For Parkinson’s Patients, Recreation Means Relief

On a rainy Tuesday morning, Terry Ellis meets one of her patients at Sargent College’s Center for Neurorehabilitation (CNR). Ken, who requested that his last name not be used, is one of 1.5 million Americans living with Parkinson’s disease, a neurological disorder that leads to difficulty coordinating movement.  

Handing Ken a red medicine ball, Ellis (MED’05), a SAR clinical associate professor, instructs him to hold it at arm’s length and slowly rotate his upper body. “This exercise loosens the trunk,” she explains. “Patients with Parkinson’s disease often experience severe stiffening of the muscles, affecting even the simplest form of movement.”

While people with Parkinson’s generally don’t begin showing symptoms until their early 60s, Ken was diagnosed at age 38. With the help of Ellis and the CNR, 20 years later he is fighting the disease with a slightly unconventional weapon — exercise.

“Because Parkinson’s is a progressive, degenerative disease, physicians do not routinely recommend physical therapy,” Ellis says. “People tend to think, why bother? It’s just going to get worse anyway.”

But Ken is evidence that people with Parkinson’s disease can and do benefit from regular, regimented exercise. “It’s actually rather amazing that I’m in as good condition as I am,” he says. “Generally, people who have had the disease for as long as I have are pretty immobile.”

While attending graduate school, Ellis noted that there was little research available supporting the ways physical therapy benefits patients with neurological disorders. Along with Robert Wagenaar, a SAR associate professor and chair of the department of rehabilitation sciences and CNR director, and Linda Tickle-Degnen, an associate professor in occupational therapy at Tufts University, Ellis led a series of controlled studies to investigate the effectiveness of physical therapy intervention in patients with Parkinson’s disease. The results indicated that those who received treatment showed significant improvements over those who did not receive treatment. This study enabled the researchers to secure a grant from the National Institutes of Health (NIH) allowing them to conduct more extensive studies, which yielded similar results. 

“This is ultimately a quality-of-life issue,” Ellis says, “Physical therapy does not cure Parkinson’s disease nor does it slow the course of the disease. But it does help the patient’s ability to function on a day-to-day basis.”

According to the National Parkinson Foundation, Parkinson’s disease occurs when neurons that produce dopamine, a chemical that coordinates body movement, become impaired or die. When about 80 percent of these neurons are damaged, patients exhibit signs of the disease, which include tremors, slowness of movement, stiffness, problems with balance, muffled speech, a shuffling gait, and coordination problems.

“It’s very frustrating,” Ken says. “Gradually, you lose your ability to stand up, and eventually, you can’t walk. Here you are, a cognitively functional person, and you’re telling your leg to move, and it just won’t.”

Currently Ellis incorporates stretching and strengthening exercises into the rehabilitation treatment. Gentle stretching helps alleviate symptoms such as stooped posture and stiff muscles, in addition to improving the patient’s balance.

“These exercises help patients walk better, and they have an easier time getting in and out of bed, standing up, and changing positions,” Ellis says. “While people with Parkinson’s disease generally have difficulty self-initiating movement, they respond well to external cues, such as music. They use the beat to guide their movements, so if we set a metronome to a certain frequency, the patient is more likely to take bigger and faster steps.”

Ultimately, Ellis wants these physical therapy programs to be offered to people with Parkinson’s disease throughout the state and the country. She recently received support from the Massachusetts chapter of the American Parkinson’s Disease Association to bring exercise programs to local communities around the state. “Until scientists discover a cure for the disease,” she says, “we should focus on improving the basic quality of life among patients.”
   
Walking across the room, Ken places the medicine ball on a shelf against the wall. “If it weren’t for these exercises, I truly believe my condition would be far more advanced,” he says. “This therapy has allowed me to live a more normal life.”              

Vicky Waltz can be reached at vwaltz@bu.edu.