Physical therapy is an effective therapeutic method that involves regularly performing various physical exercises. Exercise therapy is an excellent complement to conservative pharmacological treatment for various diseases affecting the musculoskeletal system, including Parkinson's disease. The main syndrome of this neurological disease is a violation of the functional activity of muscles, which manifests itself in tremor, muscle rigidity (excessive tone), hypokinesia (insufficient mobility) and instability of human posture.
Features of the classes
At the moment, exercise therapy is one of the simplest and at the same time effective methods of overcoming parkinsonian syndrome, since during exercise the functioning of the respiratory, digestive, motor and cardiovascular systems improves. In addition, exercise therapy has a significant positive effect on the patient’s psycho-emotional state, reducing the level of anxiety and the likelihood of depression (like any other activity).
Exercise therapy for parkinsonism helps to prolong the patient’s physical activity for many years and, with due diligence, to stop movement disorders in the future. Before starting to perform therapeutic exercises for Parkinson’s disease, the patient needs to consult with a medical specialist and create an individual set of exercises.
The main requirement for gymnastic exercises is to implement all types of loads: stretching, aerobic and strength training.
The benefits of exercise therapy
What are the benefits of physical education for osteochondrosis? First of all, physical activity allows you to keep your back muscles in good shape, so your spine can easily withstand everyday stress. Strong, elastic muscles and ligaments prevent the vertebrae from shifting during sudden body movements or lifting heavy objects, and prevent various types of injuries. In addition, moderate regular exercise promotes normal metabolism, which is necessary for tissue regeneration, especially cartilage. In people leading a sedentary lifestyle, metabolic processes are disrupted first of all, which leads to the development of diseases of the musculoskeletal system.
Exercise therapy helps maintain good physical shape in old age
Exercise therapy has other advantages:
- with the help of exercises, blood supply is normalized, tissues are saturated with oxygen;
- The intervertebral space increases, the load on the discs decreases;
- posture is straightened;
- muscle spasms are eliminated;
- efficiency increases;
- compressed nerve endings are released, pain disappears.
You can exercise not only in a physical therapy room, but also at home, the main thing is to choose the right set of exercises. Since osteochondrosis can affect any part of the spine, there are separate complexes for the cervical, thoracic and lumbar regions, the action of which is aimed at the corresponding muscle groups.
You can do exercise therapy at home
Exercises while sitting
For facial muscles:
- depiction of different emotions (joy, anger, surprise;
- moving, raising, lowering eyebrows;
- lip compression;
- moving the tongue out in different directions.
For the muscles of the neck and shoulder girdle
- slow turns of the head to the right and left;
- tilting the head in different directions: towards the shoulders, forward and backward;
- raising and lowering the shoulders;
- circular movements in the shoulder joints: touch your shoulders with your fingers and hold your hands in this position, then carry out circular movements with bent arms;
- shoulder extension: bend your elbows and pull them back, bringing your shoulder blades together, hold for five seconds, then relax and repeat.
For the torso muscles
- straightening your back, resting your hands on your lower back;
- bend back and forth, holding the chair seat with your hands.
For the muscles of the upper limbs:
- circular movements with palms closed into a fist, outward and inward;
- finger-picking: alternately touching the thumb with the fingers.
For the muscles of the lower extremities:
- alternately straightening the legs at the knee joints;
- circular movements of the feet clockwise and counterclockwise;
- flexion and extension of the toes.
Movements while standing
Exercises in a standing position:
- Extend your arms in front of you, turn your palms towards each other, then slowly spread your arms to the sides and back to the starting position.
- Half squats: leaning on the back of a chair, slowly bend your knees, keeping your back straight.
- Lifting on your toes: leaning on the back of a chair, rise on your toes, lifting your foot off the floor.
- Stretching: leaning on the back of a chair, stretch your leg straight back, squat down, bending the other at the knee, then return to the starting position and repeat the exercise, stretching the other leg.
