CEU Continuing Education in the Convenience of Your Own Home

FUNCTIONAL ASSESSMENT

When working with clients afflicted with Parkinson's disease, it is important not only to acquire written permission from their physician to participate in a physical activity program, but also documentation determining their physical limitations.

Assessing gait, balance, coordination, flexibility, agility, aerobic fitness, strength and muscular endurance has become a challenge for fitness professionals working with older adults and those with chronic disease. Presently, there are no national norms to appropriately evaluate these factors. However, in 1997, Roberta Rikli, Ph.D., and Jesse Jones, Ph.D., took on the challenge of developing normative physical performance standards for seniors focused on functions needed to maintain physical dependence in daily activities. These parameters include lower and upper body strength, physical endurance, lower and upper body flexibility, agility and dynamic balance. The assessment protocol and norms will be available in April, 1999, in the Journal of Aging and Physical Activity, published by Human Kinetics. These assessment protocols should help professionals working with older adults design appropriate physical activity programs. However, these two may need to be modified when working with clients affected with chronic diseases.

In summary, Parkinson's disease is a progressive neurological disease that affects the regulation of voluntary movement at a subconscious level. It affects individuals at varying rates of progression and levels of intensity. Drug therapy seems to be the most effective treatment, yet exercise may help lessen its effects.

Fitness professionals interested in taking on clients with chronic diseases such as Parkinson's should be well informed about the disorder. Be familiar with what it is, its causes, symptoms, preferred method of treatment and drug therapy complications. Also, refer to research studies that address the relationship of exercise to chronic disease management. Signage of an informed consent, contract agreement and liability forms is also very important. Proper prescreening and functional assessments should be administered. This may help assure proper program design and implementation. Focus on designing programs that meet your client's specific needs based on his/her physician's recommendations. Maintain open communication between yourself, your client and his/her physician. Design a program that is progressive in nature, achievable, improves or maintains functionality and promotes lifelong commitment.

On a personal note, I would like to thank Greg Welch, M.S., of SpeciFit, who works with older adults challenged by chronic disease and/or medical conditions and Morton J. Smith, AFAA certified personal trainer from 24-Hour Fitness, who has worked closely with a client affected with Parkinson's disease, for their contributions. Their dedication and input can help guide other fitness professionals towards successful physical fitness programming for seniors and chronic disease clients.