Exercise may improve balance, mobility and quality of life in people with Parkinson's

The researchers, including Colleen G. Canning, PhD, of the University of Sydney in Australia, publish their findings in the journal Neurology.

Parkinson's disease is a progressive neurological disorder that is newly diagnosed in around 50,000 Americans each year. Onset is most common among individuals over the age of 60, and the disease affects around 50% more men than women.

Triggered by damaged neurons in an area of the brain that controls movement, Parkinson's disease can cause involuntary movements or tremors, impaired balance and coordination, and problems standing and walking.

As such, falling is common among people with Parkinson's; around 60% of individuals with the disease experience a fall each year, and approximately two thirds of these fall frequently.

"The resulting injuries, pain, limitations of activity and fear of falling again can really affect people's health and well-being," notes Canning.

Exercise reduced falls by 70% in patients with less severe Parkinson's

In their study, the researchers set out to see whether exercise could reduce the risk of falls and improve balance, movement and overall life quality in 231 people with Parkinson's.

Canning and colleagues randomized the participants to either take part in a 40-60 minute exercise program three times a week for 6 months or to continue with their usual care.

The exercise program consisted of balance and leg-strengthening exercises that were recommended and assessed by a physical therapist. The majority of exercises were performed at home under minimal supervision; around 13% of sessions were monitored by a physical therapist.

The team found that participants with less severe Parkinson's disease who took part in the exercise program saw a 70% reduction in falls, compared with those who continued with their usual care.

What is more, participants who engaged in the exercise program reported improved mobility and balance, reduced fear of falls and better overall quality of life.

Commenting on their findings, Canning says:

"These results suggest that minimally supervised exercise programs aimed at reducing falls in people with Parkinson's should be started early in the disease process."

This is not the first study to note the benefits of exercise among people with Parkinson's. In 2012, Medical News Today reported on a study published in the Archives of Neurology claiming resistance training, stretching and treadmill use may improve overall fitness and mobility in individuals with Parkinson's.

Most recently, a study by researchers from the Karolinska Institutet in Sweden suggested that 6 hours of medium physical activity a day may even reduce the risk of developing Parkinson's by 43%.

"These findings are important for both the general population and the health care of patients with Parkinson's disease," the researchers of that study noted.

Taken from medical news today            

NASA Technology in Physiotherapy: Anti-Gravity AlterG Treadmill

NASA technology gives Clare athletes a lift:  Space age technology originally developed by NASA is being used at Active Ennis Leisure Complex in County Clare to help improve recovery times, increase mobility and lessen the chance of future injury for athletes and patients.

The antigravity treadmill relies on advanced air pressure technology, which, after calibrating the user’s weight, reduces the load and impact on legs and joints at anywhere between 20 and 100 percent of the user’s body weight to allow them to walk or run.

Physiotherapists throughout the world have hailed the treadmill for its role in expediting rehabilitation for athletes overcoming lower leg injuries, or for patients with a variety of medical conditions such as Strokes, Parkinson’s Disease and total knee and hip joint replacements.

It’s more widely used across the United States where it is a regular feature of the recovery process for injured professional basketballers and American Footballers.

Active Ennis Leisure Complex is the only facility in the Mid West Region to provide public access to an anti-gravity AlterG treadmill which has previously been used by internationally renowned sports stars such as former Irish rugby international Brian O’Driscoll, Barcelona footballer Luis Suarez, multiple tennis Grand Slam champion Rafa Nadal  and Irish Olympian Derval O’Rourke.

“We are delighted to expand our offering by providing this new facility in conjunction with an in-house consultant physiotherapist,” commented Tim Forde, Active Ennis General Manager.

“Built in Silicon Valley using the NASA technology, this unique device has proven to be extremely successful in the areas of sports and medical rehabilitation and obesity. It has been utilised by top Olympic athletes, Premiership soccer teams and Irish Rugby players.

“We would invite anyone interested in seeing the AlterG in operation or finding out more about the technology behind the treadmill to call into Active Ennis Leisure Complex,” added Mr. Forde.

“The AlterG treadmill is perfect for individuals who have suffered a lower extremity injury, like an anterior cruciate ligament (ACL) reconstruction, hip or foot and ankle injury,” explained Anne Marie Kinsella, a Chartered Physiotherapist who is based with Active Ennis.

“Active Ennis has already received significant interest from sports clubs looking to treat athletes who are recovering from injury or seeking to avoid an injury, as well as patients who are post-operative or trying to prevent surgery. Non-injured athletes have also found ways to utilise the AlterG before and after endurance events. For example, long distance runners can use the treadmill without the impact before a marathon, or equally as a tool for recovery following a long race.

“Even stroke patients can benefit as the AlterG helps to retrain their legs and brain with supported movements,” added Ms. Kinsella.

News Link: http://clareherald.com/2014/12/29/nasa-technology-gives-clare-athletes-a-lift-3453/

John Carey, Gym Manager along with Tim Forde , General manager and Anne-Marie Kinsella, Chartered Physio Therapist demonstrating the new anti-gravity AlterG treadmill at Active Ennis Leisure complex for John Crowe, Cathaoirleach Clare County Council this week. 

