October 1, 2019 By Sherryl Klingelhofer (Facebook)
The SCIENCE of EXERCISE in PD: why it works. (continuing our study of rehabilitation in Parkinson’s presentation by Mike Studer. I’ve tried to streamline and put into common language the information from a half dozen scientific sources…*)
I know so many people avoid exercise, aren’t interested in exercise and just plain hate exercise! But what if you knew it could improve your Parkinson’s by supporting survival of the part of the brain that effects movement?
Research shows that medication used to treat Parkinson's tends to be less effective over time, and that it exposes people to adverse effects. For this reason, they say, it is important to identify effective alternative treatments that do not involve the administration of drugs. That means you might avoid taking PD meds for a greater amount of time, and avoid the dyskinesia that can come with long-term/high doses of levadopa.
How Does Exercise Change the Brain?
• Exercise does not affect the amount of dopamine in the brain, but the brain cells use dopamine more efficiently.
• Exercise improves efficiency when dopamine signals are received in the brain (the substantia nigra and basal ganglia)
At the molecular level, at least two things happen when exercising to make dopamine use more efficient:
• Dopamine travels across a space between two adjacent brain cells called a synapse, essential for normal functioning. To end the signal, a protein complex called the dopamine transporter normally retrieves dopamine from the synapse. With exercise there is less of the dopamine transporter, mean-ing that dopamine stays in the synapses longer and the dopamine signals last longer.
• The brain receiving the dopamine signal has more places for the dopamine to bind and could receive a stronger signal. (This binding site is the D2 receptor)
Neuroinflammation
• Neuroinflammation in PD is a process that occurs alongside the loss of dopaminergic neurons, and affects the dopamine pathway … Exercise is known to effectively control inflammation and has been reported to change the inflammatory state to become anti-inflammatory, even possibly protect nerve cells against damage and degeneration
“If you have Parkinson's disease and you want to delay the progression of your symptoms, you should exercise three times a week with your heart rate between 80 to 85 percent maximum. It is that simple."
Daniel Corcos, Northwestern University Feinberg School of Medicine
“A growing body of work demonstrates the importance of exercise for living well today with Parkinson’s. Because people with Parkinson’s may have a number of different symptoms, the right exercise prescription for an individual may include some combination of endurance, strength and balance training. The findings of this investigation indicate that the endurance training should be at high-intensity to the extent possible.”
Dr. Margaret Schenkman of the University of Colorado School of Medicine
OK, so you don’t like to exercise… you don’t like what Parkinson’s does to you, either. High intensity exercise three times a week for at least 20 minutes (with a 5 minute warm up and 5 minute cool down) is pretty easy to plan, and doesn’t really take up that much time.
Choose your exercise (walking, swimming, boxing, dancing, etc.) and do it for two minutes, then 30 seconds FAST and continue this pattern for twenty minutes. OR try two or three minutes of walking, then add 30 seconds-one minute of shadow boxing, jump rope or any in-place exercise that use both arms and legs. As you improve, you can increase the amount of high intensity time.
Oh, just a note: this is exactly how I teach aquatics classes and work out for myself on the track!
*this section takes explanations from several other sources including
https://www.facebook.com/sherryl.klingelhofer
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