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Saturday, May 3, 2014

Prevent Falls And Maintain Balance With Parkinson's Disease


Falls are a frequent complication of Parkinson's disease, and preventing falls is very important. While there are many things that you can do to reduce your risk for falls, the two most important things are to work with your doctor to ensure that your treatments are optimal and to consult with a physical therapist who can assess your walking and balance. The physical therapist is the expert when it comes to recommending assistive devices or exercises to improve safety.
Falls and Common Household Hazards
If you or a loved one has Parkinson's disease, here are tips for preventing falls around the home: 
   Floors. Remove all loose wires, cords, and throw rugs. Minimize clutter. Make sure rugs are anchored and smooth. Keep furniture in its accustomed place.
   Bathroom. Install grab bars and nonskid tape in the tub or shower. Use nonskid bath mats on the floor or install wall-to-wall carpeting.
   Lighting. Make sure halls, stairways, and entrances are well lit. Install a night light in your bathroom or hallway. Make sure there is a light switch at the top and bottom of the staircase. Turn lights on if you get up in the middle of the night. Make sure lamps or light switches are within reach of the bed if you have to get up during the night.
   Kitchen. Install nonskid rubber mats near the sink and stove. Clean up spills immediately.
   Stairs. Make sure treads, rails, and rugs are secure. Install a rail on both sides of the stairs. If stairs are a threat, it may be helpful to arrange most of your activities on the lower level to reduce the number of times stairs must be climbed.
   Entrances and doorways. Install metal handles on the walls adjacent to doorknobs of all doors to make it more secure as you travel through the doorway.
Tips for Maintaining Balance With Parkinson's Disease

   Keep at least one hand free at all times; try using a backpack or fanny pack to hold things rather than carrying them in your hands. Never carry objects in both hands when walking as this interferes with balance.

   Attempt to swing both arms from front to back while walking. This may require a conscious effort if Parkinson's disease has diminished your movement; however, it will help you to maintain balance, posture, and reduce fatigue.
   Consciously lift your feet off of the ground when walking. Shuffling and dragging your feet may cause you to lose your balance.
   When trying to navigate turns, use a "U" technique of facing forward and making a wide turn, rather than pivoting sharply.
   Try to stand with your feet shoulder width apart. When your feet are close together for any length of time, you increase your risk of losing your balance and falling.
   Do one thing at a time! Don't try to walk and accomplish another task, such as reading or looking around. The decrease in your automatic reflexes complicates motor function, so the less distraction, the better!
   Do not wear rubber or gripping soled shoes, they may "catch" on the floor and cause tripping.
   Move slowly when changing positions. Use deliberate, concentrated movements and if needed, use a grab bar or walking aid. Count 15 seconds between each movement. For example, when rising from a seated position, wait 15 seconds after standing to begin walking.
   If you become "frozen," visualize stepping over an imaginary object, or have someone place their foot in front of yours to step over. Try not to have a caregiver or companion "pull" you, this may throw you off balance and even prolong the episode.
If balance is a continuous problem, you may want to consider a walking aid such as a cane, walking stick, or walker. Once you've mastered walking with help, you may be ready to try it on your own again!



Friday, May 2, 2014

Parkinson Power


Parkinson Power has uploaded Parkinson Power Ask for Help... a New Feat for Some
Parkinson Power Ask for Help... a New Feat for Some
Parkinson Power

Thursday, May 1, 2014

It's Throwback Thursday!

It's Throwback Thursday! This photo features two giants of the Parkinson's world: Muhammad Ali and Nathan Slewett, who spent over 40 years as a tireless volunteer leader of the National Parkinson Foundation.

#tbt #throwbackthursday
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Parkinson’s Disease Vaccine Treatment Approach Awarded $8M

FoxFeed Blog


Posted by  Maggie McGuire, April 29, 2014
Parkinson’s Disease Vaccine Treatment Approach Awarded $8M
Yesterday Austrian biotech company AFFiRiS AG announced a €6 million euro (more than $8 million US dollars) grant from the European Union to continue developing vaccines against Parkinson’s disease (PD) and multiple system atrophy (MSA).
The Michael J. Fox Foundation granted AFFiRiS $1.5 million in November 2011 to conduct the Phase I clinical study of its PD vaccine drug candidate, PD01. Results from that study are expectedlater this year.
Both the PD and MSA vaccines target the protein alpha-synuclein, which clumps in the cells of people of both diseases. This protein aggregation leads to cell dysfunction and cell death. A therapy that could prevent or break up the clumps may be able to slow or stop the disease process.
Read more about this research or listen to a podcast.
“It’s important to bear in mind that PD01 is still in the early stages of clinical testing,” says Kuldip Dave, PhD, senior associate director of research programs at MJFF. “But we’re definitely paying close attention to the AFFiRiS approach. This is the first study to test a vaccine for Parkinson’s disease. If successful, it could be a game changer.”
The European Union funding is another success of the MJFF de-risking model, which supports early-stage research to capture data — such as on proof of concept or safety — that would make the project more attractive to larger, more risk-averse funders. The AFFiRiS project was previously funded €25 million (more than $34 million US dollars) by venture capitalists after the initial MJFF grant.

