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CEU Continuing Education in the Convenience of Your Own Home

American Fitness, May, 1999 by Laura A. Gladwin

AFAA's Home Study provides up-to-date information on a variety of fitness topics.

AFAA's CEU Corner program is the best continuing education offer available. By simply reading and studying the comprehensive article and completing the corresponding quiz, you can earn two CEU's for a $20 fee. Successful completion of three CEU Corner exams will count as the AFAA course required for recertification. This month's CEU CORNER and quiz feature "Parkinson's Disease and Exercise".

PARKINSON'S DISEASE AND EXERCISE

TAKING ON CLIENTS AFFLICTED WITH PARKINSON'S DISEASE REQUIRES KNOWLEDGE OF ITS ETIOLOGY, SYMPTOMS, PREFERRED TREATMENT METHODS AND DRUG THERAPY COMPLICATIONS.

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Recently, our country was shocked when actor Michael J. Fox revealed he was coping with Parkinson's disease. Other prominent individuals such as Mohammed Ali and Attorney General Janet Reno have been living day-to-day with this progressive disease for years. According to the American Parkinson's Disease Association, Inc., 1.5 million Americans were diagnosed with Parkinson's disease in 1993, and the number continues to grow.

DEFINITION AND CAUSE

In 1817, the major symptoms of the disease were discovered and named "Shaking Palsy" by Dr. James Parkinson. It was not until the 1960s that pathological and biochemical changes in the brains of affected individuals were discovered.

Parkinson's disease is a progressive neurological disorder associated with a reduction of the brain's neurotransmitter dopamine. This reduction of dopamine results in the destruction of dopaminergic cells within the basal ganglia of the brain's substantia nigra, leading to a decrease in voluntary muscle movement, coordination, posture and muscle tone. The rate of progression and severity differ from person to person. There is no known cause of Parkinson's disease. However, environmental factors (e.g., toxins, pollutants) and genetics may play a role. Other contributing factors may include aging bodily mechanisms, autoimmune responses and mitochondrial dysfunction (Protas et al., 1997). An individual can be living with the disease for seven to 10 years without symptoms.

What are the risk factors for family members? According to Enrico Fazzini, D.O., Ph.D., (member of the American Parkinson's Disease Association, Inc.), a sibling has only a 5% chance of getting Parkinson's disease when one parent is affected. In families where Parkinson's disease is prevalent, the gene has been localized. However, when tested in sporadic cases, the genetic defect is not detected. Experts are still seeking answers to what causes Parkinson's disease.

INCIDENCE AND SYMPTONS

Parkinson's disease is usually found in individuals over 50 years of age, but it can afflict younger populations, as noted in the case of Michael J. Fox. Some symptoms include tremors while at rest or active, muscle rigidity starting at the neck, shoulders and upper back, migrating to trunk and extremities, freezing (sudden involuntary cessation of a movement or the incapacity to initiate a desired movement) and gait and postural abnormalities along with slowing of movement (bradykinesia). These symptoms can make it difficult for individuals with Parkinson's to perform daily activities. For example, muscle rigidity can effect the arms, making them fixated at the sides and eliminating the natural swing action performed in a natural walking pattern. This can lead to balance and gait complications. The ability to move fingers, hands, arms and legs quickly is greatly reduced, causing the performance of daily tasks to take longer than usual. The ability to rise from a chair becomes more difficult due to bradykinesia and the reduction in motor control. Gait may be impaired due to festination (the acceleration and abbreviation of movements), which accounts for a tendency to take quick running steps when a natural walk is desired. When this is accompanied by slow shuffling steps, a "stooped posture" with rounded shoulders (kyphosis) and flexed knees, the difficulty in turning the body and controlling other postural reflexes produces a potentially dangerous risk of falling. Eating, bathing, dressing, handwriting, shifting from one position to another, preparing meals and just trying to get from one spot to another can be extremely challenging.

This disease affects the muscles that control facial expression, breathing, swallowing and speaking. It can also effect the muscles responsible for eye movement, making reading difficult, decreasing the ability to clear irritants from the eyes through blinking and potentially leading to blurred vision.

DRUG MANAGEMENT

Drug management has been the most successful way to treat many of the symptoms associated with Parkinson's disease, helping correct or prevent neurochemical imbalances related to dopamine, epinephrine, norepinephrine and acetylcholine. Some common drugs used are levodopa, carbidopa/levodopa (better known as Sinemet), pergolide, benztropine and deprenyl. As with many drug therapies, side affects do occur. Some of the most common side effects include confusion, insomnia, changes in mental state and gastrointestinal upset. Long-term use can lead to dyskinesia (uncontrolled involuntary movement of the face, torso, arms and legs), a reduced response to drug therapy and a clinical fluctuation of motor disabilities.

CEU Continuing Education in the Convenience of Your Own Home

American Fitness, May, 1999 by Laura A. Gladwin

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