Our brain is super-efficient it is constantly rearranging and throwing out what it doesn’t need. When we become less active our brain tends to look a bit like an Autumn tree, the leaves are brown and withered and there are lots of gaps. The way our brain works is that we have certain areas that are assigned jobs. The front part for personality, the middle part for movement activities or sensory activities like feeling the heat from a fire, and the back part for seeing (well that’s a rough guide and tends to be a tad more in depth than that). But what happens say if we don’t use a part of our body or we stop performing a hobby (Like me I once played the clarinet, but I now could not read one single line of music to save myself) the brain prunes away the unneeded part and most often uses it for something else. Now that’s fine when it comes to me not being able to read music, I don’t have a need or want these days to play the clarinet.
But what happens when it’s something like your foot being able to lift up or your fingers being able to move well individually?? Then you get into trouble with tripping over objects or not being able to use cutlery to eat. This can then lead to not wanting to go out due to risk of falls or embarrassment when eating. We know that a person with Parkinson’s disease is 30 % more sedentary than that of someone the same age with out Parkinson’s. Not only are we working against a brain that is degenerating we have the secondary complications of sedentary behaviour, which can lead to other issues. What we want and need is for people to be active and not just plain old active we need you to be neuro active. We want to activate all those areas of the brain and turn those autumn trees into leafy green ones again.
We all know it by now and if not you might have been under a rock, time and time again I have heard that exercise and being active is important.
But I am active I hear you say…….. My answer to that is yes you maybe active but is it the right type of activity.
People are 30% less active than their peers with Parkinson’s.
Research indicates that at diagnosis a person with Parkinson’s is 30 % less active than that of age matched peers 1. And merely being active is not enough, the activity needs to be neuro active. When it is neuro active then you change your brain.
A walk around the block will not be enough to change your brain.
We talk about seven key principles that guide a neuro active exercise program. These are what we use to guide our treatments. These principles are based on the evidence of experience based plasticity2 which has been shown to change the brain and for Parkinson’s this has the potential to slow disease progression and help you move easier.
The seven principles are:
Amplitude – Move big, move with intention to create larger movements as normal movements in Parkinson’s are undersized. By moving BIG you are creating normal sized movements.
Power – Moving Strong, move with intention to create force and power behind even the smallest movement with help create normal movements. Think brushing your teeth or pulling on your socks.
High Intensity – Moving at 80 % of your maximum effort helps drive the change needed to change your brain.
Complexity – Now this is where it gets interesting,
by combining more than one task you help cement these changes in your brain. Think walking and saying the alphabet backwards or doing your times tables while cycling ( just watch the traffic if you are on the road) throwing a ball to your grand kids while standing on one leg, reciting your favorite poem while cooking dinner.
Daily – Unfortunately your Parkinson’s does not take a break so its up to you to move daily with intention and in the correct manner that is going to make the changes and continue to see you have a long and happy life. Exercise and activity is as important as taking your medication and needs to be a non-negotiable part of your day. It also needs to be that you are moving in a deliberate manner every time you move. The best thing is the more you do this the less you will have to make yourself move in the correct way it will become habit.
Fun – Choosing a fitness activity that you enjoy insures that you stick with your program, once you have learnt the principles as described here, as long as you move with intention you can adapt any activity to make it work for you, if you need to be doing something everyday you at least need to enjoy it.
Specificity – We all know that Parkinson’s takes on many forms and no two people experience it the same way. Having an exercise program that focus’s on your main issues is what will make the difference for you. It maybe focusing on amplitude for Bradykinesia (small movements), High Intensity for tremor, or complexity for those newly diagnosed.
Moving in a deliberate manner throughout the day at all times helps you fight Parkinson’s
Learning how to use these principles is important. As well as education and teaching the principles when you see a physiotherapist that has expert training in Parkinson’s disease, they will be able to identify the key areas that you need to work on to make your life easier. They will set you an independent program that motivates and excites you. Teach you how to move correctly and effectively. And not to mention helps you fight back against your Parkinson’s.
For further information check out our website at www.hibiscusneurorehab.co.nz
1 Ellis T & Motl R (2013) Physical activity behavioural changes in persons with neurological disorders: overview examples from Parkinson disease and multiple sclerosis JNPT 37:85-90.
2 Kliem JA & Jones TA (2008) Principles of experience-dependent neural plasticity: Implications for rehabilitation after brain damage. Journal of speech, language and Hearing research 51:S225-S239
Everyone presents differently with their Parkinson’s disease it is therefore important that you are working on the aspects of these exercise principals that are pertinent to you.
