Parkinson’s Patients with Tendency to Fall Control Balance Differently than Non-Fallers, Study Suggests

Parkinson's fall risk

Parkinson’s disease patients who have a tendency to fall use different strategies to control their balance than those who do not fall, according to a recent study.

The study, “Fallers with Parkinson’s disease exhibit restrictive trunk control during walking,” was published in Gait and Posture.

Due to Parkinson’s-related motor imbalance, falls are a common consequence of the disease, and the risk of falling increases as patients get older and as the disease progresses.

Parkinson’s patients are twice as likely to fall than older adults living independently, and are also nine times more likely to have recurrent falls.

Observational studies suggest these patients underestimate the amount of work necessary for their muscles to produce a certain movement. They compensate for this lack of motor and perceptual ability by adopting distinct postural strategies to keep their balance during both static and dynamic movements.

Static measures of posture control can distinguish Parkinson’s patients from healthy older adults, but not Parkinson’s fallers from non-fallers.

“A better understanding of the relationship between falls and static and dynamic movements may provide further insight into falls-risk assessment in this clinical population,” the researchers said.

To study this, researchers at the University of Ottawa in Canada conducted a study that recruited 25 Parkinson’s patients and 17 healthy older adults used as controls.

They analyzed postural differences between Parkinson’s fallers and non-fallers, based on the self-reported occurrence of falls in the previous three months, and between healthy controls.

Motor disability was measured using the Unified Parkinson’s Disease Rating Scale III, cognitive impairment by the Montreal Cognitive Assessment, and freezing of gait by the Freezing of Gait questionnaire.

Participants were given static and dynamic motor tasks, consisting of one quiet standing condition and one walking condition (walking 15 meters while looking straight ahead).

Both tasks were presented twice and lasted for 30 seconds. Testing was performed while patients were optimally medicated with dopaminergic therapies.

The standing test was sensitive enough to distinguish between Parkinson’s patients and healthy controls, but not between fallers and non-fallers with Parkinson’s disease. However, static tasks were less sensitive in differentiating between fallers and non-fallers with Parkinson’s disease and healthy older adults than dynamic tasks.

Fallers had difficulty controlling their upper body (torso) when walking, compared with non-fallers and the control group. This was also true for individuals with Parkinson’s disease versus older healthy adults.

Importantly, falling was associated with static and dynamic postural control in Parkinson’s patients, with fallers and non-fallers adopting different postural strategies to regulate balance.

“Overall, this study provides useful information for falls-risk assessments as well as for developing fall prevention program specific to fallers and non-fallers with PD,” the researchers concluded.

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Source: Parkinson’s News Today

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What Is Helping Me the Most in My Parkinson’s Battle?

 

No two Parkinson’s disease patients are alike

I am slowly coming to realize that each diagnosis of Parkinson’s disease (PD) is unique. PD patients suffer different symptoms and different rates of disease progression. Some remedies work for some, and not for others.

In many cases, those of us with PD are left to our own devices. Doctors can only suggest options for us. As for medications, in the end, we must listen to our bodies very carefully to determine what will and what won’t work. The ultimate goal is to find the right “cocktail” of drugs so that PD symptoms are masked and there are few or manageable side effects. Sadly, my experience has been that changes in medications and dosages have not given me aha! moments where I can see a significant reduction in symptoms. If there are any improvements, they are extremely subtle.

Is it the weather?

Many of my fellow PD sufferers have shared their struggles with the appearance of a possible new symptom or worsening of existing symptoms. Is it something we ate? Or do we chalk it up to a bad PD day? Could it be fluctuations in barometric pressure or is it part of the normal aging process? Is our disease progressing or have we taken our medications at the wrong times? Should we have eaten more food or had more water with our pills? Did we get enough sleep or are we too stressed? The list goes on and on. With PD, there is so much uncertainty. It is very difficult to determine what is helping my symptoms or slowing the disease progression, and what is not.

What do I think has helped me the most?

I leave no stone unturned in my efforts to combat this disease, especially when it comes to exercise and movement alternatives.

In September 2017, I started Rock Steady Boxing twice a week.

