Parkinson's Disease: Exercises Help Minimise Symptoms

Exercise is an important part of treatment for those who have Parkinson's disease.

It has no known cause, and it doesn’t have a cure. Its symptoms, the most common of which is tremoring or shaking of the hands, worsen markedly as the disease progresses. And in its later stages, Parkinson’s disease patients with joint and flexibility problems will have difficulty carrying out everyday activities without help.

HOW EXERCISE BENEFITS THOSE WITH PARKINSON'S DISEASE

While medication can help control the symptoms, exercise plays a crucial role in improving flexibility, balance and strength. Patients who exercise feel better physically and mentally, and their quality of life improves. “We encourage patients to exercise and undergo physiotherapy at the early stage of the disease. While exercise won’t reverse the disease, it will help patients have a better sense of control of their body,” said Dr Lim Ee Wei, Consultant,Department of Neurology (SGH Campus), National Neuroscience Institute.

Growing evidence from studies overseas also suggests that exercise slows the progression of the disease. The symptoms also appear to develop more slowly in people who were active before diagnosis of the disease, said Dr Dawn Tan, Senior Principal Physiotherapist, Singapore General Hospital (SGH). “Patients who led a sedentary lifestyle tended to succumb to complications faster,” she said, noting that they were also likely to have more serious symptoms like stooping, tightness, weakness and poor balance earlier than those who were active.

In the early stage, any exercise that boosts cardiovascular health, and strength, flexibility and balance, can and should be done, Dr Tan said. At this stage, patients might already experience some tremors, slowness of movement, muscle stiffness, and joint pain.

So doing a lot of exercises, or even just brisk walking or raising one’s arms, is important in “getting patients to open up and fight gravity”, she said.

SYMPTOMS IN THE ADVANCE STAGES OF PARKINSON'S DISEASE

As the disease advances, its symptoms become more pronounced. “[Patients] get tightness in the calves and hamstrings, the chest, and the front of the hips, which makes them more and more hunched,” Dr Tan said.

Patients may walk more slowly, with their steps getting smaller and smaller until they are only shuffling. They may also experience what is known as "freezing", where they feel as if their feet are glued to the floor. When those symptoms appear, their carers or therapists can look to aids such as a walking stick with a light, or floor markers, to point patients to the next step to take, or music to provide a rhythm for a regular walking pace.

Many patients also have swallowing and speech difficulties, and so might require the services of an occupational and/or speech therapist.

Parkinson’s disease is caused by a loss of nerve cells in the part of the brain called the substantia nigra, which results in a reduction in a chemical called dopamine in the brain. Dopamine plays a key role in regulating movement.

“What causes the death of these cells? People believe that there are multiple causes such as environmental, genetic and oxidative stress. We can’t find a definite cause, but what is known is that age is a risk factor,” Dr Lim said.

In Singapore, Parkinson’s affects three in every 1,000 people over the age of 50 – usually between 50 and 60. It can also hit younger people, but early onset of the disease is rare, she added.

Ref: N18

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