Some people have trouble with tremor or anxiety or it may be that you have trouble with falls or bradykinesia. It is important to really think about what your biggest challenges are and apply the principals of exercises to help your needs not the persons next to you.
We try to teach you all the same information so that you can use it to help you, and tailor your exercises, so that way you do an exercise it will be different to how someone else does their exercises.
If your main problem is tremor, you may find it helpful to focus on the force component of the training so power and high effort principals. These principals help adapt your body to stress, which can be a factor that affects tremor, therefore if your body is better able to cope with stress it could help reduce your tremor
If your main problem is bradykinesia or small movements it may be helpful to work on the principal of amplitude, so focusing on big movements to help recalibrate the brain and change what the brain sees as normal movement.
If your main problem is co-ordination, it may be helpful to work on dual tasking as this will help you complexity of tasks.
If your main concerns is balance it may be helpful to complete more balance tasks and work on power to help with muscle strength.
Ultimately it is about you using the knowledge we give you to help empower you to make the choices for your exercise to help improve your daily living.
Have you noticed yourself feeling weaker? There is evidence that weakness is one of the primary impairments in Parkinson’s disease. The thought behind this weakness is that there is a signaling problem from the brain to your muscles.
In a normal muscle our brain tells a motor unit in our muscles to move and this in turn tells the muscle fibres to contract so we can move our limbs. It is felt in Parkinson’s that there is a weak signal to the motor unit which causes inefficient recruitment of the muscle fibres and a decrease in speed of muscle contraction. This over time leads to slow movements and a loss of power in the muscles and the muscles not being used to their full potential again contributing to the slow and small movements that occur.
So it is important that we are bringing power back into our exercises and generating force behind our movements. And this needs to be brought into everything you do.
A great example is racket sports or cricket since is current the cricket world cup. If you do not put enough effort in to swinging your racket or bat the ball will go nowhere.
Last week we focused on amplitude and today we are working on making our movements powerful and big so I want to see force behind your big movements it will be challenging and difficult but with practice it will get easier we are working to change your brain and be at your best.
Amplitude refers to the size or range of movement. What we see with Parkinson’s disease is movements become small; and small movements make movements hard to do, think small shuffling steps, difficulty writing or doing up buttons, reduced arm swing.
So when you are exercising you need to concentrate on making your movements as big as your full available range of movement in your body, and this will be much bigger than what you actually perceive.
Over time your movements are likely to or have become under scaled and research is indicating that this is caused by sensory changes within the brain and that you perceive that your movements are normal size when they are small.
By focusing on the size of your movements you can overide these changes but it takes a lot of effort and concentration on a regular basis. Sometimes it requires a friend or family member to help you see if you are changing how you move. Often when we move big it feels abnormal as if you are moving too big, but this is a normal response as your sensory perception has changed. SO remember if it feels too big its probably just right.
Article in Rodney Times 13.9.2016
Physiotherapists can help older people be independent, improve their quality of life and reduce their health care costs. That was the message from thousands of physiotherapists across the world as they took part in last Thursday’s World Physiotherapy Day.
Every year, World Physiotherapy Day allows individual physiotherapists and member organisations to celebrate their contribution to global health. This year’s event built on the success of 2015, when thousands of physiotherapists used the #worldptday hashtag on Twitter to unite events across the globe.
The 2016 World Physiotherapy Day used the theme ‘‘Add life to years’’ and the hashtag #addlifetoyears, following the World Health Organisation’s World Report on Ageing and Health which says that ‘‘maintenance of functional ability has the highest importance’’ for older people.
Hibiscus Neuro Rehab are Neurological Physiotherapists. They work with older people to maintain their independence when they have a neurological condition, such as stroke, Parkinson’s disease, head injury or balance conditions.
‘‘Often people think of physiotherapists as just providing massage or treating back pain, but we are out there everyday working to make our patients lives better through prevention, rehabilitation and exercise,’’ Sarah Hopkins, senior physiotherapist and director at Hibiscus Neuro Rehab says.
‘‘Neurological physiotherapy is a specialised area of physiotherapy and rehabilitation. Focusing on assessing and treating individuals with disturbances of function and movement due to damage of the nervous system. It aims to promote recovery and independence and now more recently aims to slow down neurological decline. The primary objective is to improve the quality of life.’’