Medicines - according to the scheme
Since the development of the disease is caused by a deficiency of dopamine in the brain, patients require it to be administered externally. Unfortunately, it is impossible to deliver this substance itself - it does not penetrate the blood-brain barrier well and disintegrates along the way. But on the other hand, you can inject the patient with a biological precursor of dopamine - a drug that, once it enters the blood and reaches the brain, will immediately turn into the necessary neurotransmitter. This drug has been used in neurology for about 40 years. At the end of the 60s, it made a real revolution, because the effect of its use in patients was most impressive, especially in the first years of use. It was like a miracle: a person who was trembling and had a death grip on high muscle tone, took a pill and before his eyes became outwardly practically healthy.
Since the drug became widely used, the death rate of people with Parkinson's disease has been cut in half. But, unfortunately, the effect of the medicine is very short-lived - only 1.5-3 hours, and it causes a number of side effects. The fact is that normally a person releases dopamine evenly, but when taking medication it is released spasmodically. During a sharp increase in the concentration of dopamine in the body, which occurs some time after taking the pill, the patient begins a severe attack of motor dyskinesia, during which the body does not obey its owner and makes involuntary sweeping movements; and, conversely, with a sharp decrease in concentration, immobility occurs. Due to this, many patients were previously wary of taking this medicine. But doctors are sure that there is no need to be afraid. After all, today you can successfully combat side effects with the help of additional drugs that enhance and prolong the therapeutic effect and smooth out unpleasant moments. These medications, as part of complex therapy, are very effective, especially in young patients.
Today there are 7 groups of antiparkinsonian drugs, and each of them contains at least 3-4 more drugs. Their choice and treatment regimen are very complex; they depend on the patient’s age, form, duration of the disease and many other circumstances. Therefore, the doctor involved in the management of such patients must be very knowledgeable and experienced. In addition to the timeliness of treatment, its continuity is important - drug “vacations” are very harmful for patients.
In a supine position
Exercises in a lying position:
- Bringing the knees to the chest: lying on your back, bend your legs at the knee joint and pull them towards your chest, if necessary, helping with your hands, then return to the starting position.
- Bridge: bend your knees, placing your feet on the couch, and lift your pelvis, resting on your feet and shoulders, then return to the starting position
- Hip Rolls: Bend your knees, squeezing your hips together, then place your feet on the couch and tilt both knees to the right and left.
- Hip stretch: bend your right leg at the knee, keeping your left leg straight, grab the knee of your right leg with your hand and pull it to the left, then repeat the same with the other leg.
- Inner Thigh Stretch: Bend your knees with your feet flat on the couch and push your hips out, then back together.
- Bend: Bend your knees with your feet flat on the couch and lift your shoulders and head.
- Torso bending: lie on your stomach, try to rise and arch at the waist, leaning on your elbows.
- Leg curl: Lying on your stomach, bend your knee and try to touch your buttock with your heel, then repeat with the other leg.
Exercise to improve posture
Target:
learn to regulate the tension of the muscles of the neck and torso in order to counteract the formation of a “bent posture”.
Stand with your back to the wall, so that the back of your head, shoulder blades, buttocks, thighs and shins touch the wall; arms are placed along the body, palms rest against the wall. Try to “squeeze” into the wall with tension (up to a count of 5), and then you should relax and rest as long as you need. Repeat the exercise several times, try not to interrupt your breathing. Starting position, as in the previous exercise. Remaining “stuck” to the wall with the back of your head, back, buttocks and palms, squat down “sliding” your back along the wall. If you find it difficult to get up afterwards, place a chair nearby or take a stick to lean on. Stand facing the wall so that one cheek is turned to the side, your chest and stomach, your hips seem to “stick” to the wall. Extend your arms at shoulder level and position them so that your palms “stick” to the wall. Raise your palms “sticking” to the wall up above your head. When your palms are above your head, exhale; when they return to shoulder level, inhale. Do the exercise until you feel pleasantly tired.
"Trso Twist"
Target:
improving the mobility of the muscles of the neck, shoulders, and torso. While sitting or standing, place your palms on your shoulders or behind your neck. Turn your head, neck and torso, first in one direction and then in the other, as much as possible. You should feel a slight tension in your torso muscles. Repeat 10 times.
