Exercise for Parkinson’s Requires Comprehensive Approach

Karl Sterling from PhysioChains Education joined us in a HealthYeah interview to discuss exercise for Parkinson’s disease and so much more. Karl travels extensively as an educator to personal trainers, fitness professionals, and movement specialists. He spends 100 percent of his time focusing on Parkinson’s Regeneration Training.

Parkinson’s disease is a progressive and debilitating neurodegenerative disease. Research shows that exercise is one of the best ways of managing symptoms and preventing the progression of the disease. There are a wide range of medications and other approaches to help with Parkinson’s symptoms. However, challenges persist with falls, breathing issues, tremors, rigidity, Bradykinesia, and postural instability.

Over the past 7 years, Karl has collaborated with leading neurologists, brain experts, and movement specialists to put together a training program for Parkinson’s disease. His program is comprehensive and focuses on improving gait, grip, balance, stability, strength, and motor control and more. All from an approach of improving quality of life.

During the interview he shares his experiences and offers up some tips for those with Parkinson’s, the caretakers who love them, and also for personal trainers interested in focusing on the condition.

Below is a summary of the interview, but you are welcome to jump straight to the interview anytime!

The Symptoms of Parkinson’s Disease

During the interview, Karl breaks down Parkinson’s disease into four classic motor symptoms as he thinks about exercise programs:

  • Tremors: About 80 percent of people with Parkinson’s get tremors. While tremors can be annoying, they aren’t disabling.
  • Rigidity: Stiffness and inflexibility of the limbs, neck or trunk, is one of the primary motor symptoms of Parkinson’s disease (PD), although not all patients with PD experience
  • Bradykinesia: Slowness of movement and is one of the cardinal manifestations of Parkinson’s Up to 98 percent of all people with Parkinson’s experience slowness of movement. Bradykinesia can affect one limb, one side of your body, or your whole body, which can make you unnaturally still.
  • Postural Instability: The inability to balance and recover from variations in movement often causes falls. As Karl explains, falls are the number one killer of those with Parkinson’s disease. It’s not the fall that causes the problem, but more the hospitalization from something like pneumonia. Because of this, postural instability is one of the most distressing symptoms of PD and greatly diminishes the individual’s level of mobility.

Waking Up the Central Nervous System

As trainers think about exercises for Parkinson’s disease, Karl invites them to start first with barefoot science. This is something he learned from his mentor Dr. Emily Splichal, a podiatrist and human movement specialist. Because the feet are the foundation for human movement, Karl likes to use focus on them to wake up the nervous system. Karl spent time talking about how we spend so much time in shoes and socks. In fact, he frequently sees people who never take their shoes and socks off. But, the feet are the most highly densely populated with sensory nerve endings, mechanoreceptors, and sensory receptors.

The goal is to wake up the nerve endings to generate sensory inputs that shoot messages through peripheral and central nervous system right to the brain. In his training, Karl uses Naboso Proprioceptive Mats and Naboso Insoles to stimulate the nerves in the bottom of the feet. He has seen incredible, immediate results by putting the Naboso Textured Insole into the shoes of those Parkinson’s. This is why he also incorporates the Nabosa Proprioceptive Mats into training in his gym.

At Excy, we strongly encourage our customers to pedal with bare feet when they can for similar reasons, whether at home, at work, or the hospital. We were born barefoot. Our feet are packed with innumerable nerve endings, muscles, tendons, ligaments, bones, and fascia that respond and react to the environment. We want people to wrap their toes around the pedals and make stronger efforts to both push and pull the pedals to work different muscles. Cycling has also shown to be a great exercise for Parkinson’s Disease.

Focus on the Nerve Endings in the Hands

Both the human hand and foot represent a triumph of complex engineering. Just as Karl likes to focus on the feet in training for Parkinson’s, he also likes to focus on the sensory nerve endings and receptors in the human hand. While he uses multiple approaches and techniques, one of his favorite products is the Hypersphere vibrating massage ball by Hyperice. The Hypersphere ball was designed to activate, soothe, or loosen muscles/fascia in the: feet, calves, hamstrings, gluteus, hip flexors, shoulders, back, and forearms.

Karl focuses on using to active nerve endings in the hands and has seen it help with tremors. The help is only temporary, but this temporary assistance can be helpful for performing find motor tasks, like eating, putting on make-up, and getting dressed.

Integrating Cognitive Exercise with Physical Exercise

We are all told to exercise and realize it’s important, but for Parkinson’s disease, it is crucial to relieve some of the motor symptoms of PD. After Karl focuses on the feet and hands to wake up the central nervous system, he then focuses on teaching exercises that people can do in the gym and at home. But, it’s not just a focus on exercise for the body, but also incorporating the brain.

To do this, in addition to focused movements, Karl adds a lot of cognitive exercises and turns to research from Dr. Lisa Muratori, and associate professor at Stony Brook University. Dr. Muratori has extensive clinical experience in school and hospital-based facilities focusing on treatment of individuals with neurological deficits. Karl applies her teachings during his courses by asking those with Parkinson’s to perform physical tasks with cognitive motor interference. For example, asking people to say the alphabet or count backwards while boxing. Or, dribble a basketball, while performing simple math equations. Or, asking the person to recall directions to their favorite store from their house while passing a ball.

Karl also teaches the key aspects of getting out of bed or getting up from a flat position. This ranges from getting up from a face down position, to crawling forwards and backwards, and then learning how to pull oneself up.

Vigorous Exercise for Parkinson’s Disease

During the interview we also touched on the need for people with Parkinson’s to engage in a regimen of intense, or vigorous exercise. Research shows that the greatest benefits come from exercise three times a week with your heart rate between 80 to 85 percent maximum. As Karl explains, this is important because the elevated heart rate causes the brain to create this growth hormone called brain-derived neurotrophic factor, BDNF. John Ratey talks about it in this book called Spark. When we create BDNF, the elevated heart rate, the neurotrophic factor circulates in the brain. This helps us slow the progression of dying brain cells.

Karl also went into a conversation with Dr. Wendy Suzuki at New York University who talks about how BDNF helps to give birth to new brain cells. This is especially important in olfactory bulb area, which is sense of smell, and the hippocampus, which is memory and future planning. At Excy, we find that having those with Parkinson’s pedal with the arms is often the fastest, most efficient way to get the heart rate up quickly. Karl also explained that swimming boxing, arm circles, even flapping a towel can be other fun ways to do upper body cardio and conditioning to get the heart rate up.

Caretaker Suggestions

Try to get them to do something. To go somewhere. Group fitness is great for socialization. There are no bad Parkinson’s classes. Get them to do anything to move more. Participate in classes together. Like Yoga, dancing, Rock Steady Boxing, martial arts and more can be done in pairs. We also find sitting next to your spouse and simply watching TV while they pedal can also be motivating.

Karl’s Reading List: Applicable Across Parkinson’s and More

We always ask our HealthYeah guests what they are reading. Karl gave us a wonderful list that has had a profound affect on how he educates and work with clients. You can find that list here. Those interested in attending a Parkinson’s Regeneration Training workshop can find more details at www.parkinsonsregenerationtraining.com. Karl also founded The Parkinson’s Global Project, which is dedicated to funding Parkinson’s research and supporting Parkinson’s associations around the world. You can support the project here.

There is so much more amazing advice from Karl and we invite you to watch the video on the Excy YouTube channel.

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