Does regular exercise slowdown the progression of PD (Forum)

teokimhoeJoined: 03 Mar 2007Posts: 132Location: Malaysia
Posted: Tue Apr 07, 2009 5:06 am Post subject: Does regular exercise slowdown the progression of PD?

Physical exercise helps to maintain body fitness. However it neither relieves the motor symptoms nor slowdown the disease progression in Parkinson's._________________to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
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harleybluzJoined: 29 Dec 2008Posts: 9
Posted: Mon Apr 27, 2009 2:10 pm Post subject: Not necessarily

My Mom had PD and now I do. I don't really exercise but my Mom walked several miles daily and did weight strengthening exercises as well. She did everything she was supposed to do but the PD progressed rather quickly. I know that exercise will help you feel better mentally, which is big if you've got PD, and will also help your appetite and mobility. I'm sure it will help with many of the symptoms, so I would say exercise in one way of being in control of this thing. I've done more research on this disease since my Mom and I've read nothing that will slow the progress honey. But PLEEEEEESE, exercise for me too. I hate exercising. Maybe I'll feel better by proxy? :)
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strength and mobility

Anonymous
Posted: Fri Apr 24, 2009 9:30 pm Post subject: strength and mobility

I have written twice to you on this subject but I think I might not have made it clear on the issues I would like you to explain. I notice from my exercise, that I do possess strength, for example, I have he strength to hit, box and kick during my exercise. However, I do have difficulty in moving well. Mobility seems to be the problem here. I don't seem to be able to move fast with strength simultaneously. Although I can execute some moves sufficiently strongly, but I lack the speed in execution. Can you please enlighten me on why although I possess strength, I experience difficulty in mobility. I have checked with other patients suffering from Parkinson's Disease and they seem to have the same symptoms as me. Can you please elaborate on this. Teo Kim Hoo
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Mon Apr 27, 2009 6:15 am Post subject:

Thanks for the question. Patients with PD often experience slowness in the execution of tasks and we refer to this as bradykinesia or akinesia. As the disease progresses this symptom may become increasingly less responsive to levodopa._________________Michael S. Okun, M.D.

depression and anxiety

Posted: Fri Apr 10, 2009 10:40 pm Post subject: Anxiety and depression

I have depression and anxiety since I am at adult. I have seen psychiatrist for treatment. I am diagnosed as Parkinson's 2005. Questions: 1. Is my depression may be started before I have parkinson's? 2.I have sideeffect on taking my prescription i.e 1 dosage of Xanax 0.5mg and Prozac 20 at bedtime. Xanas is for my anxiety and Prozac for depression. I feel fresh and engergetic the next day. However I feel tired and dizziness easily in the afternoon after my regular exercise at gym. I have normal blood sugar level. My medication 5 dosages of Requip 2mg and 3 dosages Sinemet CR 50/100 daily. Kindly adviseBack to top
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Dr. FernandezJoined: 20 Jan 2007Posts: 90
Posted: Wed Apr 15, 2009 8:37 pm Post subject:

I'm not sure that you should necessarily blame your dizziness and fatigue with the drugs. If you experience them more right after you exercise, perhaps you should take it a little easy...either change the time that you exercise, to go to heavy, but you can stretch it a little to pace yourself...? As for your question on depression, here is an exerpt that we wrote about the topic: Depression in Parkinson’s disease is characterized by long periods of sadness or loss of interest and pleasure in almost all activities. The depressed patient feels gloomy, has decreased energy, is constantly fatigued, has poor concentration, difficulty sleeping, and loss of appetite. They can also be preoccupied with guilt, feelings of worthlessness, and hopelessness. Some may have physical complaints (such as poor sleep, loss of appetite, etc). The clinical appearance of depression in Parkinson’s disease often include slowing of motor functions and may result in worse performance of activities of daily living. Depression is very common and can affect up to 50% of Parkinson’s patients (Cummings and Masterman, 1999). Fortunately, only a small percentage (less than 20%) of depressed Parkinson’s patients actually suffer from major depression (Weintraub et al, 2004) . The majority experience minor forms of depression. While depression can result from frustration and a reaction to Parkinson disability, it is increasingly recognized as an intrinsic feature of the illness. The rate of depression does not vary with disease severity. It may even precede the motor symptoms of Parkinson’s disease. Diagnosing depression in Parkinson’s disease can be as simple as asking the patient whether he or she has been feeling sad for some period of time or whether he or she has lost interest in daily activities. However, it can sometimes be challenging as some physical features of depression such as insomnia, weight loss, loss of appetite, and motor slowing are also common features of Parkinson’s disease. Occasionally, depression can be a non-motor manifestation of “wearing-off”. In fact, depression is often under-recognized. Failure to diagnose and treat depression in Parkinson’s disease may result in suboptimal management or ineffective treatment, which can lead to significant disability. The initial approach to the management of depression in Parkinson’s disease involves optimizing dopaminergic medication to improve motor symptoms and minimize motor fluctuations. Dopaminergic medications such as levodopa, dopamine agonists and selegiline also have a mild antidepressant effect. Cognitive behavioral therapy and psychotherapy are often helpful in enhancing the coping mechanism in the Parkinson’s disease patient (Dobkin et al 2007). Family support and counseling may help improve depression in Pakinson’s patients. Selective serotonin reuptake inhibitors (SSRIs) are the most well-tolerated and most commonly used medications to treat depression in the elderly, followed by tricyclic antidepressants (TCA), serotonin norepinephrine reuptake inhibitors (SNRI), monoamine oxidase inhibitors (MAOIs), and even Parkinson’s medication that have selective D3 antagonists properties (such as ropinirole and pramipexole). These will be discussed in detail in Module 5. Patients unresponsive or refractory to medications may respond to electroconvulsive therapy (Moullentine et al 1998) (This therapy is not as bad as it sounds, really. ECT is actually a painless procedure and may even transiently improve motor symptoms of Parkinson’s disease. However, it can cause some memory loss). Repetitive transcranial magnetic stimulation (another painless, non-invasive procedure using magnets placed above the head to “stimulate” areas in the brain) also seems promising and has been recently approved by the United States Food and Drug Administration (US FDA) for the treatment of depression in the general population (Fregni et al 2005). Yours,_________________Hubert H. Fernandez