Wednesday, April 30, 2014

Boxing can Help Patients with Parkinson's

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Sunday April 27, 2014
Ilene Raymond Rush
The Inquirer - Parkinson's patient Lori Katz, 60, is whipping a jump rope around her head as she calls out words beginning with the letter B.
At the ready nearby: a heavy weight bag that Katz will attack later in her workout - before donning boxing gloves to match mitts with her physical therapist, Joellyn Fox.
"Go, go, go!" Fox screams as Katz nimbly steps from one set of colored circles to the next, landing punches against her therapist's gloved hands. "Orange! Green! Red!" Fox is a whirling dervish of energy and encouragement. "All we need," she rhythmically chants, "all we need is . . . dopamine!"
At Pennsylvania Hospital's Parkinson's rehabilitation center, the latest novel therapy is known as Rock Steady Boxing. Despite the name, a metaphor for fighting the disease, it's a noncontact, intensive exercise routine that can help improve flexibility, range of motion, gait, posture, and activities of daily living - all serious issues for patients with Parkinson's disease.
Developed in 2006 by retired Indianapolis district attorney Scott C. Newman, who found that boxing eased his early-onset Parkinson's symptoms, the therapeutic workout is done mainly in group classes. Rock Steady Boxing, which uses all the training elements of the sport, helps push patients to simultaneously work on gross motor movement, rhythm, core strength, balance, and hand-eye coordination.
The nonprofit program, housed in an Indianapolis gym that specializes in Parkinson's and that is now affiliated with the University of Indianapolis, has trained more than 100 coaches across the country - two physical therapists at the Philadelphia rehab center are the first in this region - and has 24 affiliates in 12 states as well as in Italy, Canada, and Australia.
The key to Rock Steady Boxing is intense exercise that pushes participants just beyond "where they think they've had enough," said Jessica Fithen, the program's affiliate services director. Medical studies have shown this type of high-exertion activity may be "neuroprotective for the brain, and may help reconnect parts of the brain that are being lost in the disease," she said.
Boxing - real and not - is also a bilateral exercise. This helps Parkinson's patients who often have forced, stiff movements on one side of their bodies. "By using the entire body at the same time, boxing can reverse and delay some of the symptoms of Parkinson's disease," Fithen said.
Though exercise may be good for everyone, Fithen said, this level of intensity for patients with neurodegenerative diseases has been studied only in Parkinson's, which is not a muscle-wasting disease but a condition that prevents signals from the brain from reaching the body.
In August, Fox and physical therapist Heather Cianci traveled to Fithen's facility from the Dan Aaron Parkinson's Rehabilitation Center, part of Good Shepherd Penn Partners, to become certified in the boxing program. After months of use with individual clients, a pilot program of Rock Steady Boxing group classes is scheduled to begin this week.
Recent research in the Journal of Applied Physiology showed that high-intensity training combined with interval training produced significant improvements in quality of life, mood, and motor function for older patients with Parkinson's disease. During 16 weeks of high-intensity training, participants improved their muscle-endurance capacity and showed much improvement in the function of muscle mitochondria, which help fuel muscle fibers and fight muscle fatigue.
Though this study did not address boxing, lead author Marcas Bamman, director of the University of Alabama Center for Exercise Medicine, said that "with boxing's high-intensity, rapid movements, you're likely to see improvements in Parkinson's patients."
Stephanie Combs-Miller, an associate professor at the Krannert School of Physical Therapy at the University of Indianapolis, has done several small studies on the safety and effectiveness of Rock Steady Boxing for Parkinson's patients. Her most recent presentation, at the World Parkinson Disease Congress in Montreal in October, described an ongoing, two-year study that compares 39 Rock Steady boxers to 26 other exercisers, all with Parkinson's. After one year, preliminary findings showed that although all participants benefited from exercise, "boxers demonstrated significantly greater comfortable 10-meter walking speed compared to non-boxers," the abstract indicated.
"We're really interested in slowing the progression of the disease," Combs-Miller said in an interview. "And so far, we didn't see any progression of symptoms in the boxers. "
The opportunity for group exercise also makes Rock Steady Boxing attractive for Parkinson's patients, she said. Research shows that people are likelier to follow exercise plans if they are part of a group and if the members share the same diagnosis and stage of disease.
"I think the whole concept of boxing is interesting and intriguing," Coombs-Miller said. "In general, we're learning that people with Parkinson's disease need to exercise - whether it's boxing, tango dancing, tai chi, or walking on a regular basis."
Parkinson's is caused by a decrease in dopamine, a hormone involved with internal rhythm and movement that normally happens without thought, like swinging your arms when you walk. Primary symptoms are trembling in hands, arms, legs, jaw, and face; rigidity, or stiffness, of the limbs and trunk; slowness of movement; and impaired balance and coordination. Patients may have difficulty walking, talking, or completing simple tasks.
As many as one million Americans live with Parkinson's, and about 60,000 are diagnosed each year, according to the Parkinson's Disease Foundation. It usually affects people over 50.
One of the hallmarks of the disease is a motor and sensory disconnect - people don't realize their voices and movements have become diminished, like the arm swinging.
"They need to see themselves in a mirror and recognize, 'Oh, I really do look like that' or hear themselves and say, 'I really do sound like that,' " said Joan Levicoff, the rehab center's site manager. So physical and speech therapy both work on improving amplitude, of movement and voice.
"Normally, we don't think about how we get up off a chair and answer a phone," said Fox. "But in Parkinson's, patients lose that automatic response. Instead of rising up, we might see rigidity and tremors. Hip flexors can become tight, posture can become stooped, and you don't take a long enough stride. Your balance can be affected, as well."
Rock Steady Boxing addresses many of these issues. "Shadowboxing and sparring helps you gain that high level of amplitude. Boxing forces you to maintain the bigness of movement," said Fox.
A lack of control over your own movements can be exasperating, and the exercises help there, as well. "There's a lot of frustration with Parkinson's," Fox said. "Patients wear their symptoms on their sleeves. It's not a disease you can hide. It's great to work out, hit a bag, and shout out loud."
Katz, the Parkinson's patient, who lives in Cherry Hill, calls herself a guinea pig for every new idea or type of treatment; she recently recovered from surgery to implant a small pacemakerlike device in her brain, for a therapy known as deep brain stimulation, to help decrease her symptoms.
Her twice-a-week boxing workouts are the "best hours of the day," Katz said. "Boxing energizes me." She recently received a pair of boxing gloves as a birthday present.
Rock Steady isn't the only kind of boxing around. Margaret Rohdy, a 66-year-old patient with multiple sclerosis, was sharing the workout room with Katz and sparring - with soft plastic "noodles" - with Cianci, her physical therapist.
"Everybody has something they want to hit," said Rohdy, who lives in Center City. "In real life I don't get to hit; all I get to do is try not to fall down."
Cianci seems to understand that need.
"People feel strength and speed," she said. "They're energized. After boxing, they're more animated and feel more confidence."
Perhaps, added Levicoff, the rehab center manager, it's also something else.
"It's something new, something that people don't think they can do. And when you do it -," Levicoff shook her head. "What a sense of empowerment."
Raymond Rush, Ilene. (27 April 2014). The Inquierer. Boxing can help patients with Parkinson's. http://articles.philly.com/2014-04-27/news/49440054_1_red-fox-patients-boxing-program

