Did You Know There are Physical Therapy Treatments for Parkinson’s Disease?

Sep 19, 2018

Joshua Niesen

by Joshua Niesen
PT, DPT | Sun City

Parkinson’s disease: most of us have heard of it, but know little about the disease. Do you know someone who has Parkinson’s disease? Do you have a family member with the disease? Have you recently received a diagnosis of Parkinson’s disease? Regardless of the situation, it is important to have an understanding of the disease and the treatments that are available — including physical therapy.
What is Parkinson’s Disease?
Parkinson’s disease is defined as a neurodegenerative disease that affects dopamine-producing neurons in an area of the brain called the Substantia Niagra by the Parkinson’s Foundation. Degenerative loss and destruction of these neurons produce several motor and non-motor symptoms expressed through movement and function.
There are four key symptoms associated with Parkinson’s disease:

  • Resting tremor: often seen in the extremities, especially the hands
  • Bradykinesia: “slow movement”
  • Rigidity: predominantly in the limbs but progressing throughout the body.
  • Gait and balance problems

There are several other symptoms that can be associated with Parkinson’s disease that also relate to movement dysfunction.
Currently, the cause of Parkinson’s disease is not well understood though several factors may be linked to the disease. Parkinson’s disease is listed as the 14thleading cause of death in the United States according to the Parkinson’s Foundation. There is currently no viable cure or a way to arrest the disease. However, various treatments exist to manage symptoms, promote function, and improve quality of life.
Parkinson’s disease is treated in several ways. One method is through medication to reduce the primary symptoms of Parkinson’s disease. Other surgical interventions may assist with certain symptoms, such as deep brain stimulation for tremor symptoms. Another avenue is through physical exercise and sensory recalibration through specific therapies such as physical therapy.
Physical Therapy for Parkinson’s Disease
There have been numerous research studies conducted on Parkinson’s disease including its various treatments and outcomes. However, there is one common thread in all of the studies: exercise is one of the most beneficial treatments for Parkinson’s disease. Studies have been conducted on a variety of treatments including, but not limited to: yoga, strength training, tandem bicycling, Tai Chi, Nordic walking, boxing, Pilates, as well as others.
However, one noticeable fact supported by these studies was that the mode or “type” of exercise the person performed was not nearly as critical as the intensity or “amplitude” of the exercise. Essentially, the harder and more vigorous the exercise, the better a participant with Parkinson’s disease fared overall. Several techniques and methods have evolved from this trend including LSVT® BIG and the Rock Steady Boxing® Method.
LSVT®, or Lee Silverman Voice Training, is one of the most thoroughly researched treatment protocols regarding Parkinson’s disease available today. The company is named after the first patient who successfully received the training. LSVT® BIG formed later when therapists applied the same “high amplitude” focus to large body movements and intense exercise. The program has shown to be a success at slowing progression and maintaining a higher level of function in those with Parkinson’s disease.
LSVT® BIG is a specialty certification obtained by qualified personnel — such as physical therapists—, trained in administering a high frequency, high amplitude, and intensive training regimen with an emphasis on daily exercise, functional daily activities and tasks, and gait activities — such as walking. It is provided in a one-to-one format with the therapist or certified professional with goals and activities that are difficult for the specific client, such as getting out of chairs, taking the stairs, or buttoning a shirt. It is a very intense program that is based on research and shown to improve symptoms associated with Parkinson’s disease, especially those with an early diagnosis or in the earlier stages.
Several therapists within the Foothills Sports Medicine community are certified in this program, so please contact your local clinic for information on this type of treatment and to discuss if it is right for you. Several clinics have staff trained in this program and other treatments for Parkinson’s disease as well.
Rock Steady Boxing Method
As mentioned earlier, several exercise types have been researched for those with higher intensity requirements. How does one choose a particular method for exercising and has there been any research to show one way is better than another?
The answer: it depends on you! Above all else, the bottom line is exercise and “pushing yourself” are crucial parts of Parkinson’s treatment. However, certain exercises have been shown to have better outcomes for those with Parkinson’s than others. One of the most beneficial exercise methods was a surprise to many: boxing.
Boxing may seem intense at first glance. However, research has shown that boxing, due to its high level of intensity and focus on a combination of footwork, aerobic activity, forward reaching, and “explosive” (i.e. high amplitude) activities encompass a complete treatment of all the deficits a Parkinson’s based exercise program should include. There are specific boxing programs for Parkinson’s disease as well.
Rock Steady Boxing® was created by a man diagnosed with Parkinson’s disease at the age of 40. Instead of relying on the medications alone, he sought to exercise based on the studies regarding high-intensity exercise. A close friend suggested he try boxing.
He saw his health and his ability improve. He was able to not only maintain his level of function but improve his function beyond where he started. He sought out other boxing and medical professionals which would lead to the creation of the Rock Steady Boxing® program with the establishment of its main gym in Indianapolis, Indiana. Today, the program certifies individuals in a non-contact boxing program that focuses on high intensity and is available to EVERYONE with Parkinson’s disease regardless of the level or stage they are at. The program itself has also been the center of several studies, including one by the University of Indianapolis of which you can view with this link.
Safety with Exercise programs for Parkinson’s Disease
An issue with those seeking exercise as a treatment for Parkinson’s disease is safety. A patient may be deterred from seeking treatment if they have an advanced case with severe balance issues or chronic injuries, such as the back or knees.
As skilled medical professionals and movement disorder specialists, that is where the physical therapists and other skilled personnel working at Foothills Sports Medicine come in. We see a variety of different chronic musculoskeletal injuries and conditions and, coupled with our medical knowledge and experience with Parkinson’s disease, we properly formulate and create a program tailored specifically for the individual client with their needs in mind.
I am personally certified in LSVT® BIG and am a certified as a Rock Steady Boxing® coach. I am located in our Sun City physical therapy clinic, serving the West Valley. Other members of the Foothills Sports Medicine community are also certified and experienced working with clients with Parkinson’s disease. Please reach out to us and contact us with any questions and we will do our best to serve you!

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