Healthy living

Healthy living and exercise ideas for people in the East Midlands.

Staying Active

Where do I begin?
If you’re looking for exercise ideas, this page contains plenty of information and links on how you can stay active. If you’re not sure about the best exercise for you, Parkinson’s UK have put together a great resource to help you decide how best to stay active, and what exercises you should focus on. This is available via the ‘Parkinson’s UK- Exercise’ button.


How do I stay active at home?
Parkinson’s UK have released a webpage with information to help people stay active at home; Staying active at home. This includes a link to their YouTube channel, which amongst other great information, has a set of varied 30-minute exercise videos for people to try. An example exercise video is available adjacent.


Exercise Classes in the East Midlands
PEMRIG have created a document of exercise classes available in the East Midlands, which you can download adjacent. Please be aware that whilst we will endeavour to keep this list up to date annually, we would recommend that you contact class organisers directly for further details. There is also a document containing helpful websites for people with Parkinson’s on physical and mental health which can be downloaded adjacent. You can also search using your postcode for exercises classes near you via the Parkinson’s UK website, This can be accessed via the adjacent button.

Alternatively, phone the Parkinson’s UK Helpline number 0808 800 0303 to enquire about various activities in your area of the UK


Physiotherapist recommendations on exercise and Parkinson’s
Bhanu Ramaswamy is a specialist physiotherapist, she recommendations: 
* Sally Tawhai and the 2.6 Challenge she did for the Reach your Peak team and
* Vigorous exercise to music by Andy McNeill 
Both of these programmes can be completed seated or standing.

If 30 minutes is too much, try a 10-minute chunk with the Power for Parkinson’s ‘Take 10’ series of fitness videos. An example of this is shown in the YouTube video above.


The Benefits of Exercise
Physiotherapist Julie Jones spoke at a Parkinson’s UK research event in December 2020. Check out her talk on the importance of exercise in the YouTube video adjacent.


Paper-based exercises
Finally, if you prefer paper-based exercise, the NHS website has produced a variety of gym-free exercises at: Live-well gym free workouts


Resources for different types of exercise
It is well established that exercise is of importance to the welfare of People with Parkinson’s. Exercise is healthy and helps in maintaining balance, mobility and daily living activities. Exercise also has a potential neuroprotective effect. Here are some general websites to activities such as Tai Chi, Nordic Walking, exercise and dance as well as details of two helpful books. Click the buttons to the right for access to more information about the different exercise types.


Nordic Walking
The international body, INWA, has links to all the known research around Nordic Walking and Parkinson’s here: Nordic Walking and Parkinson’s. All this research has been carried out using the technique of Nordic Walking taught by INWA-qualified instructors, adapted as necessary for the condition.


Exercise with mild symptoms
Do you have mild Parkinson’s symptoms? If so, Parkinson’s UK also provide excellent information on the best way to stay active and exercise with mild symptoms. Checkout their guide in the ‘Mild Symptoms’ button.


Is exercise neuroprotective?
Find out more about the neuroprotective benefits of exercise by clicking the ‘Neuroprotective Benefits’ button.

Living Well

Your mental health matters
The NHS have provided a very informative site, enabling you to identify the signs of symptoms of a mental health problem and ideas for strategies to help. Click the button for more information.


Mindfulness
Stress can make your Parkinson’s symptoms worse. Read this article for more information.

Another great antidote to stress is laughing. You may only pretend to laugh at first but this can then lead to actually laughing. Check out the Action for Happiness website for more information.


Vitamins and Parkinson’s
Here are a selection of articles on vitamins and Parkinson’s. These have been extracted from the East Midlands RSN and are from 2017-2019, so may not be the most up to date.


6 tips for improving speech in Parkinson’s

PD IN PRACTICE

Author: Mary Spremulli Published: 12 November 2020

Speech therapy

Mary Spremulli runs a speech-language pathology private practice in Florida, US, specialising in the treatment of adults with voice, speech, and swallowing problems associated with Parkinson’s disease. Here, she lists her six top tips for healthcare professionals working with people living with the condition


1. Listen out for ‘low volume’

The most typical speech and voice problems in people living with Parkinson’s are low volume (hypophonia) and ‘word finding problems’ (cognitive-linguistic decline).

With hypophonia, there may also be a change in perception. The voice has become softer, but to the individual it still feels normal, and a request to be louder is often met with resistance or a comment such as “that feels like I’m shouting.”

Patients with cognitive-linguistic decline can experience word finding problems, reduced attention and concentration, and reduced memory. If you combine these problems with soft voice, conversational speech becomes a real challenge, and many people may start to withdraw from social interactions.

