Working up a Sweat

Intense treadmill exercise can be safe for people who have recently been given diagnoses of Parkinson’s disease and may substantially slow the progression of their condition.  The New York Times.

A lot has happened in the Parkinson’s world this past year.  We have heard a lot about the connection between the gut and Parkinson’s.  And faulty genes, mitochondria, stem-cell treatments, ultrasound treatments, repurposing of drugs, and on and on.  Each month brings some new theory that could just be the breakthrough we were looking for. A month later, there is yet another new finding that could be the one.

But let’s not forget about exercise.  If you have been following me, you know that I exercise a lot.  I go to Boxing for PD classes, yoga and still manage to play some tennis. Last week’s big news was a study published in the NY Times about the benefits of intense exercise for PD.  There have been a number of studies over the past 10 years that have looked at exercise for PD, with varying outcomes.  But this one was apparently the first set up as a clinical trial.   For the new study, which was published in JAMA Neurology, the researchers decided to treat exercise as if it were a drug and carefully track the safety and effectiveness of different “doses” of exercise in a formal Phase 2 clinical trial.  In the trials, those patients in the high-intensity group had better outcomes.   Their findings:  “High-intensity treadmill exercise may be feasible and prescribed safely for patients with Parkinson disease.”  As someone who emphasizes exercise, this did not surprise me.

About six months ago, Mr. Twitchy and I acquired a Peloton Bike.  In case you’ve managed to miss the much-played commercials for Peleton showing a mom exercising on her Peloton Bike in her living room,  while her kids play quietly nearby (whoever dreamed this up does not have small children), the Peloton Bike is a Spin Bike for your home.   It’s not cheap and there is a monthly fee for “attending” classes (either live or “on demand”)  You can log into numerous classes led by cute, young, and way-too-fit instructors, who guide you through a workout while you watch on the big video screen attached to the bike.

If only riding my Peloton would make me look like her!

Classes range from at 10 minutes to 90 minutes long.  The instructor encourages you to move to the beat of the music and to adjust your resistance to increase or decrease the intensity (which simulates biking up and down hills).

This is not a commercial for Peleton.  While I have never been a big fan of exercise bikes (or real bikes for that matter), this is fun!  And it is some of the most intense exercise I have done.  Being competitive by nature, I try to keep up with that cute guy on the screen, and the cadence and resistence calls he makes.  Although not always successfull, I can feel myself improving and I have worked my way up to 20 minute classes, frequnetly ready to drop at the end of the session, but stronger for the effort.  I never went to the spin classes at the gym.  The thought of going to one of those classes in a hot sweaty room with 25 other people was terrifying, so I avoided them.  Now, in the privacy and comfort of my own home, I can choose whatever class I want, and quit if I want to, or scream at the instructor, or at myself,  when I can’t keep up.  The best part, is that I am getting the benefits of intense exercise that the experts now say will keep me going and going and going…….

WARNING:  When starting any form of strenuous exercise, please consult your doctor first.   This is NO exception.  In fact, you may want supervision by a trainer or Physical Therapist until you learn what you can do on the Peleton or any other resistance  training bike. It is much too easy to overdo it, which could lead to other problems.

Much Ado about Parkinson’s

As we celebrate the 200th anniversary of Dr. James Parkinson’s groundbreaking essay of “The Shaking Palsy”, there seems to be a flurry of announcements of possible breakthroughs in diagnosis and treatment of Parkinson’s.  Eight years ago, when I was first diagnosed with Parkinson’s, the prevailing theories all stated that PD was a disease that started with “dopamine-producing cell death in the brain.”  Sometimes the cause was genetic.  Other times exposure to pesticides or other chemicals were to blame.  But most of the time, there was no apparent cause.  Just 6 months ago, at the World Parkinson’s Congress, we began to hear about  different ways of looking at PD.

We have known for years, that Parkinson’s is a designer disease.  The progression can be very different for each person.  But now doctors and researchers are looking at PD as a group of syndromes, not just a single neurological condition that caused movement disorders.   Many other symptoms and diseases not typically considered Parkinson’s were now seen as part of PD.    There have been a lot of studies of possible treatments that seemed promising, but the hope for a cure still seemed elusive.  In fact, one of the speakers at the WPC, whom I believe was Tom Isaacs, quipped that the cure was always 5 years away, no matter what the research said.

