by Jeremy Parker

Many sufferers of Parkinson's disease quickly find that various aspects of their life are no longer controllable in the way that they used to be however by exercising regularly Parkinson sufferers can continue to control their gross movements i.e. walking,holding objects etc. for longer which adds a mental and emotional boost to their well being. Research has shown that exercise may also improve the synthesis of dopamine in the brain and increase the levels of neurotrophic factors which are beneficial compounds.

Exercise for people diagnosed with Parkinson's disease incorporates muscle strengthening, flexibility and toning activities so that muscles and joints stay flexible and strong. It is normal for a physiotherapist to implement an exercise schedule for the patient that includes a range o factivities to work all muscles of the body over a two or three day period. So for example, day one of the cycle may include walking and strengthening exercises for the arms and hands whereas day two might be a yoga class where flexibility of the joints is the main focus.

It is essential to monitor the patients progress, not only so that any improvements and decreases in function are recorded but also as a stimulus for the patient; when people see improvement and can visualise the effort that they put in they are much more positive about continuing the regime.

In general exercise should test the entire body and not just the limbs so that posture and movement is maintained for a slong as possible. Good posture is essential in the later stages of Parkinsons disease because stooping can hamper breathing and swallowing. Exercises for posture include callisthenics, yoga, Pilates,tai chi, and swimming however not every sufferer will enjoy these types of activities. Simply sitting upright while reading a book or watchingTV and walking with a straight back will also help though, thus walking the dog or playing with the children or grandchildren are great ways to work the body muscles and to enjoy daily exercising.

Regular exercise for the Parkinson's sufferer will reduce the incidence of muscle cramps, rigidity of the joints and the aches and pains associated with staying still for long periods of time. Also, because exercise helps the sufferer to maintain control over many of their gross movements (although maybe not the tremors) it gives them a heightened sense of achievement and so stress and anxiety levels remain low.Keeping a positive mental attitude is incredibly important in conditions like Parkinson's disease where sufferer can very easily become frustrated and discouraged with their predicament.

As with all exercise routines, the patient should start with a good warm up followed by the exercise activity of their choice or which has been scheduled for that day, and then they should finish with a positive cool down so that the chances of developing muscle cramps and injuries are greatly reduced. An exercise session should ideally last around 15-20 minutes and should not by any means exhaust the patient. Overexertion can be equally as damaging to a Parkinson's sufferer as no exercise at all.

In order to make daily exercise more appealing and less of a chore it maybe worth trying to find a friend or relative that is willing to exercise with the patient. Also, a bit of variety in the type of exercise will not only mean that the exercise stays interesting but it will also ensure that all muscles and joints of the body are used to a satisfactory level.

J Neurol Neurosurg Psychiatry.

Authors: Mller T, Muhlack S

BackgroundFollowing cued levodopa (LD) intake, endurance exercise showed abeneficial effect on scored motor performance in patients withParkinsons disease (PD) in comparison with rest. This may result froman exercise induced increase in endogenous dopamine synthesis. As aresult, beneficial effects on movement and reactivity may occur.Objectives To measure reactivity and motor performance in a repeatedfashion with instrumental tasks after cued administration of soluble 200mg of LD/50 mg of benserazide. Design PD patients consecutivelyperformed paradigms, which assess reactivity and movement performance,after a standardised period of rest or of age-related, heart rateadapted endurance exercise on two consecutive days in a random order.Results Reactivity and execution of simple and complex motion serieswere significantly better following exercise than after rest. DiscussionEndurance exercise has a beneficial effect on reactivity and movementbehaviour in PD patients following cued application of LD probably dueto an augmented synthesis and release of dopamine and othercatecholamines and release in the prefrontal cortex, the nucleusaccumbens and the basal ganglia. Small changes in catecholaminemodulation of prefrontal cortex cells can have profound effects on theability of the prefrontal cortex to guide behaviour. Previous exercisemay also improve pedunculopontine nucleus function, which is involved inmotor-related attention processes.

