In June, the Foundation hosted a Hot Topics call “Living with PD: Going Beyond Medications” with featured speaker Dr. Monique Giroux, MD, co-founder and medical director of the Colorado Movement Disorders and NeuroPerformance Center.
Following the call, some participants shared additional questions they had that Dr. Giroux didn’t have an opportunity to answer.
Dr. Giroux was happy to provide follow-up responses to some of these, including insights into how exercise, nutrition, and “the mind-body connection” can affect a person’s experience with Parkinson’s.
Q: I run every day. Does my exercise reduce or ‘eat up’ the efficacy of my levodopa and Mirapex? It seems that my off time between med cycles when I run is increasing.
Dr. Giroux: Dr. Giselle Petzinger from the University of Southern California is researching the effect of vigorous exercise on brain chemistry. Her research shows that vigorous exercise actually modulates brain activity in the basal ganglia (the movement region of the brain affected by Parkinson's) to utilize dopamine more efficiently for exercise. Total dopamine levels do not appear changed but how efficient your brain is at using available dopamine does change.
There are many factors that can affect an individual's response to medicine. Diet, fatigue, blood pressure, endurance, medication side effects (sedation or low blood pressure for example), efficiency of movement and the added work or energy consumption' required to move with Parkinson's symptoms can all play a role. Be sure to talk with your healthcare provider to be sure your medication regimen is optimized for your daily routine. A physical therapist can also review your exercise routine to explore whether additional strengthening, balance or flexibility exercises can help balance out an exercise program and improve running efficiency or identify movement patterns or habits that can affect performance.
Q: On the call you mentioned yoga and tai chi as good forms of exercise. How do you feel about Pilates?
Dr. Giroux: There are many forms of exercise that are helpful and what works may depend on the needs and preferences of the individual. Pilates' focus on core strength (strengthening truncal muscles around the back and abdomen) can be very helpful for power. Tai chi's gentle, slow and precise movements enhance balance and coordination. Yoga styles vary and can range from the physical focusing only on poses, strength and posture to styles that blend the mind-body connection to focus on the body' healing response.
Follow these principles when selecting an exercise program:
1. Fortunately there are many exercises that are beneficial - 'not one size fits all'
2. Listen to your body and respect how it feels. Be careful not to push your body too hard with new exercises or through pain to avoid injury.
3. Start with a physical therapist or specialized trainer with experience in Parkinson's to avoid injury.
4. Remember you will be more successful with exercises you enjoy or have access to.
5. A balanced exercise program including a variety of exercises optimizes endurance, health, strength, balance and motor control.
Q: Has the benefit of sound therapy been tried for people with PD?
Dr. Giroux: Music and its effect on mood, well-being, creative expression and movement is just one example of how sound affects body, mind, brain and Parkinson's disease. Sound therapy, on the other hand, is designed to use the effect of specific sound frequencies on mood, energy and well-being. Currently, there are no studies analyzing its effect on individuals with Parkinson's.