Neurological physiotherapists can now be known as neuroplasticity experts, which essentially assists you to reconnect the brain / spinal cord and the body.
If you or someone you know that has a neurological condition and want to add life to your years contact Hibiscus Neuro Rehab on 09 424 3254 – they are ready to help
Research is now showing that people with hearing loss are more likely to develop dementia that those with normal hearing.
READ MORE HERE Hearing loss and dementia or untreated hearing loss makes the brain shrink.
While this is been shown it has been shown that the use of hearing aids reduced cognitive decline and could delay the onset of dementia.
READ MORE HERE Hearing aid reduces cognitive decline or hearing aids stimulate brain activity.
Why may hearing loss cause decline in brain health and function?
The auditory process of hearing is processed in your brain, when a sound is heard and registered messages are sent by a network of neurons and synapses in your brain to recognition centre so you register and comprehend sounds and conversations.
When you no longer hear well you are not stimulating these pathways in the normal way, these pathways can become inactive, which causes changes within the brain, in the same way the loss of a limb affects the brain function. Loss of hearing can also cause social isolation, which leads to a cascade of other health issues both in mental health and physical function. With an overall impact on quality of life.
If you or your loved ones suspect hearing loss it is best to have your hearing tested early and regularly as restoring hearing will impact your overall brain health and quality of life.
While being a physiotherapist I advocate physical activity over brain training for brain health. I definitely believe there are benefits to completing brain games and puzzles. Now this does not mean endless sessions on the play station or solitaire on the computer. The research is definitely stacking up in favour of researched and carefully planned activities. One great website I have found is BrainHQ which is heavily based on research in the field of neuroplasticity. New research is also showing that specific brain training is having an impact on dementia and improvements in executive functioning.
Brain HQ was started by Michael Merzencih, he is the founder of a great website Posit Science and prominent neuroscientist that works in the field of Neuroplasticity.
One study called the ACTIVE trial has shown that with just 10 hours of speed training ( a type of brain exercise offered by BrainHQ) dementia risk is almost halved. There was a 33% reduction in the incidence of dementia with 10 hours training and 48% reduction in the study participants that practised for longer than 10 hours. For more information on Speed training you can read the results on Posit Sciences Blog here, for full details do check out the FAQ.
Other studies have also shown how the use of brain training from Posit science have had benefits in executive functioning including speed, attention, working memory and useful field of view. This independent research was published in Plos one. For a summary and information on other research into BrainHQ brain training exercise read this blog article on Posit science.
See what you think is it time to add some brain training to your day on top of your physical activity.
STROKE CARERS DAY
Information Day for Carers of those affected by Stroke
Organised by the Stroke Foundation
An event with:
• Guest speakers
• Workshops & Information tables covering:
o Carers experiences and connecting with other carers
o Grief adjustment and self-care
o Entitlements and access to services
o Continence and Pharmacology
Date: Wednesday, 2 November 2016
Venue: Commerce Club of Auckland, 27-33 Ohinerau Street, Remuera
Time: 9.30am to 3.00pm
Cost: $10 per person – includes registration, tea/coffee and lunch
Please contact Tracey Dealey for a registration form
Telephone: 09 475 0070 or Email: firstname.lastname@example.org
Neurological rehabilitation is a specialised area of medicine and health with many different expert professionals involved all striving towards one common goal…
To improve the quality of life of the individual living with the neurological condition.
Health modules have presented for decades that close team work with good communication and a client centered approach are vital to achieve and maintain goals. However in reality this can often be difficult to achieve and even more so when outside of a hospital setting and in the community. With more and more health care systems turning towards different types of private set ups clients can get easily lost in the system and be completely unaware of the amazing professional skills out there.
Also as a health professional our quality of service is highly lifted when I am able to referrer and suggest all types of other professionals that would be able to assist my client. For example, neurological orthotists, clinical psychologists, dietions, speech and lanuage therapists, yoga instructors, equipment companies and even engineers who can help create leading technology.
With all this in mind we have set up the NZ Neuro Rehab Networking Group, we will have an informal get together in Auckland one evening once a quarter which is open to any professional working in the field of neurological rehabilitation. This will provide a platform for some fantastic networking and relationship building with all the same goal in mind…
Please like and follow the facebook page below to join the group and be kept up to date for when the first meeting will be. FACEBOOK GROUP
Owner/operator and Senior Physiotherapist of Hibiscus Neuro Rehab.