By Michael Hutch PhD

Various forms of yoga have beenscientifically shown to handle and perhaps even remedy variouspersistent diseases. Listed below are various medical issues that havebeen proved scientifically to be improved by yoga.

Asthma: Yogabreathing exercises possibly could assist sufferers of mild asthma andmay help decrease their use of low-dose drug inhalers in wheezingattacks. Researchers from the Respiratory Medicine Unit, CityUniversity, Nottingham, call for added studies of ways of improvingbreathing mastery which they say have been largely unheeded by Westernmedicine. while yoga practitioners have long believed in the benefits ofpranayama breathing exercises for asthmatics, this has been difficultto examine formally. But, using a Pink City lung a device that imposesslow breathing on the user and can mimic pranayama breathing exercises it was possible to measure the effects of controlled breathing in ahospital test. Two simulated pranayama exercises were tested: slow deepbreathing and breathing out for twice as long as breathing in. Inasthma, the airways become restricted making breathing difficult. It isincreasing in the UK, with more than three million children and adultsaffected, and are responsible for 2,000 deaths annually. The doctorsused standard clinical tests to measure the volume of air patients wereable to blow out in a second and to test the irritability of theirairways. After yoga, their airways were two times less irritable.

Parkinsonsdisease: Yoga has a key purpose in management of Parkinsons as it hasemerged as a helpful alternate therapy and an ideal mode of exercise forParkinsons patients because of its gradual movements. Following thesteps mentioned below could successfully help individuals withParkinsons: 1. Concentrate on controlling your breath (Pranayama) asthis brand of yoga helps in moments of panic such as feet sticking tothe flooring when walking. In this form of yoga, the mind is alwayswatchful. 2. Few yoga exercises like back strengthening postures, lotsof shoulder movements, breathing practices and some meditationpositively helps. 3. One of the most useful forms of yoga used forParkinsons is Ashtanga Yoga. It works to strengthen the body andperform increases blood circulation. 4. day-to-day practice of yoga isall-important since Parkinsons itself does not inevitably weaken themuscles. Weakening of muscles is ordinarily caused by lack of motion.Daily exercise should be encouraged, but not enough to generatetiredness. 5. Parkinsons also result in the loss of motility of thefacial muscles. Pranayama and supplementary yoga movements could aid inrelaxing those muscles and bring a smile on the face of the patient.

Diabetes:Diabetes in a lot of forms affects up to 5percent of the worldpopulation with 12 million diabetics in Western Europe alone. Of theunique ways in which diabetes presents, noninsulin-dependent diabetesmellitus (NIDDM) is probably the most usually encountered geneticcondition. NIDDM or Type II diabetes is multifactorial, depending alsoon environmental factors including obesity, sedentary lifestyles andnutritional imbalances. One of the studies conducted to cure diabeteswas the one set up by the Yoga Biomedical Trust, founded in 1982 bybiochemist Dr Robin Monro, and an Indian yoga research foundation whichdiscovered that practicing yoga for 30 minutes a day for one monthhelped reduce blood glucose levels in some diabetics.The yoga patientstook part in one or two 90-minute sessions a week and were asked topractise at home. The classes included the particular yoga exercises ofthe spinal twist, the bow and abdominal breathing. At the conclusion ofthe 12 weeks blood sugar levels fell significantly in all patients inthe group and were slightly raised in a control group which had notjoined in the yoga sessions. Three yoga students managed to cutbacktheir medication, including one man who had not altered his drug regimenfor 20 years. It is not necessarily the exercise element of the yogatherapy package which is most significant, as there is not adequatephysical exercise to account for the changes, but stress decrease has alot to do with it. Stress hormones increase sugar levels in the blood.individuals also benefit from the stabilisation of their moods whichyoga brings, an increased perception of well-being and a belief of beingmore in mastery, which may assist with their diet control andconsequently their diabetes.