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

 

Cell Study Provides Hope for Treatment of Parkinson’s Disease

By Alice Melão

Deregulation of calcium levels in nerve cells has been linked to early symptoms of Parkinson’s disease. Now, researchers at Aarhus University have found that inhibition of a protein called SERCA can prevent calcium variations and protect nerve cells from degeneration.

This finding may open new therapeutic avenues to treat Parkinson’s motor symptoms, but also non-motor symptoms such as sleep disorders, gastrointestinal problems, anxiety, and depression.

The study, “Alpha‐synuclein aggregates activate calcium pump SERCA leading to calcium dysregulation,” was published in the journal EMBO Reports.

The team showed that in nerve cells with the same type of stress involved in Parkinson’s disease, there is a significant loss of calcium, a basic element in the body without which cells cannot function and eventually die.

The reason behind this observation seems to be the fact that in these cells, α-synuclein aggregates — protein aggregates thought to be behind Parkinson’s development — interact and activate a calcium pump known as the SERCA protein. Interestingly, this process is specific to α-synuclein clumps, as isolated molecules did not interact or activate SERCA.

To further confirm the relevance of these findings, the team analyzed samples of human brain collected from patients affected by dementia with Lewy bodies, characterized by α-synuclein aggregates. They again found the same pattern in which α-synuclein clumps interacted with SERCA and promoted calcium transport outside of the cell.

“The study indicates that the treatment of calcium disturbances is meaningful because the nerve cells are protected. This may help to prevent the disease from developing into such a disabling disease as would otherwise be the case,” Cristine Betzer, PhD, investigator at the brain research centre DANDRITE at Aarhus University and lead author of the study, said in a press release.

By inhibiting SERCA activity with a chemical compound that specifically blocks SERCA in a worm model of Parkinson’s, calcium levels became more stable and cell survival improved. Importantly, inhibition of SERCA protected nerve cells from α-synuclein aggregates’ neurotoxic stress.

“Experiments in the United States with similar models have shown that once the worms with the Parkinson’s protein have lived for eight days, their nerve cells begin to die. In our study, we treated the worms with an inhibitor against the calcium pump and then counted the nerve cells in the worms. And there were many cells left. Which is a sensational and encouraging result,” Betzer said.

Although these findings cannot be directly translated to the human disease they can open new study opportunities that may be useful for the development of new, more efficient therapies.

“Our study points towards the usefulness of treating patients throughout the whole course of the disease, as the calcium pump will otherwise continue to pump and thus contribute to the patient’s symptoms,” Betzer added. “Perhaps the protection of nerve cells can also mean that the damage caused by Parkinson’s disease in the brain does not develop as severely as it otherwise would.”

The post Cell Study Provides Hope for Treatment of Parkinson’s Disease appeared first on Parkinson’s News Today.

Source:: Parkinson’s Today

Pre-clinical research may slow effects of Parkinson’s

by: ABC 33/40

ABC 33/40′ spoke with two people who live with the disease about new findings from Purdue University researchers.

Published in the scientific journal Molecular and Cellular Neuroscience, the researchers say they have pinpointed an important compound in the development of Parkinson’s disease in the brain.

Their work could be significant because it may impact how we treat the disease in several ways: like better therapies, new drugs and earlier diagnoses or preventative care.

Two men gave reporter Patrick Thomas a glimpse into what new treatments in their lives could do.

Whether he stands or sits, with shaky hands and trembling feet, Parkinson’s is life for Wayne Cook for the last ten years. “The things that you, used to take for granted,” Cook says as he tries to raise his left hand to his chest but can’t hold it still. “The fine motor skills are difficult.”

The same goes for Ken Cater over the last nearly 13 years of his life. “But you know it’s tough. Right now I’m dealing with a progressive disease,” says Cater.

Which Purdue University researchers say when they located the compound called Acrolein, it may lead to discoveries that alleviate symptoms of Parkinson’s. Cook tries to explain how it affects his speech. “You get something here (points to his brain) and then you know what you want to say, but it just stops right here. It won’t come out all the way.”

Cater explains what he thinks most fighting the disease want right now. Cater says, “The Holy Grail that we are looking for right now is something that can slow or stop the progression of the disease.”

Right now the research includes work that has been tested in animal models and cells, not humans.

Cook says he is even willing to be a part of any research that may eventually include human testing. “I’m anxious for it to happen. If they have got a study and they need volunteers I raise my hand,” says Cook.

But through the research, scientists say they lessened and reversed effects of Parkinson’s using the drug Hydralazine

Since it’s still only pre-clinical research Cater says he will wait and see. “I’m hopeful for a cure in the near future if not at least better treatments,” he says.

If you have questions about living with Parkinson’s as a patient or caretaker, the Parkinson Association of Alabama may be able to help.

Source: Pre-clinical research may slow or reverse effects of Parkinson’s, patients weigh in

Tears May Be Used as Biological Marker to Detect Parkinson’s Disease

By Jose Marques Lopes, PhD

Tears may be used to diagnose Parkinson’s disease, according to preliminary findings of a study that will be presented at the 2018 American Academy of Neurology’s (AAN) Annual Meeting in Los Angeles, California, April 21-27.

“We believe our research is the first to show that tears may be a reliable, inexpensive and noninvasive biological marker of Parkinson’s,” Mark Lew, MD, the study’s author from the Keck School of Medicine of University of Southern California, said in a press release.

