Tips for living well with Parkinson's disease

Created date

July 6th, 2017
Individuals with Parkinson’s have experienced an impressive decrease in speech problems when working on vocal exercises with speech-language pathologists to strengthen muscles in the larynx.

Individuals with Parkinson’s have experienced an impressive decrease in speech problems when working on vocal exercises with speech-language pathologists to strengthen muscles in the larynx.

Parkinson’s disease affects about one million people in the U.S., according to the Parkinson’s Disease Foundation. By age 80, 1 in 20 people will have the disease. 

Unlike some other medical conditions, Parkinson’s disease is considered both chronic and progressive. Researchers have identified some risk factors associated with the disease, including advanced age, a family history of the disease, male gender, Caucasian race, and chronic exposure to herbicides and pesticides.  

The typical symptom is a tremor in the hands or fingers, which can spread to the arms, jaw, face, or legs. Other symptoms include muscle stiffness, slowed movements (bradykinesia), emotional changes, sleep disruption, problems with coordination and balance, urinary and bowel problems, and difficulty speaking.

“Symptoms among patients vary,” says Andrew Feigin, M.D., board-certified neurologist and Parkinson’s disease specialist at the Northwell Health Neuroscience Institute in Manhasset, N.Y. “Some people have problems functioning; others have an easier time of it.”

“My patients say they have the most difficulty in specific situations,” says Peter T. Orlic, M.D., medical director at Cedar Crest, an Erickson Living community in Pompton Plains, N.J.  “Getting up to walk, starting to speak, or rising from a chair can become particularly problematic and frustrating.”  

Treatment can help but not cure 

“Symptoms of Parkinson’s disease occur because you are losing brain cells that manufacture dopamine,” Feigin says. “Dopamine is a neurotransmitter, which means it enables brain cells to communicate with one another.”

Standard treatment usually involves a combination of the medications levodopa and carbidopa. According to the National Institute of Neurological Disorders and Stroke, this combination helps about 75% of patients. “Levodopa converts to dopamine in your brain,” Feigin explains. “It cannot restore the dying brain cells, however, and although medication can help, the disease will continue to progress.”

For people with profound problems functioning that are not alleviated by medication and other conservative means, a therapy called deep brain stimulation may be the best route. The Food and Drug Administration has approved this technique, in which electrodes are placed into the brain and then connected to a small electrical device that can be operated externally.

Get moving to keep moving

As is the case with many, if not all, chronic conditions, one of your best treatments is exercise.

Results of a study published this year, which included over 3,400 Parkinson’s disease patients in three countries, found that even people in advanced stages of the disease who exercised experienced a better quality of life and maintained their mobility longer than people who didn’t exercise.

Although the researchers didn’t evaluate the type of exercise, they found that 150 minutes a week of any activity seemed to help. “People who exercise more vigorously seem to have better outcomes,” Feigin adds. 

“The problem facing some patients is that symptoms make it very difficult to be active,” Feigin continues. “A physical therapist can be very helpful in teaching strategies to help you move more.”

Participating in other therapies may also help. “Some people may need a speech-language pathologist to help them cope with speech and swallowing difficulties,” Feigin says. “An occupational therapist can teach patients how to work through daily activities.”

Keeping your brain active is just as important as keeping your body active. “Mental changes can accompany physical symptoms,” Feigin says. “Depression has been associated with Parkinson’s disease. You may feel unmotivated or disinterested in certain things. Getting involved with others and learning new things can help lift your mood. There are also antidepressants and other medications available that won’t interact with your other medicines.”

“I find that a team approach to treatment is crucial,” Feigin says. “Your health care provider, therapists, mental health professional, and social worker, among others, are available to help you or your caregiver with the issues that arise with Parkinson’s disease. Participating with your team can decrease your symptoms, improve your safety, and enhance your quality of life.”

Be big and loud

In the early 1980s, researchers from the University of Colorado developed a treatment called the Lee Silverman Voice Treatment (LSVT, or LSVT LOUD). In this program, patients practice vocal exercises with speech-language pathologists, usually during one-hour sessions several days each week for about a month. The goal is to strengthen muscles in the larynx to help combat the speech problems associated with Parkinson’s. The results of LSVT LOUD are impressive: About 90% of patients show significant improvement, and 80% maintain improvement for one to two years after participating. 

The success of LSVT LOUD inspired researchers to develop the LSVT BIG program, which addresses movement disorders. Physical and occupational therapists teach patients how to improve speed, balance, and quality of life. Improvements aren’t quite as dramatic as they are for LSVT LOUD, but patients have been shown to have up to 15% improvement in their walking and flexibility. Researchers say even a small improvement can have a positive effect on daily functioning and quality of life. “These programs are effective for many patients,” Feigin says. “I’ve heard nothing but good reports from patients who participate.”

Did you know?

Nicola Culpeper (1616–1654) was an English doctor who treated Parkinson’s disease symptoms using winged ant oil and earthworms.