Bending of the torso
Target:
improved posture and improved mobility in the thoracic and lumbar spine.
Sitting on a chair, place your palms on your knees, lean forward, then arch your back and straighten your shoulders. Then sit up straight. Repeat 10 times.
While sitting on a chair, place your hands on the lower back area (“grab yourself by the lower back”). Bend at the waist, sticking your chest forward and straightening your shoulders, counting to “20”. Then sit up straight. Repeat 10 times.
Abdominal exercise
Target:
strengthening the abdominal muscles.
Lying on your back (on the floor, on the bed), bend your knees, placing your feet on the floor (bed). Slowly extend your arms forward and sit down, raising your shoulders and head (while your lower back touches the floor) as many times as you have the strength to do without losing your breath. Touch your hands to your knees. Then return to the starting position. Repeat 10 times.
"Bridge"
Target:
strengthening the muscles of the trunk, thighs and training turns in bed. Lying on your back, bend your knees, placing your feet on the floor (bed), lift your pelvis, leaning on your feet and shoulders, turn left and right. Repeat 10 times.
Push ups
Target:
Stretching the shoulder muscles and improving posture. Stand facing the corner of the room. Place your hands on both walls and lean towards the corner, bending your elbows so that you feel the muscle tension. When bending, do not lift your feet off the floor. Bend over and continue to rest your hands on the walls, count to 20. Then return to the starting position. Repeat 10 times.
Circular movements and bending of the torso Purpose: to improve the mobility of the torso muscles. Starting position: standing, feet shoulder-width apart, hands at the waist. Perform circular movements with your torso (as if you were twirling a hoop), as well as bending forward, backward, and to the sides. Repeat 10 times in each direction. Exercises for the muscles of the neck and shoulder girdle Turning the head to the sides Goal: improving mobility in the cervical spine. While sitting or standing, slowly turn your head from side to side, trying to look behind your shoulder when turning. Turn your head and hold it in this position for a count of 5. You should feel a slight tension in your neck muscles. Repeat 10 times.
Head tilts to the sides
Target:
improved mobility in the cervical spine. In a sitting position. Slowly tilt your head to the sides, towards each shoulder in turn. While bending, try not to turn your head, look forward. With each bend, you should feel a slight tension (“stretch”) in the neck muscles. Perform 10 bends in each direction.
Head tilts forward and backward
Target:
improving posture and reducing the fixed flexion position of the head.
In a sitting or standing position. Bend your neck and push your chin forward.
Then return to the starting position. Repeat 10 times. Lower your head and touch your chin to your chest, return your head to its original position. Repeat 10 times. After this, slowly tilt your head back (if you perform this movement while standing, it is better to play it safe by holding on to a strong, stationary object or a bracket on the wall). Leaning your head back, try to relax your neck muscles and “feel this position.” It should counteract the fixed position of the neck in a flexed position.
Exercises for the muscles of the shoulder girdle
Exercise for alternately tensing and relaxing the muscles of the upper shoulder girdle (“prayer”)
Target:
achieve tension and relaxation of the muscles of the upper shoulder girdle by training.
While sitting or standing, bring your hands together with your palms facing each other.
Strain your arms as hard as you can so that your palms rest against each other. Count to "20". Then relax your arms and “throw” them down. Repeat 5-10 times. Try to record in your memory how you feel when you tense your arms and when you relax them. Try to reproduce the feeling of relaxation when stiffness increases. Shoulder extension (“straighten your shoulders”)
Target:
increased range of motion in the joints of the upper shoulder girdle. While sitting or standing, bend your elbows and move your elbows back, bringing your shoulder blades closer to each other. Hold them in this position for a count of five. Then relax and return your arms to the starting position. Repeat 10 times.
Circular movements in the shoulder joints
Goal: increasing the range of motion in the shoulder joints. While sitting or standing, make circular movements with your shoulders (the shoulder moves up, back, down and forward). Perform together or alternately with each shoulder 5 times. Then repeat circular movements in the opposite direction (down, forward, up, back).
