Exercise therapy for Parkinson’s disease

From ABC Health and Wellbeing, 21 August 2013:

Argentine tango, tai chi and Pilates are activities you’d expect to find on offer in adult education classes, but emerging research shows these and other exercise therapies may also provide a range of benefits for people with Parkinson’s disease.

Exercise therapy is emerging as a new and exciting area of treatment for Parkinson’s, not only because it can lead to significant improvements in symptoms, but also because it has minimal side effects and comes with a whole lot of additional health benefits.

While it is still early days for research on exercise therapy, says Associate Professor Susan Fox, professor of neurology at the University of Toronto, the evidence is mounting.

“People are recognising that it’s good that these patients are moving and exercising,” says Fox. She says evidence suggests exercise can help improve some of the motor symptoms of Parkinson’s – such as tremor or rigidity – in a similar way to adding in a new drug.

“You’re getting equivalent benefit without the side effects, plus all the other added benefits of exercise,” says Fox. “It’s cheap, easy therapy.”

The role of dopamine

Parkinson’s disease currently affects around one in 350 Australians, and 1 per cent of people over the age of 60 will be diagnosed with the disease.

It’s a degenerative neurological condition caused by the loss of cells that produce dopamine deep inside the brain. Dopamine is message-carrying chemical (or neurotransmitter) that is associated with movement. The loss of these cells, and the resulting depletion of dopamine, leads to a range of motor symptoms, including tremor, rigidity, slowed movement and gait difficulties.

In addition, people with Parkinson’s experience other symptoms, such as depression, sleep problems, lethargy and sometimes dementia, not all of these symptoms seem to be related to dopamine depletion.

There is no cure for Parkinson’s, but treatments can reduce the severity of symptoms. Most Parkinson’s treatments have focused on trying to boost dopamine levels in the brain using medications. While these have been very effective in managing motor symptoms of the disease, they have significant side effects and their effectiveness reduces over time.

“[But] there’s now some preclinical evidence that when patients move and exercise that it releases dopamine within the brain, so there’s some biological evidence that it may actually have a positive symptomatic effect,” Fox says. Read more.

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