Parkinson’s disease is mainly characterized by selective loss of neurons that produce dopamine in a brain area called substantia nigra. Patients with Parkinson’s typically exhibit Lewy bodies – protein clumps mainly composed of aggregated alpha-synuclein – in the brain, leading to nerve damage and disease progression.

Besides pathological changes in the brain, the disease also affects nerve function in the periphery. As the secretory cells of the tear gland are stimulated by nerves, researchers hypothesized that nerve changes in Parkinson’s could result in altered protein levels in tears.

The scientists collected tear samples from 55 Parkinson’s patients and 27 healthy controls who were the same age and gender.

The tears were analyzed for the levels of four proteins. The results revealed that levels of normal, non-clumped alpha-synuclein were lower in Parkinson’s patients than in controls. However, levels of unhealthy, aggregated alpha-synuclein were increased in tears of Parkinson’s patients (1.45 nanograms per milligram of tear proteins versus 0.27 nanograms, respectively).

Researchers hypothesize that the secretory cells in the tear gland could themselves produce these different forms of alpha-synuclein, which would be secreted directly into tears.

“Knowing that something as simple as tears could help neurologists differentiate between people who have Parkinson’s disease and those who don’t in a noninvasive manner is exciting,” Lew said.

“And because the Parkinson’s disease process can begin years or decades before symptoms appear, a biological marker like this could be useful in diagnosing, or even treating, the disease earlier,” he added.

Nonetheless, larger studies need to be done to evaluate whether these changes in alpha-synuclein levels can be detected in tears from Parkinson’s patients before symptoms start.

The post Tears May Be Used as Biological Marker to Detect Parkinson’s Disease appeared first on Parkinson’s News Today.

Source:: Parkinson’s Today

Naked Art to celebrate Valentine’s, raise money for local causes

PAA is thrilled to be the beneficiary of a Parkinson’s Patients Art Show, hosted by Naked Art Gallery. Below is a great article from Iron City Ink that details the personal connection between Parkinson’s Disease and Vero Vanblaere, owner of the Naked Art Gallery.

Read more

Source: Iron City Ink

Parkinson’s Foundation Enrolls 10,000th Patient in Largest Clinical Trial of the Disease Ever

By Carolina Henriques

The Parkinson’s Foundation has enrolled the 10,000th patient in the largest clinical trial of the disease yet to be conducted.

Among the critical discoveries so far, the research has shown that regular visits to neurologists, more exercise, and more attention to mental health could help improve patients’ wellbeing.

The Parkinson’s Outcomes Project is evaluating a broad range of factors associated with the disease, including medications, treatments, movement symptoms, cognition, anxiety and depression, and the disorder’s burden on caregivers.

Launched in 2009, the project has become a comprehensive platform for studying the lives of Parkinson’s patients. And it has led to the formation of a consortium of 29 experts in five countries.

The study includes over 100 people who have lived with Parkinson’s for more than 30 years and 83 who learned about their diagnosis before they were 30 years old. Its records include 25,000 visits to doctors and information from almost 9,000 caregivers.

Key conclusions drawn from the study include:

Regular visits to neurologists should be a priority for patients and caregivers because it could save thousands of lives a year.

Recent research has listed regular visits to a neurologist as an important step in Parkinson’s management. However, in a 2011 study, only 58 percent of 138,000 Parkinson’s-related difficulties led to neurologist care. Race was a significant demographic predictor of neurologist treatment, with non-whites being less likely to receive care.

Doctors should give patients’ physical activity more attention because studies have shown that increasing exercise and movement to at least 2 1/2 hours a week can slow the decline in patients’ quality of life.

Researchers have found that, in Parkinson’s, it’s not the type of exercise a patient engages in, but the frequency of the workout that’s important. Physical therapists recommend exercises whose goals include improving balance and coordination, flexibility, endurance, and strength.

Patient’s mental health should be a priority because researchers have found that depression and anxiety are leading factors in patients’ overall health.

Depression is one of the most common non-movement symptoms of the disease, with up to 60 percent of patients affected at one time or another.

Finally, doctors should do a better job of addressing gender differences between patients. A key reason is that many men can rely on wives and other family members for daily support and doctor visits. Women are less likely to have family caregiver support and be more frequent users of formal, paid caregiver services.

This discovery is supported by recent findings that confirm these gender disparities, such as a study in Neurology in 2017.

“We have obtained a wealth of information in what now represents the broadest and most inclusive patient population ever assembled in a clinical study of Parkinson’s,” Peter Schmidt, the senior vice president of the Parkinson’s Foundation, said in a press release. He has been directing the study.

“This project is truly innovative in that it not only follows thousands of patients over time, but that it studies everyone with Parkinson’s, from the newly diagnosed to people who have lived with the disease for 30 years or more,” added Thomas Davis, the study’s co-chair.

Researchers have been using the Parkinson’s Foundation’s Centers of Excellence network of 42 medical centers to enroll patients in the study.

In addition, “we are studying the quality of Parkinson’s care delivered at our Centers of Excellence to help patients who aren’t being seen at one,” said Fernando Cubillos, who oversees the study’s operations. “Our goal is to help identify the best care and disseminate that information widely.”

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Source:: Parkinson’s Today