Parkinson's disease is a progressive neurological disease affecting about 1.5 million people in the United States. It's characterized by a lack of muscle control that results in trembling throughout the body. Exercise or physical therapy is often part of the treatment, but more studies are needed to determine if exercise can help in all stages of this degenerative disease.
Stages of Parkinson's Disease
Harvard Medical School defines five stages of Parkinson's Disease using the Hoehn and Yahr Staging of Parkinson's Disease model. The fifth or end stage presents with body wasting and weakness, complete invalidism with continuous nursing care required. Range of motion exercises at this stage would be very limited and may be impossible because of advanced dementia and disorientation.
Adaptations
Parkinson's disease occurs when the cells producing dopamine in the brain stop working. Dopamine is a neurotransmitter that enables your brain to communicate movement to your body, and without it you lose control of your muscles. According to the Parkinson's Disease Foundation, exercise may improve the muscle control of patients by making the brain more efficient at utilizing the dopamine it has available.
Passive Range of Motion Exercises
Passive range of motion exercises are done with the help of a nurse or caregiver to improve flexibility and movement in your joints. In the end stage of Parkinson's disease, the patient is bedridden and may not be able to communicate. But if the patient is alert, basic ROM exercises may improve discomfort and mental outlook.
Facial Expressions
To potentially improve the muscle tone in your face, perform exaggerated facial expressions, such as pursing your lips, or squinting your eyes. If you are unable to control your facial muscles, have a caregiver massage your face to improve muscle tone, and if possible, exercise your voice by trying to speak, exaggerating your facial movements as much as possible.
Head and Neck
Passive ROM exercises for your head and neck begin with removing your pillow so your head is flat on the bed. Have your caregiver slowly move your head to the left until your nose is in line with your shoulder. After a few seconds, slowly move your head to the right and repeat. Once completed, your caregiver should gently lift your head off the bed and tip it downward into your chest. Repeat several times or until you become tired.
Legs and Arms
Passive ROM exercises for your extremities involve slowly lifting your arm, keeping it straight, from the side of your body to your head and then back down. Your legs should be gently lifted from the bed a few inches, and then move one leg away from the body as far as possible and bring it back, crossing it over the resting leg as far as possible. Repeat with the other leg.
References
- Harvard Medical School: Hoehn and Yahr Staging of Parkinson's Disease, Unified Parkinson Disease Rating Scale (UPDRS), and Schwab and England Activities of Daily Living
- Parkinson's Disease Foundation: What Is Parkinson's Disease?
- Parkinson's Disease Foundation: Does Exercise Impact Parkinson's?
- The Center for Neurological Study: Exercises for the Parkinson Patient
- Parkinson Research Foundation: What Is Parkinson's Disease"
