Parkinson’s disease symptoms and signs may vary from person to person. Early signs may be mild and may go unnoticed. Symptoms often begin on one side of your body and usually remain worse on that side, even after symptoms begin to affect both sides.
Parkinson’s signs and symptoms may include:
Tremor: A tremor, or shaking, usually begins in a limb, often your hand or fingers. You may notice a back-and-forth rubbing of your thumb and forefinger, known as a pill-rolling tremor. One characteristic of Parkinson’s disease is a tremor of your hand when it is relaxed (at rest).
Slowed movement (bradykinesia): Over time, Parkinson’s disease may reduce your ability to move and slow your movement, making simple tasks difficult and time-consuming. Your steps may become shorter when you walk, or you may find it difficult to get out of a chair. Also, you may drag your feet as you try to walk, making it difficult to move.
Rigid muscles: Muscle stiffness may occur in any part of your body. The stiff muscles can limit your range of motion and cause you pain.
Impaired posture and balance: Your posture may become stooped, or you may have balance problems as a result of Parkinson’s disease.
Loss of automatic movements: In Parkinson’s disease, you may have a decreased ability to perform unconscious movements, including blinking, smiling or swinging your arms when you walk.
Speech changes: You may have speech problems as a result of Parkinson’s disease. You may speak softly, quickly, slur or hesitate before talking. Your speech may be more of a monotone rather than with the usual inflections.
Writing changes: It may become hard to write, and your writing may appear small.
See your GP if you have any of the symptoms associated with Parkinson’s disease — not only to diagnose your condition but also to rule out other causes for your symptoms. Your GP would refer to a Movement Disorder Specialist or you can contact Parkinson’s Victoria team who can also suggest a list of Parkinson’s Specialist.
Because the cause of Parkinson’s is unknown, proven ways to prevent the disease also remain a mystery. However, some research has shown that caffeine — which is found in coffee, tea and cola — may reduce the risk of developing Parkinson’s disease. Green tea also may reduce the risk of developing Parkinson’s disease.
Some research has shown that regular aerobic exercise may reduce the risk of Parkinson’s disease.
Exercise is an important part of healthy living for everyone, however, for people with Parkinson’s disease (PD) exercise is not only healthy, but a vital component to maintaining balance, mobility and daily living activities, along with a potential neuroprotective effect. Most of the experts agrees that exercise is important to good outcomes in PD, and data supports that. Exercising enhances the sense of wellbeing, even across different disease stages and severities. There is a growing consensus among researchers about the short and long-term benefits of exercise for people with PD.
Research has shown that exercise can improve gait, balance, tremor, flexibility, grip strength and motor coordination. Exercise such as treadmill training and biking have all been shown to benefit, along with Tai Chi and Yoga. So far, studies have shown:
Engaging in any level of physical activity is beneficial, rather than being sedentary — this is associated with improved motor symptoms.
For people with mild to moderate PD, targeted exercises can address specific symptoms for example: aerobic exercise improves fitness, walking exercises assist in gait, resistance training strengthens muscles.
Exercise may also improve cognition, depression and fatigue, but the research is still ongoing in these areas.
There is a strong consensus among physicians and physical therapists that improved mobility by exercising may improve thinking, memory and reduce risk of falls. By avoiding complications from falls you can prevent further injury. At this time, we know that people who exercise vigorously, for example running or cycling, have fewer changes in their brains caused by aging. Studies in animals suggest exercise also improves PD symptoms.
We would recommend a regimented exercise program to their patients and also to people who are worried about getting PD due to family connection.
Exercising did not affect the amount of dopamine in the brain, but the mice that exercised the brain cells were using dopamine more efficiently.
Exercise improves efficiency by modifying the areas of the brain where dopamine signals are received — the substantia nigra and basal ganglia.
Scientists at University of Pittsburgh found that in animal models, exercise induces and increases the beneficial neurotrophic factors, particularly GDNF (glial-derived neurotrophic factor), which reduces the vulnerability of dopamine neurons to damage.
Dopamine travels across a space between two adjacent brain cells called a synapse. This process is called signaling and it is essential for normal functioning. To end the signal, a protein complex called the dopamine transporter normally retrieves dopamine from the synapse. The first thing Fisher et al. found is that animals that had exercised possessed less of the dopamine transporter, meaning that dopamine stayed in their synapses longer and their dopamine signals lasted longer.
They found the cells receiving the dopamine signal had more places for the dopamine to bind in animals that exercised, and could receive a stronger signal. This binding site is the D2 receptor.
They also studied the D2 receptor in a subset of the human subjects who were within one year of diagnosis and not on any medications, using an imaging technique called positron emission tomography (PET). They found that exercise increased the expression of D2 receptors in humans.
Any exercise is beneficial.
Any form of physical exercise you do without injuring yourself will provide benefit. Before beginning any new exercise, consult with your physician and, if available, a physical therapist that understands PD.
Formal exercise programs balance several different aspects of fitness including strength, balance, coordination, flexibility, and endurance.
Each of these areas provide a benefit to people with PD. Achieving a balance that works and engages you in a program you can start, maintain and expand upon is the goal.
Many programs target the rapid gains that can be achieved through a focus on improvements in functional capacity and mobility. These programs vary according to different aspects of physical training. Examples of exercise programs for people with PD include:
Intensive sports training
Treadmill training with body weight support
Alternative forms of exercise (Yoga)
Home-based exercise (YouTube videos)
Practice of movement strategies
Right now! Everyone should exercise more, whether they have PD or not.
In PD, a special kind of neuron (brain cell) that produces the chemical transmitter dopamine gets damaged and lost. However, there is a lag between the time when neuron loss begins and when PD movement symptoms start to show. By the time most people are diagnosed, as much as 40 to 60 percent of their dopamine neurons are already gone. The reason people with PD don’t experience symptoms until they reach this point is that the brain can compensate for the loss of dopamine neurons by adapting. In fact, the brain reshapes itself throughout life in response to experience. Scientists call this ability to change and compensate “experience-dependent neuroplasticity.”
The best way to see benefits is to exercise on a consistent basis. People with PD enrolled in exercise programs with durations longer than six months, regardless of exercise intensity, have shown significant gains in functional balance and mobility as compared to programs of only two-week or 10-week durations.
When it comes to exercise and PD, greater intensity may have greater benefits. Experts recommend that people with PD, particularly young-onset or those in the early stages, exercise with intensity for as long as possible as often as possible. Your doctor might recommend an hour a day three or four times a week, but most researchers think that the more you do, the more you benefit.
Intense exercise is exercise that raises your heart rate and makes you breathe heavily. Studies have focused on running and bicycle riding, but experts feel that other intense exercise should provide the same benefit.
Regardless of your condition, always stretch, warm up and cool down properly.
Exercise in a way that is safe for you. Know your limits.
Many support groups, therapists and exercise programs can help with PD-safe exercises or help you set up your own program.