Review of exercise and PD, and creativity and PD

Today’s feed brings me the following two articles, one of which points out that exercise is not a “one size fits all” approach to controlling PD symptoms, and the other which is more exploratory in nature and thought-provoking.

Exercise and PD – review article 

In this review article, the authors

” briefly review the state of the art in key areas and speculate on the likely state of research in each area in the next 20 years. Key areas relate to: (1) the physiological benefits of exercise with respect to disease modification; (2) the best type of exercise; (3) the optimal intensity of exercise; and (4) implementation strategies for increasing exercise/physical activity uptake.”

“Does exercise have significant promise to mitigate the burden and possibly the course of PD? We think so. But to answer that question we will need to design trials that account for the multisystem nature of PD, identify the specific effects of exercise and target the underlying pathophysiology/mechanisms. A better understanding of this would allow for a more personalized approach rather than the current ‘one size fits all’ and could most likely confer greater benefits.”

Art for Better Health and Wellbeing

A provocative article that discusses the relationships among, Dopamine, creativity, and Parkinson’s Disease:

“Dopamine’s role in creativity seems causal: when patients with
Parkinson’s receive dopaminergic medicine to improve their
mobility the treatment also stimulates curiosity, motivation, and
even creativity in as many as 10% of patients.

Some develop beautiful art, even if their creative intelligence had never
expressed itself before. Other patients change their existing
artistic expressions under dopaminergic stimulation, sometimes
strikingly.

Perhaps even more provocative is the recent finding that healthy
people who had chosen an artistic profession early in life had
a reduced risk of developing Parkinson’s disease.”

 

A couple of studies on gait improvement in PD, and a thesis on music therapy

What looked promising turned out to be fairly lackluster as far as results – although it appears that putting in time on a treadmill might be better for Parkinson’s patients than some other forms of exercise, when it comes to gait and balance. And challenging courses of treatment were recommended for people with PD.

Exercise and Parkinson’s – comparison

Background and Purpose: Impaired gait, balance, and motor function are common in Parkinson disease (PD) and may lead to falls and injuries. Different forms of exercise improve motor function in persons with PD, but determining which form of exercise is most effective requires a direct comparison of various approaches. In this prospective, controlled trial, we evaluated the impact of tango, treadmill walking, and stretching on gait, balance, motor function, and quality of life. We hypothesized tango and treadmill would improve forward walking and motor symptom severity, and tango would also improve backward walking, balance, and quality of life.
Results: In this study, treadmill walking improved forward and backward walking.

Healing Sounds: an anthropology of Music Therapy

explore embodiment, relationship – building and aesthetic creation as three areas n which music can allow the harnessing of affect towards health goals. I note music’s powerful affect on the human body and movement, and the ways in which these affects are mobilized towards specific clinical goals. I explore the various human –  to – human and human – to sound relationships that are mobilized, created or strengthened through music therapy interventions, and how they relate to health and to the affect of “becoming”. Finally, I note the strong evidence for musical and esthetic creation as a part of self – care, both by music therapists and by their clients, and argue for a broader understanding of how creativity impacts health, by allowing people to affect their environments

Exercise and Gait

Methods: Forty-seven PwPD (mean age: 73 years; 19 females, Hoehn and Yahr stages 2-3) who had participated in 10 weeks of highly challenging gait and balance training were included. Baseline demographics, disease-related factors, physical and cognitive ability, and perceived health were used for the prediction of percent change in balance performance (the Mini-BESTest) and comfortable gait speed between the pre- and postassessments, using multiple linear regression analyses.
Results: Thirty-five percent of the variance of change in balance performance was explained by General Health Perceptions (β = −0.36), the Timed Up and Go test (β = −0.33), and the single-task performance of a cognitive task (β = −0.24). Forty-nine percent of change in gait speed was explained by gait speed while performing a dual task (β = −0.46), dual-task interference while walking (β = 0.43), time to complete the Timed Up and Go test (β = −0.29), and percent error on a cognitive task (β = −0.25).
Discussion and Conclusions: The results may suggest that the PwPD with overall lower perceived health, functional mobility, and cognitive functions are the ones most likely to benefit from highly challenging and attention-demanding gait and balance training.

High cholesterol < lower Parkinson's Risk

http://www.medscape.com/viewarticle/881576?src=wnl_edit_tpal

Higher levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) are associated with a decreased risk for Parkinson’s disease (PD) in men, a large observational study shows.

Just my luck – my total cholesterol has always been low, even though recently my HDL has been a high percentage of LDL and total cholesterol.

261,638 persons aged 40 to 79 years not taking statins.

…followed from baseline to death, end of study, or PD diagnosis.

From annual blood tests, researchers collected information on levels of TC, LDL-C, and high-density lipoprotein cholesterol (HDL-C).

They categorized TC levels into upper (210 mg/dL or more), middle (180 to 209 mg/dL), and low tertiles and LDL-C levels into upper (140 mg/dL or more), middle (110 to 139 mg/dL), and low tertiles.

Among men, compared with low levels, middle and upper levels of TC and LDL-C were significantly associated with lower risk for PD.

Biomarkers,cardio training, singing and dancing, and how jokes work.

This is a long post. Most of the links are to free, full text articles or reports.

Recent advances in Biomarkers for Parkinson’s A review of the advances currently being made in the search for a cure.

INTERVAL TRAINING FOR CARDIOMETABOLIC AND BRAIN HEALTH

 

1. Engaging in interval exercise can boost fitness and improve your mood in a time-efficient manner.

2. Short exercise breaks like climbing the stairs can refocus attention and help maintain productivity in the workplace.

3. Combining interval exercises with motor skill training in a clinical setting can augment the recovery of function.

Dance and Health Training research report   

The aim of this research was to create a best practice model of dance and health continuing professional development (CPD); to create a dynamic, interdisciplinary course of study for dancers who are engaged in facilitating dance across a range of dance genres within health care contexts.

