortunately, my balance is good enough that I can now walk and run. Before my medications were well-adjusted, though, I used an exercise (stationary) bike. And I still use it a couple of days a week. The elliptical machine is also good, since you hold on to handles while you're using it, and I used to use it a lot. It mimics running motion, without the pounding or the balance issues.

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