Physical therapy helps a Parkinson's patient exercise
Even if the person with Parkinson's is a couch potato, it's never too late to benefit from exercise. To get started, she should first discuss with her doctor whether she has any health issues that might preclude certain kinds of activities.
- Get workout pointers from a physical therapist. It's important to take advantage of rehabilitative care services such as physical therapy early in Parkinson's disease rather than waiting until problems arise, says Julie Carter, associate director of the Parkinson Center of Oregon, in Portland.
The person with Parkinson's can ask her neurologist for a referral to a PT to help her plan a moderate exercise program. It's preferable to consult someone knowledgeable about Parkinson's disease rather than simply see a trainer at the gym. People with Parkinson's often develop a stooped posture in which their spine and shoulder muscles -- along with other big muscle groups in the arms and legs -- flex forward. Strengthening the major extensor muscles, such as the back shoulder muscles, can work to counterbalance this, but the average personal trainer may not realize the importance of that in Parkinson's patients, says Carter.
Based on an evaluation of the patient's physical condition and her personal goals, the PT can design a targeted program of strengthening, stretching, balance, or aerobic fitness exercises. Your family member can do these on her own or work on them with a gym trainer (make sure the trainer doesn't modify the program without the PT's approval).
- Stretching is key. Because Parkinson's patients tend to become stiff and lose the ability to turn the torso, flexibility exercises are crucial for improving range of motion. In Portland, Carter's center set up classes in pilates, a low-impact exercise system that focuses on breathing and rotating, extending, and flexing the spine. Pilates or a basic stretching routine can make "a big difference in how functional people are over time," says Carter. "You can just see that they're visibly able to take bigger strides, they can reach better, they can turn better."
Similarly, gentle yoga techniques of stretching, breathing, and relaxation can lengthen the spine and extend the big muscle groups, says physical therapist Marilyn Basham of the Parkinson's Institute and Clinical Center in Sunnyvale, California. "If the spine is elongated, breath comes in easier, swallowing is easier, conversation is easier," she says.