Monday, December 18, 2017
Health

Whether it's cycling or boxing, vigorous exercise can ease Parkinson's symptoms

Exercise helps with everything from weight loss and depression to warding off heart attacks, stroke, diabetes, even cancer.

For years, doctors have been telling their patients that exercise helps with the symptoms of Parkinson's disease, too, but now they're getting some help from organized exercise programs designed specifically for Parkinson's patients.

The classes are usually led by specially trained and certified instructors who have learned about the disease and how to work with those who have it.

Parkinson's is a neurodegenerative brain disorder that slowly and progressively robs patients of control over their bodies. For reasons that are not fully understood, the brain stops producing dopamine, a chemical necessary to relay messages that control smooth, coordinated body movement.

It usually takes years to produce symptoms, and the earliest signs are often dismissed as tiredness, stress or simply aging. By that time, dopamine production is down 60 to 80 percent. After that it can take months or years to become disabling.

Nothing stops Parkinson's from worsening. Eventually it causes movement problems such as slowness, stiffness, stooping posture, a feeling of being frozen in place, foot dragging and shorter, shuffling steps. Medications and certain surgical procedures may help. But exercise is almost always part of the prescribed treatment plan.

Now there's some evidence that intense exercise — the kind that makes you breathe hard and sweat — may hold off worsening symptoms longer than anything else.

"A number of studies have looked at slowness, stiffness and tremor, and exercise has clearly demonstrated benefits lasting from hours to days," said Dr. Robert Hauser, director of the USF Health Byrd Parkinson's Disease and Movement Disorders Center. "The reason it helps isn't entirely clear, but it might have to do with chemical changes that occur in the brain during high-intensity exercise — like a runner's high. It may also be the increased blood flow to neurons in the brain during exercise."

Whatever the mechanism, exercise seems to keep Parkinson's patients active and able to manage activities of daily living longer, compared to those who don't exercise. The more high-energy and challenging the activity, the more it seems to help.

Frank Marcia noticed a change in his wife, Linda, not long after they joined the Pedaling for Parkinson's class at the South Tampa YMCA. Linda was diagnosed with Parkinson's disease almost eight years ago. Since starting the class she has more energy, so she feels like doing more each day.

"I'm not as tired as before," said Linda, who is 72 and cycles alongside 71-year-old Frank. "I'm not as fast as the others, but (the instructor) told me not to worry about it."

At first, Linda needed help getting on the bike and strapping her feet into the pedals. Now she can do it on her own. She has gone from being able to cycle for just 10 minutes to 30 minutes.

"The other day I was on for 45 minutes," she said. If she needs a break, she walks around the room for a few minutes then rejoins the class — without help.

But help is always close by. Two volunteers and the instructor circulate among the small group of stationary bikes pulled into a circle. Conversation and sharing are encouraged, but instructor Yvette Wilmath gently coaxes participants to keep up their speed and to push the pedals with their heels, not their toes — something people with Parkinson's are prone to do.

A metronome taps out the beat so everyone reaches 80 to 90 revolutions per minute, the speed which, studies have shown, gives Parkinson's patients the most benefit.

"Our participants tell us they have more of the better days than bad days since taking the class," said Melissa Brockman, the South Tampa Family YMCA's Pedaling for Parkinson's coordinator and an exercise physiologist.

Sharon Eliason, 71, and her husband Fran, 72, have been taking the class for about two months. Sharon was diagnosed with Parkinson's in 2010 and has involuntary body twisting, a common symptom of the disease. She, too, has improved over time and now has no trouble cycling for 40 minutes, twice a week.

Fran said Sharon is still able to work around the house doing laundry, the dishes and making beds. Together they do some form of exercise almost every day. "Exercise is better than medicine," he said.

Pedaling for Parkinson's is free for all members of the YMCA and for the first eight sessions for nonmembers. After eight classes, nonmembers can purchase an eight-class pass for $40. An annual membership is not required to participate.

The South Tampa Y is the only one currently offering the Pedaling for Parkinson's program.

Not interested in cycling? Then try giving Parkinson's a knockout punch. An exercise class based on the fitness and training routines of boxers is gaining popularity nationwide and has made its way to Largo.

Known as Rock Steady Boxing, it provides a challenging workout that helps improve the symptoms of Parkinson's disease.

"I don't know where I would be without this class," said 54-year-old Rob Strathmann of Clearwater, who started taking Rock Steady about two and a half months ago. He credits the workouts with helping him remain on the job as a commercial truck driver.

Strathmann was diagnosed with Parkinson's last March. When not on the road, he's in class at least three days a week.

"I see people who have more advanced Parkinson's than me and I know that's my future. I don't want to get there right away," he said. "I see the others in the class and everyone improves."

Classes include stretching and exercises that improve balance, coordination, flexibility and reflexes. Then it's on to hitting the heavy bags and speed bags. Participants never hit each other, only the bags and the "focus mitts" that the trainers hold.

At the end, along with a cooldown, there's some voice work — Parkinson's patients typically develop a soft, low voice and have to work at speaking up to be heard. "We may yell, scream or sing," said Rock Steady instructor and exercise physiologist Jordan Whittemore.

Rock Steady Boxing is offered six days a week at Bodyssey Performance and Recovery on Walsingham Road in Largo. The cost is $99 a month for unlimited classes. The initial assessment, boxing gloves and wraps are extra. Other Rock Steady locations can be found at rocksteadyboxing.org.

You don't need to be an athlete or have boxing experience to participate. Class members range in age from 52 to 92. Almost everyone improves in some way, particularly with activities of daily living.

"One man in our class hadn't stood up in the shower in seven years. He had to use a shower bench. Now he can stand in the shower," said Whittemore. "One lady refused to do floor exercises because she has a history of falls and couldn't get herself up off the floor. We taught her how to get up."

Strathmann says exercise is as important as the prescription medication he takes for Parkinson's every day. Especially since research suggests it might delay worsening of his symptoms.

"When I can't go, it's awful for me," he quipped. "Boxing class is my best friend."

Contact Irene Maher at [email protected].

     
       
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