Parkinson's Disease or "PD"

The Perfect Step Approach

While some healthcare professionals might be prone to prescribing medications to reduce tremors and progressive onsets of Parkinson’s, The Perfect Step believes that “Exercise is Medicine.” While exercise is important for most anybody to live, it can be a pivotal component for individuals living with Parkinson’s in increasing or maintaining balance, mobility, and basic movements to daily living. Intense exercise-based therapy, which is facilitated at TPS, can help contribute to slower declines of quality of life, rather than those who choose to not participate in exercise or making the body move. While there is not a cure or an exact science to preventing Parkinson’s or the onset of the disease, TPS believes that through participation in their exercise program, that clients can not only have better quality of life, but they also might be able to reduce and/or regain control of their tremors, which inhibit them.

What is Parkinson's?

Parkinson's disease (PD) is a neurodegenerative disorder that affects predominately dopamine-producing (“dopaminergic”) neurons in a specific area of the brain called substantia nigra. Symptoms generally develop slowly over years. The progression of symptoms is often a bit different from one person to another due to the diversity of the disease. People with PD may experience:

  • Tremor, mainly at rest and described as pill rolling tremor in hands. Other forms of tremor are possible

  • Slowness of movements (bradykinesia)
  • Limb rigidity
  • Gait and balance problems

The cause remains largely unknown. Although there is no cure, treatment options vary and include medications and surgery. While Parkinson’s itself is not fatal, disease complications can be serious. The Centers for Disease Control and Prevention (CDC) rated complications from PD as the 14th cause of death in the United States.

The first step to living well with Parkinson’s disease is to understand the disease and the progression:

It is possible to have a good to great quality of life with PD. Working with your doctor and following recommended therapies are essential in successfully treating symptoms by using dopaminergic medications. People with PD need this medication because they have low levels or are missing dopamine in the brain, mainly due to impairment of neurons in the substantia nigra.

It is important to understand that people with PD first start experiencing symptoms later in the course of the disease because a significant amount of the substantia nigra neurons have already been lost or impaired. Lewy bodies (accumulation of abnormal alpha-synuclein) are found in substantia nigra neurons of PD patients.

Scientists are exploring ways to identify biomarkers for PD that can lead to earlier diagnosis and more tailored treatments to slow down the disease process. Currently, all therapies used for PD improve symptoms without slowing or halting the disease progression.

In addition to movement-related (“motor”) symptoms, Parkinson’s symptoms may be unrelated to movement (“non-motor”).People with PD are often more impacted by their non-motor symptoms than motor symptoms. Examples of non-motor symptoms include: apathy, depression, constipation, sleep behavior disorders, loss of sense of smell and cognitive impairment.

In idiopathic Parkinson’s disease, progression tends to be slow and variable. Doctors often use the Hoehn and Yahr scale to gauge the progression of the disease over the years. The scale was originally implemented in 1967 and it included stages zero to five, where zero is no signs of Parkinson’s and five is advanced PD. It was later changed to become the modified Hoehn and Yahr scale.

Causes & Statistics

Parkinson’s disease (PD) is an extremely diverse disorder. While no two people experience Parkinson’s the same way, there are some commonalities. Parkinson’s affects about one million people in the United States and ten million worldwide. The main finding in brains of people with PD is loss of dopaminergic neurons in the area of the brain known as the substantia nigra.

Symptoms

Parkinson’s disease (PD) symptoms may be related to movement (motor symptoms) or unrelated to movement (non-motor symptoms). Each person with Parkinson's will experience symptoms differently. For example, many people experience tremor as their primary symptom, while others may not have tremors, but may instead have problems with balance.

By definition, Parkinson’s is a progressive disease. Although some people with Parkinson’s only have symptoms on one side of the body for many years, eventually symptoms will also affect the other side. Symptoms on the other side of the body often do not become as severe as symptoms on the initial side.

Treatment

There is no standard treatment for Parkinson’s disease (PD). Treatment for each person with Parkinson's is based on his or her symptoms.

Treatments include medication and surgical therapy. Other treatments include lifestyle modifications, like getting more rest and exercise.

There are many medications available to treat the Parkinson’s symptoms, although none yet that reverse the effects of the disease. It is common for people with PD to take a variety of these medications — all at different doses and at different times of day — to manage symptoms.

While keeping track of medications can be a challenging task, understanding your medications and sticking to a schedule will provide the greatest benefit from the drugs and avoid unpleasant “off” periods due to missed doses.

Exercise

Exercise is an important part of healthy living for everyone. For people with Parkinson’s disease (PD), exercise is more than healthy — it is a vital component to maintaining balance, mobility and activities of daily living. Exercise and physical activity can improve many PD symptoms. These benefits are supported by research.

The Parkinson’s Outcomes Project shows that people with PD who start exercising earlier and a minimum of 2.5 hours a week, experience a slowed decline in quality of life compared to those who start later. Establishing early exercise habits is essential to overall disease management.


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Beau Morris