Exercise with a stick
1) raising and lowering
Goal: increasing the range of motion in the shoulder joints. While sitting or standing, take a wooden stick (cane) about 1 meter long with both hands and lift it to chest level. Then try lifting the stick above your head. Next, lower your arms to chest level and then lower your hands to your knees.
Repeat 10 times.
Recommendations
Recommendations for physical therapy for Parkinson's disease:
- try to do exercises every day;
- the volume of classes is determined by the attending physician and exercise therapy methodologist;
- conduct classes when antiparkinsonian drugs are most effective;
- during classes, wear comfortable clothes and shoes;
- divide the exercises into small parts, rest in between;
- Repeat each exercise 10 times.
In addition to the above exercises, it is important to maintain an active lifestyle, walk more (maintaining a walking rhythm will often be difficult, but you can determine the appropriate rhythm and pace of walking for yourself), talk (the speech motor muscles also need constant support), write (strengthening the muscles responsible for for fine motor skills).
Monitoring of patients who practiced physical therapy daily for Parkinson's disease showed that exercise for six months or more significantly contributed to the stabilization of motor coordination, improved balance, and significantly slowed down the progression of the pathology. Remember, the more careful you are with your exercises, the sooner you can return to full participation in everyday life, such as going to the theater or doing something you enjoy. Old age is not a time for passive relaxation, it is a time when children are adults and you can live actively, play sports, improve your health and fulfill your dreams.
How to “escape” from Parkinson's disease
Parkinson's disease is a progressive neurodegenerative disease for which there is still no specific treatment. The mechanism of development of this pathology is associated with the death of neurons that synthesize the neurotransmitter dopamine
. One of the functions of dopamine is participation in the regulation of the motor sphere: with a lack of this neurotransmitter, a mismatch in the functioning of the motor systems of the brain occurs, which is expressed in general muscle stiffness, difficulty moving and instability when walking. Over time, symptoms progress and the person becomes wheelchair-bound.
One of the mechanisms for the development of the disease involves the presence of a mutation in the gene encoding the alpha-synuclein protein, which results in the formation of an “incorrect” modification of the protein that easily forms aggregates. Accumulating in dopamine neurons, such protein aggregates have a neurotoxic effect, leading to cell death.
Scientists conducted experiments on models of Parkinsonism - laboratory mice whose neurons, as a result of genetic engineering intervention, produce a mutant form of the human alpha-synuclein protein. These mutant animals, like humans, begin to show symptoms of Parkinson's disease around midlife. When the mice reached their middle age (1 year), running wheels were installed in their cages. In the cells of the control group they were also installed, but blocked.
Researchers from the University of Western Ontario (Canada) found that just 10 minutes of exercise on an exercise bike is enough to improve brain function. Participants in the experiment, before and after training, performed a task in which they were required to follow the movement of an object on a monitor with their eyes. After ten minutes of exercise on an exercise bike, their results improved both in accuracy of answers and in reaction time. Now scientists are finding out how long this effect lasts, because the duration of the workout is important not only for lazy people, but also for sick people who are physically unable to pedal for a long time.
After three months, the experimental animals moved much better and showed better cognitive performance compared to the controls. At the same time, in the brains of “runners” animals, the amount of neurotoxic alpha-synuclein aggregates noticeably decreased, and in the brain and muscles, the DJ-1 gene was activated and the content of the protein it encodes, which is involved in protecting cells from reactive oxygen species,
. It is known that “bad” mutations in the DJ-1 gene are guaranteed to cause Parkinson’s disease at a relatively young age, and mice that do not have this gene at all move noticeably worse than normal. Therefore, it is clear that the DJ-1 protein is necessary for normal motor activity.
Thus, it can be considered proven that exercise can slow the progression of Parkinson's disease by increasing the expression of the protective gene DJ-1, and the protein encoded by this gene appears to, among other things, prevent abnormal aggregation of alpha-synuclein.
Photo: https://www.flickr.com and https://commons.wikimedia.org
Prepared by Maria Perepechaeva