But something has changed since then.  In the last few months, researchers are coming out with reports that Parkinson’s does not start in the brain, but may actually start in the gut.  Many say the culprit in some cases may be microbiomes in the gut. WOW!  If this is true, scientists at Caltech say it may mean that PD can be detected much earlier and drug treatments can be designed to remove those nasty little bacteria that are causing problems in our gut and our brain.  This treatment may also be more effective because medications

271-smts-gutbrain-connection-news-web
Credit:  Caltech

can easily be absorbed in the gut, unlike treatments for the brain, which is protected by the blood brain barrier.  There has been much written about this, and it is probably confusing for most of us who are not researchers.   I am not a biologist, or a scientist, but I do understand that treating the cause much earlier, if it is in fact in the gut, is much easier that treating the damaged neurons in the brain, especially since symptoms don’t appear until it is way too late to reverse the damage.

Here is a quick look at some of the other announcements over the last few weeks:

  • Biomarkers  can be used to used to define disease subtypes.  “This precision-medicine approach will likely yield smaller, but well-defined, subsets of [Parkinson’s disease] amenable to successful neuroprotection.” according to Alberto Espay, MD, who conducted a study titled “Precision Medicine For Disease Modification In Parkinson Disease.
  • Last week the FDA approved Xadago   (Safinamide) for people with Parkinson’s disease (PD) who are taking levodopa but experiencing “off” episodes.
  •  Also last week, researchers from the University of New Brunswick    found that an extract from the brown seaweed Alaria esculenta can prevent this conversion and, therefore, could be useful in avoiding the onset of the disease or delaying its progress.”  Ok.  Does this mean we should eat more sushi?
  • A new study published in the Annals of Neurology suggests that redheads may carry a gene variant that increases the risk of both Parkinson’s disease (PD) and melanoma. Researchers have long known that having either PD or melanoma heightens the chances of developing the other condition, but it’s been unclear exactly why.  What if you are blonde and have had both, like I have???  I think this means I am in trouble….
  • The Food and Drug Administration finally gave approval for 23andMe to sell to consumers genetic tests and their accompanying health risk reports for up to 10 diseases, including late-onset Alzheimer’s and Parkinson’s.
  • And finally, the New York Times declared that exercise is good for us old people.

All kidding aside, it seems that the big breakthrough may just come in less than 5 years, which would make all of us very happy.

According to the New York Times….

Exercise Can Be a Boon to People With Parkinson’s Disease

No kidding…….I have written many times about the benefits of exercise for people with Parkinson’s Disease, as have my fellow Parkinson’s bloggers.  An article in yesterday’s New York Times reiterates much of what I have said before.  The author says: “For Parkinson’s patients in particular, regular exercise tailored to their needs can result in better posture; less stiffness; improved flexibility of muscles and joints; faster and safer walking ability; less difficulty performing the tasks of daily living; and an overall higher quality of life.”  If you are like me and exercise regularly to help improve your symptoms, you already knew that.

I can attest to the benefits of exercise for me, especially since I am returning today from an 18 day cruise.  While I tried to exercise daily, it is hard to maintain a routine while traveling and by the end of the trip I could really feel the difference; my body was just not in sync.  So my body and I are both looking forward to getting back to yoga, boxing and the other activities that keep us moving.

I have found that regular yoga helps with flexibility and balance and boxing builds strength, endurance and agility.  The combination of the two has wIMG_0386orked well for me (and many others).  They make a huge difference in performance in other areas like tennis — better footwork, faster response times and even in seeing the ball better. Most importantly, I just feel better overall.

BUT do not start an exercise program without consulting your doctor first, especially if you have not been exercising.  Your doctor may want you to begin an exercise program by working with a Physical Therapist to establish a baseline for you and to help you learn exercises that will be beneficial for your specific needs.  And don’t forget getting motivated,  Working with a personal trainer provides one kind of motivation through personal attention; group classes provide a different kind of positive social reinforcement.  Find the mix that works best for you.

And don’t forget to exercise your brain; doing puzzles, playing cards or practicing with a musical instrument.  I may have found a new mental exercise in getting reintroduced to playing Bridge during our cruise. During days at sea we joined the daily beginners classes in the morning, and often played with the group in the afternoon as well.  Bridge, more than any other card game I have played, requires total concentration and attention to the every aspect of the game.  And the game’s conventions have changed dramatically since we learned to play over 40 years ago.   I hope that relearning the game almost from scratch will provide new and fun mental exercise (boxing for the brain??) and improve my mental concentration the way phsyical exercise has helped my body.

Hopefully we will find a way to continue to play Bridge now that we’re home and that it will find its own regular place in my daily or weekly routine (without becoming another Parkinson’s obsession).  Introducing and maintaining changes in those routines while keeping everything in balance is itself a challenge that we should look forward to meeting.hand35-b