Does regular exercisee slowdown the progression of PD?

Anonymous	Posted: Tue Apr 07, 2009 5:09 am Post subject: Does regular exercise slowdown the progression of PD? Physical exercise helps to maintain body fitness. However it neither relieves the motor symptoms nor slowdown the disease progression in Parkinson's. Kindly advise Regards
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Dr. Okun Joined: 19 Jan 2007 Posts: 251 Location: University of Florida	Posted: Fri Apr 10, 2009 2:53 pm Post subject: There are studies now in animals suggestion that exercise may upregulate important brain chemicals and may thus influence disease progression. There are several sites including USC, Rochestor NY, and Pitt interested in clinical trials. _________________ Michael S. Okun, M.D.

antioxidant containing supplements

nonymous	Posted: Tue Apr 07, 2009 5:20 am Post subject: Antioxidant containing supplements I am taking antioxidants regularly for the past three years. In addition I monitor the blood level of antioxidants every six months. What is your opinion on antioxidants treatment in Parkinson's disease? Kindly elaborate
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Dr. Okun Joined: 19 Jan 2007 Posts: 251 Location: University of Florida	Posted: Fri Apr 10, 2009 2:54 pm Post subject: There is no evidence that they are helpful and certainly no evidence the cost of checking blood levels is justified. However, some people think they may help, we lack studies, and most are safe.... So check with your doc! _________________ Michael S. Okun, M.D.

oral dental health and gum disease-forum

teokimhoeJoined: 03 Mar 2007Posts: 127Location: Malaysia
Posted: Sat Apr 04, 2009 3:43 pm Post subject: oral dental health and gum diseases

Oral dental health and Gum disease

Due to slow saliva swallowing in our throat (ridigity and stiffness of our facial muscle) we have phelgm, a thick substance produced in our nose and throat that caused bacterial infection and viruses that enter the body through mouth or nose we are at the risks by gum disease ( the pink parts inside our mouth that our teeth grow out of) it is common that parkinson patient often have loose teeth

Besides we have difficulty to hold on with our denture in our gum as we have thick and slippery phelgm even you put on the gel paste.

We have to clean our denture after every meal

_________________to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
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cfinlaysonJoined: 29 Jun 2007Posts: 285
Posted: Sun Apr 05, 2009 7:36 am Post subject:

Teokimhoe, What you said sure makes sense. I had a cyst to form in my mouth and left a hole and caused me to have a wisdom tooth extraction with a bone graft. I still have a hole in the back of my mouth as well as the back for teeth on the bottom left side of my mouth are moveable, not to the point where they are about to come about, but when I bite down, I can feel them move. I have tried to explain to all of my doctor's about this, but because I don't run fever often, they just don't seem to think I have infection. Even the oral surgeon argued with me about having infection until he got under the tooth and had to get tons of pus and yucky stuff out. One day people are going to listen to us, because we know more about our bodies than anyone. Thanks for your comment. Candy

oral dental health and gum disease

Anonymous
Posted: Sat Apr 04, 2009 3:37 pm Post subject: oral dental health and gum diseases

Oral dental health and Gum disease

Due to slow saliva swallowing in our throat (ridigity and stiffness of facial muscle) we have phelgm, a thick substance produced in our nose and throat that caused bacterial infection and viruses that enter the body through mouth or nose we are at the risks by gum disease ( the pink parts inside our mouth that our teeth grow out of) it is common that parkinson patient often have loose teeth Besides we have difficulty to hold on with our denture in our mouth as we have thick and slippery phelgm even you put on the gel paste.