Boxing has been one of the most effective tools in my arsenal for fighting PD. It has given me the confidence to feel like the athlete I once was. Boxing helps me improve my stamina, speed, and strength, and the participants (everyone in the class has PD) offer great support and camaraderie. As I set out on my one-hour commute to Rock Steady Boxing class twice a week and put on my hand wraps and gloves, I truly feel like a warrior getting ready for battle.

helping
(Photo by Michael Heller)

Boxing and movement, in general, have helped me the most in my daily struggles with this disease. In no particular order, I also credit the following with helping me in my war against PD:

  • Physical therapy once a week (for balance)
  • Massage once or twice a week (for stiffness and rigidity)
  • Yoga two times per week and meditation for 20 minutes up to five times per week (to train me to be in the moment, and not focus on the prognosis of this disease)
  • Attitude adjustment (accepting that I have this disease and counting my blessings)
  • Sinemet (carbidopa-levodopa), medication to relieve internal tremors

Treating PD appears to be all about finding the right combination of some or all of the following components:

  • Exercise
  • Diet
  • Supplements
  • Prescription medications

A formula for one PD patient may not work for another PD patient, and the plan must continuously be tweaked. As difficult as it is, we must reduce our stress levels. I believe both good and bad stress exacerbate our symptoms.

In a future column, I will share some of my experiences with the Rock Steady Boxing classes.

***

Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to Parkinson’s disease.

The post What Is Helping Me the Most in My Parkinson’s Battle? appeared first on Parkinson’s News Today.

 

Adaptive fitness class focused on Parkinson’s patients

Registration is now open for Adaptive Fitness at EW Motion therapy. Taught by Katie Cederberg (ACSM CPT) Adaptive Fitness is designed for Parkinson’s patients to increase overall fitness through evidence-based, safe, and effective full body workouts. The class seeks to improve participant balance, strength, flexibility, and mobility with adaptive exercises using exercise bands, medicine balls, weights, and Kettlebells. All exercises are adapted to fit each person’s strength and individual needs, including the option for chair, or wheel-chair based exercises.

The cost is $30 per class or $200 for 8 sessions. The class is taught each Saturday at 10:30 AM. CLICK THIS LINK TO SIGN-UP FOR THE CLASS ONLINE.

Katie Cederberg, ACSM CPT, is a doctoral student in the Rehabilitation Science Program at the University of Alabama at Birmingham, where she dedicates her time and effort to increasing physical activity and exercise for people with physical disabilities. She received her Bachelor’s degree from Linfield College in McMinnville, Oregon and her Master’s Degree in Exercise Science from Central Washington University. She previously worked as a fitness specialist at Oregon Health and Science University in Portland, Oregon where she developed individualized exercise programs for people with and without disabilities.

The Apple Watch just got a lot better at tracking symptoms of Parkinson’s Disease

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The Apple Watch will soon be able to track tremors experienced by Parkinson’s Disease patients to help them manage their condition.

Later this year, Apple will release a software update to make it easier for medical researchers to understand the difference between a random movement, and the shakes and dyskinesia that Parkinson’s patients experience when they’re getting treated with medications.

Apple made the announcement this week at its developer conference, WWDC.

The new “movement disorder API” will accelerate research that’s already underway in how wearable devices can be used to track the progression of Parkinson’s, said Peter Schmidt, a Parkinson’s researcher and vice dean of the Brody School of Medicine at East Carolina University, who has been advising Apple’s health team.

About 60,000 people are diagnosed every year with Parkinson’s in the U.S. alone and an estimated 10 million people have the disease globally. Not all of these patients will have access to an Apple Watch, or be able to afford one, but Apple is starting to work with health insurance companies like Aetna in figuring out ways to subsidize the cost.

CLICK TO READ THE FULL ARTICLE

Source: CNBC

Brian Grant Won’t Back Down From Parkinson’s Disease

by Chris Ballard

He could hear the roar from the back hallway of the Rose Garden, the clatter of 20,000 fans.

For years, Brian Grant had fed off that roar, back when Blazers fans wore T-shirts that read “Rasta Monsta” and embraced him as they had few others. Never the fastest, biggest or most skilled, Grant got by on hustle and desire. What was it Tim Duncan once said? “Hardest-working guy in the league. You’ve got to respect that cat.” And Grant took pride in that. On playing an entire season with a torn labrum. On never backing down, whether it was guarding Karl Malone or levering his 6’9″ frame into Shaquille O’Neal. On trying harder than anyone else. He got out of Georgetown, Ohio, by not trying; survived 12 years in the league by trying; tore up both knees by trying.

But now, standing in that concrete corridor on a November night in 2008, two years after his final NBA game, Grant felt only fear and anxiety. He was there to honor an old friend, former Blazer Kevin Duckworth, who’d died of heart failure at 44. All Grant needed to do was be present. Wave, bow his head, pay his respects. And yet he’d already sweated through his white undershirt, the perspiration breaching his blue button-down and threatening his navy blazer. He thought about ducking into the bathroom to towel off, maybe even bolting the arena. Read more at Sports Illustrated…

Source: Sports Illustrated