Some people also experience a change in speech rate – particularly in post-DBS patients –it’s what I refer to as “run-away speech,” meaning, despite what the individual tries to do, it feels impossible for them to slow down their rate.

2. Speech therapy is not a “one size fits all” solution

Clinicians need to be familiar with current scientific evidence and treatment recommendations for specific problems, but they also need to regard patient preferences, values and beliefs in treatment planning. A patient may have no interest in going to Tai Chi, for example, which can help with balance. They may express an interest in bowling instead – this can also help with balance issues

In planning treatment consider the type of support someone has at home. Patients may self-limit their sessions because of cost, so giving the most effective treatment in the least number of visits is important. Home-based practice is always a large component of treatment.

3. Don’t give up on ‘challenging’ patients

Some “challenging” patients are those who are experiencing a more rapid decline due to the nature of their disease. When providing treatment and home programmes, it can feel as if you are trying to stay two steps ahead of the disease. Swallowing decline for some patients is often a big issue, and eventually the benefits and/or risks of feeding tubes must be discussed.

Others “challenging” patients are those who experience a decline in muscle function and may have lost the normal drive to eat. In these cases therapy has to be somewhat aggressive, while at the same time, cautious so as not to compromise safety.

4. Group classes can improve outcomes

If an individual stops home practice, it’s likely they will experience a de-training effect and a gradual voice decline. Remember, voice changes don’t happen because someone is being lazy, or just not trying hard enough – they come about because of the disease in the background changing the way muscles are working. So, to some extent, if someone hopes to retain improvements made in speech and physical therapy, they need to continue some level of home practice for the duration. Group classes and after-therapy programmes can be a tremendous asset in this regard as they provide a light-hearted atmosphere.

5. Sometimes, it’s psychological

Some issues that people with Parkinson’s face, when struggling to speak, be heard and understood are psychological. The comments I hear most often from patients is that they are “starting to withdraw”, or “people are passing me by.” Conversational speech is fast, and full of interruptions and distractions. If thinking has become a little slower, processing what other people say will be a little slower. With these changes people may just make the decision, consciously or unconsciously, to speak less. I think the real loss in these situations is for other family members. It is really such an important part of our human connection.
6. Embrace tech to empower patients

Apps and devices can give individuals more control over the choice of therapy plans.  There are already apps available for home practice such as Speak Up For Parkinson’s, for improving loudness or for normalising speech rate. There are also speech aid devices such as Speech Vive and Speech Easy. I offer some online coaching using the internet, and it is really a great way to deliver some speech and voice treatment. Even some of my 80-year-old patients have computers and smart phones, so the possibilities are almost limitless. As long as people realise that the technology and the devices are just the mode of delivery, and hopefully, they will never replace the human interaction between patient and therapist.

RECOMMENDED BOOKS:

1.  Goodbye Parkinson’s Hello Life: The Gyro-Kinetic Method for Eliminating Symptoms and Reclaiming Your Good Health

Authors: Alex Kerten and David Brinn

This book is reviewed at: Goodbye Parkinson’s, hello life

An extract from the review says “Alex Kerten’s book has the goal of reducing Parkinson’s symptoms by lowering anxiety through mindfulness and creating motion in the body through music, movement, and rhythm.  Kerten explains that anxiety is often rooted long before a diagnosis of Parkinson’s, and he addresses how to recognize it and change the negative scripts that might be playing in your mind.  “Our biochemistry and our psychology start to change as we learn to control our way of thinking.” Movement is through a series of exercises that focus on breathing, movement, self-massage, conducting, and improvised dancing.  By synchronizing your thoughts and actions, you can become a “Parkinson’s warrior” —  a person who is unafraid to change their story and feel good again.”
Margaret Tuchman and Gloria Hansen, The Parkinson Alliance

2. Parkinson’s Disease and the Art of Moving; Dancing with the dragon

Author: John Argue

This book was recommended by a Parkinson’s Physiotherapist who provides exercise classes for a group of Parkinson’s patients (when Covid allows)

Neurologists universally recommend making exercise a part of the daily regimen of every Parkinson’s patient. This is an excellent book that tells people with the disease and their caregivers how to follow that advice. Movement teacher John Argue has distilled the information from his classes for Parkinson’s patients into a comprehensive exercise program designed to help readers improve flexibility, balance, gait, and communication. Over 100 photographs clearly illustrate the exercises, which derive from Yoga and Tai Chi techniques and theatre movement skills, and encompass a variety of daily activities.

Published by John Turner

John Turner

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