SPRINGFIELD - Licensed physical therapist Debra R. Ellis, of Amherst, is again offering a six-week group exercise program for individuals with Parkinson's disease, this time at the Springfield Jewish Community Center.
The program, which Ellis offers twice a year at different area venues, is designed to help improve the daily mobility of individuals with the progressive neurological disorder that affects movement. It was designed by the Boston University Center for Neurorehabilitation.
The program will be held Wednesdays and Fridays, from 1 to 2:30 p.m., beginning Wednesday, Oct. 25 through Friday, Dec. 15, at the JCC, 1160 Dickinson St.
Evaluation sessions will be scheduled before and after the program to measure progress. Cost is $249 in advance; $239 for JCC members. Some scholarship money is available.
There will be no class Friday, Nov. 10 and Thanksgiving week.
A practicing physical therapist for 26 years, and a clinical specialist in neurologic physical therapy for 20 years, Ellis has administered the Parkinson's Community Wellness Program since 2009.
She explains further about the disease and her program in her answers to the questions below:
What is Parkinson's disease?
Parkinson's disease is a chronic progressive movement disorder that gets worse over time. The cause of the movement challenges are due to death of vital nerve cells in the brain. These nerve cells are responsible for producing dopamine, a brain chemical that among many functions, controls movement and coordination.
As the nerve cells die, dopamine production decreases and people with Parkinson's struggle to move normally. There are over a million people in the U.S. living with the disease. There are 60,000 new cases diagnosed each year. Men are more likely than women to be diagnosed.
How does it manifest itself?
People with Parkinson's present with varying symptoms. Some cases are mild and slow progressing, others progress more rapidly. Some people are diagnosed with Young Onset Parkinson's, that is age 49 and under, but most are diagnosed in their 60s.
The most common cardinal signs of the disease are resting tremor, bradykinesia (a slowness of movement), rigidity or stiffness in the limbs and trunk, and postural instability- impaired balance and coordination.
There are functional challenges related to these cardinal signs of the disease. These include gait or walking abnormalities, difficulty rising from a chair, decreased endurance, balance and postural abnormalities, decreased fine motor coordination, soft speaking voice and oral motor stiffness/dyscoordination.
There are also non motor symptoms often associated with Parkinson's. The most common non motor symptoms may include sleep challenges, mood fluctuations, cognitive challenges, blood pressure fluctuations, constipation and decreased sense of smell.
How much is understood about what causes it?
There is a lot of ongoing research, but the majority of people diagnosed are categorized as idiopathic, meaning we don't know why they have the disease. There seems to be a genetic link in a very small percentage of cases and some environmental factors as well. Aging is a primary risk factor. There is a 2 to 4 percent increased risk in people over 60 as compared to the regular population.
What are some of the newer treatments for it?
There is ongoing research and regular advances in medications for symptom control. Two major classes of medications work to optimize access of existing dopamine in the brain and a third class of medication acts to replace levels of usable dopamine in the brain. There are other medications that may be prescribed to help with other motor and non motor symptoms.
There are currently two surgical procedures often performed for people living with Parkinson's. Deep Brain Stimulation (DBS surgery) where electrodes are inserted into a targeted area of the brain. These electrodes are paired with impulse generators (similar to pacemakers) under the collarbone. The impulse generator sends electrical impulses to stimulate the underactive part of the brain involved in motor function.
The other surgery is Duopa. This is when a tube is implanted in the stomach and is designed to deliver a dopamine replacement gel directly to the intestines. This can help modulate symptoms in people who are struggling with the oral medication wearing off times.
How do these exercises help people affected by it?
There are many types of exercise that benefit people with Parkinson's. The Parkinson's Community Wellness program is an evidence based program incorporating progressive resistive strengthening exercises, flexibility exercises, some balance reeducation, gait training, and information and instruction on the benefits of aerobic conditioning. We also work on postural flexibility, strength and awareness.
There is compelling research supporting the clear neuroprotective benefits of moderate aerobic conditioning and progressive resistive strengthening exercises. Two individual studies followed participants for two years and measured both quality of life and the need to start or increase medications.
Both studies show significant delay in the need to start or increase medication dosing compared to the control groups. We discuss these parameters and work on strategies to overcome typical barriers to ongoing exercise compliance.
We also incorporate problem solving strategies around challenging mobility skills associated with Parkinson's. The goal of these exercises and this program is to empower the participants with tools and knowledge that help them control their Parkinson's symptoms.
Why is there an evaluation before and after?
Participants benefit from the feedback. We run standardized functional tests measuring balance and walking efficiency before the program starts and then again at the end of the six weeks.
The gains are often startling and help the participants to understand the benefits of the hard work they are doing and importance of continuing to exercise. Self efficacy improves compliance on an ongoing basis. Additionally, the data is sent to Boston University. They utilize this information to evaluate program efficacy and incorporate changes when necessary.
How will the exercises continue to help people once the sessions are over?
This program is designed to teach participants a progressive program they can then continue to do on their own. A manual includes detailed instructions and is set up to help keep participants on track.
There are also Parkinson Community Wellness Program Continuation programs in the Pioneer Valley - currently at the Hampshire Regional YMCA and at the Westfield YMCA -where participants who have completed the six-week program can continue to exercise with a group and receive small group support and encouragement.
It is critical that people with Parkinson's exercise regularly and this program works to provide a comprehensive foundation as well as ongoing support.
For further information on participating in the program, contact Ellis at (413) 695-6069, email deb@debellispt.com or visit her website.