Evidence: Hospital-based exercise program improves quality of life for adults with arthritis

Hospital-based exercise program improves quality of life for adults with arthritis

It may seem counterintuitive, but exercise can be beneficial for people suffering from arthritis and other muscle and joint conditions. A new study at Hospital for Special Surgery (HSS) finds that older adults experienced less pain, reduced stiffness and less fatigue after participating in a hospital-based exercise program.

"The study adds to the growing body of evidence that exercise can help people with muscle and joint conditions," said Sandra Goldsmith, MA, MS, RD, director of Public and Patient Education at Hospital for Special Surgery.

Up to 50 million adults in the United States have some type of musculoskeletal condition, affecting mobility and quality of life. Ms. Goldsmith and colleagues set out to assess the impact of HSS exercise classes on pain, stiffness, fatigue, balance, falls and physical activity.

A total of 1,400 adults participated in various exercise programs at the hospital during the course of the study, which began in 2011. The low-cost classes, led by certified instructors, included pilates mat, therapeutic yoga, yoga-lates (a combination of yoga and pilates), t'ai chi and dance. Classes met once each week and were open to the general public.

"Our data indicate that hospital-based programs can play an important role in pain relief, improved quality of life and improved levels of physical activity in older individuals with musculoskeletal conditions," Ms. Goldsmith said. The research was presented at the American Public Health Association annual meeting in November.

"Often patients with musculoskeletal disease are more deconditioned than their disease-free counterparts. Strengthening the muscles around an arthritic joint has been shown to slow the progression of osteoarthritis and reduce pain," said Linda Russell, MD, a rheumatologist and member of the Community Benefit & Services Committee of the Board of Trustees at Hospital for Special Surgery.

The majority of participants in the exercise program were age 75 or older. Thirty-six percent were 75 to 84 years old; 31.2 percent were over age 85; 24.8 percent were age 65 to 84; and eight percent were under 65. Ninety-two percent were women.

A total of 204 individuals handed in questionnaires both before and after completing the program. Survey results covered September 2011 to July 2014.

The study found that after taking the classes, fewer participants reported experiencing a high level of muscle/joint pain from their condition (56 percent before the program started vs. 47 percent after completing the program). The study also reported statistically significant reductions in how much their pain interfered with their general activities, ability to walk, mood, sleep and enjoyment of life.

Eighty-three percent of participants indicated a reduction in stiffness; eighty-two percent said they felt their balance improved; and sixty-seven percent said they experienced less fatigue as a result of taking part in the program.

Health outcomes were also related to the type of exercise class participants chose, with the greatest reduction in muscle/joint pain reported by those who took t'ai chi.

"The survey results indicate that the hospital's exercise programs have a positive impact on the musculoskeletal health of participants," said Ms. Goldsmith. "Hospital for Special Surgery will continue to offer these programs to this community to help them stay active, decrease pain and improve their overall health."

Adopted from original media release.

Incentive Spirometry

   Incentive spirometry

·         Deep breath can be facilitated by an incentive spirometer which gives visual feedback

·         It consist of a mouth piece with 3-5 cylindrical chamber is been graded with markings

·         Colored balls acts as visual feed back

        

   The suggested technique is the following:

i.                     A demonstration is given using a separate device.

ii.                   Patient should be relaxed and positioned as for deep breathing, either side-lying or sitting upright, preferably in a chair.

iii.                  With lips sealed around the mouthpiece, the patient inhales slowly and deeply.

iv.                 Two out of three plastic balls should be raised and the breath sustained for some second while they are suspended.

v.                   The third ball is a control and should not be raised because this indicates high flow and turbulence.

vi.                 An inspiratory hold is sustained.

vii.                After exhalation, shoulder girdle relaxation is rechecked.

(Throughout the procedure the patient watches the incentive spirometer while the physiotherapist monitors the patient’s breathing pattern.)

·         Those on oxygen can use nasal cannulae or an incentive spirometer while entrains oxygen. 

·         People with tracheostomies can use a connecting tube.

·         Once technique is faultless, patient are asked to take 10 incentive spirometry breaths per walking hour.

·         It is also suited to children and those with learning difficulties because it can be learnt by demonstration.

·         It is not suitable for breathless patients.

Precaution

           ·          Lower chest and diaphragm breathing is emphasized

           ·          Avoid use of accessory muscles.

Advantages

           ·          Improves lung volume and capacity

           ·          Prevents collapse of lungs

           ·          Prevents post-operative pulmonary complication

           ·          Provide visual feed back

           ·          As a mean of thoracic expansion exercise and is used inspiratory muscle in case of neuromuscular disorders

Tenderness and its Grades

Tenderness : Pain on touch.

Grades of tenderness.

Grade I: Mild pain.

Grade II: Patient winks his eyes on pain with slight pressure.

Grade III: Patient winks his eyes and withdraws his limbs on pain with pressure.

Grade IV: Patient does not allow touching.