Outcomes of the project:  Full listing of international and national examples of best practice, core literature, key expert practitioners, full course content and delivery requirements are set out in this report.

(Note: specifically related to Ireland).

Sing while you work

This pilot study is the first Irish study of the health and wellbeing benefits of HSE workplace choirs. It is one of few studies to investigate the health and
wellbeing benefits of choir for Health Service Staff internationally.  Qualitative data confirms previous study findings; namely that a workplace choir can promote social connectedness, enjoyment at work, and staff
engagement; reduce stress; and improve perception of health and wellbeing.
Benefits of attending are noticed across workplace communications.

Comparison of two different exercise programs  (abstract only)

After treatment, UPDRS-II scores improved (mean change: EXE, -4.5 points; CYC, -3.2 points). The results for the other outcomes (EXE and CYC, respectively) were: PDQ, 13 and 17%; BDI, -2.5 and -2.1 points; 6MWT, 129.6 and 141.6 m; and EQ-5D, 12 and 9% (all p < 0.05, but there was no difference between groups). EXE vs. CYC resulted in improved SE-ADL (8.4 and 4.0 points, effect size [ES]: 0.12), BBS (8.8 and 4.2 points, ES: 0.44), and 2 measures of posturography (ES: 0.11 and 0.21) (p 0.05).

CONCLUSION:
Two highly different exercise programs resulted in similar improvement of most motor and clinical symptoms in PD patients.

One thing Parkinson’s People do to help cope with  an incurable (so far), progressive, degenerative, neurological disease is to use humor.

The following showed up in the Dance+Parkinson’s search feed, and are included here with a caveat that some of the jokes used to illustrate the ways in which humor works (theoretically) can be be considered offensive.

How do jokes work?

Back before the Internet, there was a Humor list-serve, dedicated to the study of humor and how it works.  The above PDF attempts to address the varieties of jokes, and repeats some potentially offensive ones to illustrate its concepts. Much of the text refers to the following free e-book on the Gutenberg project.

Laughter: an essay on the meaning of humor   by Henri Bergson

 

 

 

Nordic Walking & PD – no decision yet.

Abstract

Background

It is well known that physical exercise is the main therapeutic element of rehabilitation programs for people with Parkinson’s disease (PD). As traditional forms of exercise can guarantee significant health benefits, the emergence of non-conventional physical activities, such as Nordic walking (NW), may add positive effects.

Objective

To appraise the available evidence on the main effects of NW in the rehabilitation programs for people with PD and to propose a design for upcoming research that might improve the uniformity of future trials.

Study Design

Systematic review

Literature Survey.

A literature search of five established databases (PubMed, MEDLINE, Scopus, Web of Science and Cochrane) was conducted.

Method

ology. Any relevant randomized controlled trials (RCTs) pertinent to NW in PD published in English from inception to February 2017, were included. PRISMA guidelines were followed and the methodological quality of each study was assessed by the PEDro scale.

Data Synthesis

Sixty-six studies were retrieved and 6 RCTs (221 subjects) entered the qualitative synthesis. Overall, these studies portrayed NW as feasible and likely to be effective in improving the functional and clinical outcomes of people with PD. When comparing NW with other exercise-based interventions such as treadmill training, free walking, a program of standardized whole-body movements with maximal amplitude (LSVT®BIG training) or a home-based exercise program, the findings proved controversial.

Conclusions

High heterogeneity and methodological discrepancies among the studies prevent from drawing firm conclusions on the effectiveness of NW in comparison with other exercise-based interventions currently employed in people with PD. Further investigations with a common design are necessary to verify whether NW may be included within conventional rehabilitation programs commonly recommended to people with PD.

What are we going to do tonight, Brain?

Same thing we do every night, Pinkie – SING!!!

Okay, if you caught the reference to Pinkie and the Brain, you probably already like to do stuff that stimulates the neurons with witty references to arcane bits of history, pop culture, and the like. So you won’t be terribly disappointed if I caper about with just a few links to reports on and research on how singing benefits the brain and the lives of those who sing.

http://newsvote.bbc.co.uk/mpapps/pagetools/print/news.bbc.co.uk/2/hi/health/4448634.stm

How singing makes you happy  (summary article and its sources below:

Can Music provoke involuntary body responses?  Now I’ve heard everything – using music to provoke salivation!

 

Eat now, exercise later, protect against insulin insensitivity – and more news!

From Medical News Today:

 “Harm from a weeks overeating may be canceled by exercise”

That’s the limit to the good news, though. The article also reports that even occasional binging can cause problems, and a week of overeating could have a negative effect on insulin sensitivity. Exercise could protect against this metabolic damage.

 For certain, a lack of exercise and an unhealthy diet have been linked to obesity and metabolic syndrome. The article is at this link: http://www.medicalnewstoday.com/articles/313881.php

related article “Healthy living linked to higher brain function, delay of dementia

A diet high in vegetables and fruits leads to better cognitive functioning, and when combined with exercise, the effect is extended downwards to those who reported eating half as many vegetables.

the original research article is at http://jpubhealth.oxfordjournals.org/content/early/2016/10/28/pubmed.fdw113

 In other news…

Mayo Clinic researchers found that it only takes 1 mutation in the PINK1 gene to increase the risk of early onslaught PD. Until this report, it had been thought you needed to have 2 mutated genes to make it happen.  Here are links to the pages:  http://www.medicalnewstoday.com/releases/313885.php or

Heterozygous PINK1 p.G411S increases risk of Parkinson’s disease via a dominant-negative mechanism