Tuesday, April 29, 2014

Depression May Lessen Effectiveness of Parkinson’s Drugs

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Monday April 21, 2014
PsychCentral - In an unexpected finding, new research suggests depression can hamper cognitive function among Parkinson’s’ patients receiving traditional dopamine replacementtherapy.
Scientists from the University of Kentucky College of Medicine found that the dopamine replacement therapy commonly used to treat motor symptoms of Parkinson’s disease (PD) was associated with a decline in cognitive performance among depressed Parkinson patients.
In the study, as published in the journal Psychiatry Research, investigators found that in contrast, non-depressed Parkinson patients’ cognitive function improved on dopamine replacement therapy.
The study also found that mood in depressed Parkinson’s patients was actually worse while on dopaminergic medications.
“This was a surprise,” said Lee Blonder, Ph.D., the study’s principal investigator.
“It is the opposite of our original hypothesis that both groups of PD patients would improve in cognitive performance on dopaminergic medications, and that mood in the depressed PD group would also improve.”
A cohort of 28 patients with PD — 18 nondepressed and 10 depressed — were given a baseline series of tests to assess cognitive function and the incidence and severity of depression. They were then re-tested with and without their dopamine replacement therapy.
Results revealed a statistically significant interaction between depression and medication status on three measures of verbal memory and a facial affect naming task.
In all cases, depressed Parkinson’s patients performed significantly more poorly while on dopaminergic medication than while off. The opposite pattern emerged for the non-depressed Parkinson’s group.
Depression is a common and serious comorbidity in patients with Parkinson’s; studies suggest that approximately 40 percent of PD patients suffer from depression.
Blonder cautions that these results are to some extent preliminary due to the small cohort of 28 participants.
“Additional studies are required before these results should be used to alter treatment plans,” Blonder says.
But, “future research should ultimately focus on investigating treatment options for patients with Parkinson’s and depression to maximize patient function without compromising their mental health.”
Nauert, Rick PHD. (21 April 2014). PsychCentral. Depression May Lessen Effectiveness of Parkinson’s Drugs. http://psychcentral.com/news/2014/04/21/depression-may-lessen-effectiveness-of-parkinsons-drugs/68780.html