We have to clean our denture after every mealBack to top


Dr. FernandezJoined: 20 Jan 2007Posts: 90
Posted: Sun Apr 05, 2009 8:05 am Post subject:

Thanks!_________________Hubert H. Fernandez

Genetic and parkinson's

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Anonymous
Posted: Tue Mar 31, 2009 9:14 am Post subject: Genetics and parkinson's

In my family we have three brothers were diagnosed with Parkinson's in the last few years. Is it hereditary? Is it coincidence? Parkinson's is more than a century disease is there genetic test that can accurately predict who will ultimately develop Parkinson’s disease in the family? Regards
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Dr. FernandezJoined: 20 Jan 2007Posts: 90
Posted: Wed Apr 01, 2009 9:54 am Post subject:

You ask very important questions. Here is an exerpt from the "199 Questions and Answers on PD" that Dr. Okun and I wrote. It will soon be available in the bookstores. I think it answers your questions. Who gets Parkinson’s disease? Is it genetic? Age is the most prominent risk factor for the development of Parkinson’s disease. We like to tell people that if the neuroscientists realize their dream and make everyone live forever, we may all end up with Parkinson’s disease. The simple truth is that anyone can get it, and even though the worldwide average age is in the mid-fifties to early sixties, it can occur at any age. Men are more likely than women to come down with Parkinson’s disease. Parkinson’s disease is probably not one disease. It is likely a syndrome with multiple diseases that share common clinical symptoms (tremor, stiffness, slowness, non-motor features). There are now several families that have been identified as having a single gene as the responsible factor for their Parkinson’s disease. These single gene defects, or abnormalities in the DNA to date account for less than 10% of all cases. The most common and publicized gene defects include LRRK2 and PARKIN(Klein 2001; Klein and Schlossmacher 2006; Bonifati 2007; Klein and Lohmann-Hedrich 2007; Klein and Schlossmacher 2007; Wider and Wszolek 2007; Biskup, Gerlach et al. 2008). Gene tests are not in wide commercial use, and those people and families who choose to have a gene test should meet with a genetic counselor. The implications of knowing that you are gene positive for a disease that may strike at any age can result in serious and life changing implications. In Huntington’s disease, where ½ of all children with one parent carrying the disease will become afflicted, following genetic counseling only (approximately) one half of patients will ask for a genetic test. The most widely publicized recent case was Segey Brin, the co-founder of Google. After learning his mom had Parkinson’s disease, he and his mom were both tested, and Sergey himself was gene positive. Though he doesn’t have symptoms, there is a high likelihood at some point in is future he will develop Parkinson’s disease. He has dedicated much of his time and resources to preventing and treating a disease he will eventually personally suffer from. The new paradigm in thinking about genetics is that it is more than just the abnormality in the DNA. There is likely a complex interaction between the gene and the environment. Some experts have playfully referred to this as the gene loading the gun and the environment pulling the trigger. There is an outstanding lay review of Parkinson’s disease genetics on the website called Genetics Home Reference and it is produced by the National Library of Medicine. On this site they detail information such as the gene mutations that seem to cause Parkinson’s disease, “LRRK2, PARK2, PARK7, PINK1, and SNCA,” as well as genes associated with Parkinson’s disease, “GBA, SNCAIP, and UCHL1.” The home reference notes that how genes cause disease is unknown but they offer the following insight, “some mutations appear to disturb the cell machinery that breaks down (degrades) unwanted proteins. As a result, undegraded proteins accumulate, leading to the impairment or death of dopamine-producing neurons. Other mutations may involve mitochondria, the energy-producing structures within cells. As a by product of energy production, mitochondria make unstable molecules, called free radicals, that can damage the cell. Normally, the cell neutralizes free radicals, but some gene mutations may disrupt this neutralization process. As a result, free radicals may accumulate and impair or kill dopamine-producing neurons. So far we believe that LRRK2 and SNCA only require the parent to pass one copy of the gene to the child for inheritance (autosomal dominant). Two copies (one from each parent) seem to be required for PARK2, PARK7, and PINK1 (autosomal recessive). We are still researching inheritance patterns of genetic forms of Parkinson’s disease(Klein and Schlossmacher 2006; Klein and Lohmann-Hedrich 2007; Klein and Schlossmacher 2007). Yours,_________________Hubert H. Fernandez
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