W7: Parkinsons

Question 1

Define parkinsons. Describe its mechanism and some of the symptoms that occur

Answer 1

parkinsons is a neurodegenerative disease in which dopamine producing cells degenerate in the basal ganglia in the brain. The dopamine produced in the basal ganglia are responsible for exciting motor actions, therefore a degeneration in the dopaminergic cells means that motor movement impairments are observed. The mean age of onset is around 65 years.

Some of the symptoms are hypokinesia (loss of movement), bradykinesia (slowness of movement), shuffling gait, rigidity, cognitive and emotional functioning, and loss of postural reflexes.
However one thing that parkinsons patients are able to do are use external cues to produce movement. This means that a shift in the way movement is learnt changes where the cortex becomes regulator.

Question 2

What might be some of the perceived barriers of parkinsons patients in engaging in physical activity

Answer 2

Low expectations of outcomes, fear of falling, and lack of time were the perceived barriers for engagement with physical activity in parkinsons disease patients (ellis et al., 2013)

Question 3

Why would a parkinson’s patient want to exercise? What’s the mechanism in improving Parkinson’s disease. Whats the evidence behind the benefits of physical activity in parkinson’s disease

Answer 3

There are several reasons: one is to prevent any more complications such as cardiovascular diseases or diabetes, another is to maintain a social life. This means that parkinson’s patients are not ashamed of how they are viewed in public. the third is to prevent any Parkinson’s related disease such as osteoporosis, depression etc. Finally and possibly the most important is to slow down the deterioration of the parkinson’s disease (Ahlskog et al., 2011).

Exercise can actually reduce the dopaminergic neuron damages through reducing inflammation, oxidative stress, repairing mitochondrial damage, modulating autophagy and inducing neurotrophic factors, neurogenesis, and angiogenesis (Xu et al., 2019).

Multiple studies have investigated the effects of physical activity on Parkinson’s disease. Some of the known benefits from general physical activity were, improved balance (Choi et al., 2020), strength, gait speed, physical. functioning, HRQoL (Lee et al., 2017;
Goodwin et al., 2008), and cognitive functioning (Da Silva et al., 2018).

Moreover, in a study on gait specific interventions compared to normal physical activity on walking improvements, gait specific exercises benefitted patients gait cadence and stride length. (Ni et al., 2018). This result meant that if the focus was specifically on gait/walking, then walking specific exercises should be implemented.

Question 4

Give some recommendations for exercise in Parkinsons patients

Answer 4

There are many types of exercises associated with different types of benefits, therefore Parkinson’s patients may want to tailor each exercise towards their needs.
For instance, aerobic exercise brings improvements in motor function and balance (Shu et al., 2018). However this study fails reveals that there is a lack of evidence towards follow-ups on the lond-term effects.

Tai Chi can be used as a methods to prevent falls or improve balance, and motor functionality of the patient (Liu et al., 2019)

Dancing can be used as a method to improve motor symptoms, and timed up and go tests (Dos Santos Delabary et al., 2018)

Evidence also suggest that both home-based and centre based exercises bring about improvements in gait speed and balance-related activities therefore depending on the preferences, patients could choose a home-based exercise mode rather than the latter (Flynn et al.,).