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Parkinson's Disease: Killing the messenger.

Dopamine is a neurotransmitter. You can think of Dopamine as a messenger to the neurons in your brain. The message it sends is very important for movement control, it constantly fine tunes the way we move. Someone with lower levels of Dopamine in their brain could have trouble moving fast, rigid muscles, a tremor at rest, freezing gait and poor balance and motor coordination. As the Dopamine levels get even lower, non-motor symptoms like depression, anxiety and apathy could appear. This is Parkinson's Disease (PD) in a simplified nut shell.

PD is a progressive neurodegenerative disease, where the neurons that produce dopamine gradually deteriorate. There is currently no cure. If you (or someone you love) has been diagnosed with Parkinson's you are not alone. Over 100,000 Canadians live with PD but no cure doesn't mean no treatment. There is significant and ample research out there demonstrating the power you have to fight back and it starts by knowing. You need to know what you're up against and you need to attack from all angles.

I am not a Parkinson's expert, but I have experience treating Parkinson's from a physiotherapy point of view. I have seen with my own eyes the positive impact a holistic approach (drug, exercise, speech, psychology etc) to treatment can have on someone's life who is living with PD.

Physiotherapy focuses mainly on education, balance, coordination, strength, endurance and flexibility. Our primary goal is to slow the progression of the disease while improving overall quality of life. One way we do this is by teaching little tricks, one of which is based on the BIG & LOUD Therapy Program. Without getting into too much detail, it is important to train functional activities with increased repetition, cueing for exaggerated, large movements. For example, when walking (as a functional activity) we will teach to take big steps and large arm swings, maybe count "1,2" out loud... PD makes movement small and short, so exaggerating the movement in therapy will translate into a more "normal" movement size in everyday activities. Why is this important? Many reasons. For example, if Donald is walking with shuffling feet, hardly lifting his feet off the ground and his steps steps are very small, chances are, Donald is going to trip on that rug his living room. Or what happens if Donald only moves his muscles a little, or if he only moves a joint 20 degrees out of the potential 100 degrees? Eventually his joint will be so stiff he wont be able to go past 20 degrees even if he wanted to. There are many reasons training BIG is important for PD, and this is just one area we cover in physiotherapy.

The American College of Sports Medicine has recommended the following for PD:

Aerobic 20-60 min/ day, 3-5 days/ week. Resistance training for large muscle groups 2-3x/week. Flexibility training with focus on spine and trunk muscles 2-3x/ week and Balance training for 10-15 minutes 2-3x/ week. Another important part of physiotherapy is creating a safe, home exercise program specific to the client, following these recommendations.

In summary, I want to re-iterate that we can't wait around for a cure, we must focus on what we can do today. Don't wait, start now and power to you!

One of my clients with PD once said "there are good days and bad days, but there are always daily victories that we must acknowledge." Focusing on his daily successes, even if sometimes small, helped him stay motivated and stay in the right head space.

Please spread the word.

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