Transcription:
The Benefits of Exercise for Parkinson's Disease Patients

Carl Maronich: And we’re joined on the podcast today by Dana Mercer. Dana Mercer works at the Riverside Health Fitness Center and she works with Parkinson’s patients in what is called the power program and we’re going to learn a lot more about that and about Parkinson’s, but first we're going to learn a little more about Dana, who hasn't been with Riverside all that long. She comes to us from First Florida and Virginia. You have a Master's in...?

Dana Mercer, EP-C: I have a Master’s in clinical exercise physiology and I also have my Bachelor’s in exercise science.

Carl: Did I get those transitions right over in Virginia to Florida?

Dana: Nope, from Florida to south Florida to central Virginia and now here.

Carl: Going north and west.

Dana: I don’t know. I think I'm going in the wrong direction. It’s getting a little too cold.

Carl: I'm sure the first winter is not a great one perhaps, but summer’s here now, so you'll get the heat back. We’re going to talk about Parkinson’s today and your education has been in exercise physiology, is that the right term?

Dana: Yes. As I got into my Master’s, I went more of the clinical route working with special populations, people who have cardiac issues, pulmonary issues, people with neurological disorders such as Parkinson’s or people who have had a stroke.

Carl: We’re going to focus today on Parkinson’s disease and let's first make sure we all know and understand just what Parkinson’s is.

Dana: Parkinson’s is a neurological disease. It affects the central nervous system which also affects speech, movement and so on. It progressively gets worse.

Carl: Most commonly, I think people see people shaking and they associate that with it. There may be Parkinson’s patients that don’t shake or some that do very severely, so as we've learned and as you're going to talk about, exercise can play a role in helping with the progression of the disease. Is that accurate?

Dana: It actually can help decrease the progression of the disease. It won't take the tremors away or anything like that, but it will help lessen the severity of the disease.

Carl: We’ll talk more about specifically the kind of exercise that you do and for each patient, it's a little bit different, but just the idea of regular exercise helping movement, helping them get a better control of their body. Is that the idea behind it?

Dana: Basically, just how anybody can benefit from exercise, people with Parkinson’s can benefit from exercise. I won't get in too much detail, but what we do is we focus on big repetitive movements that counteract the symptoms of Parkinson’s and we can talk about that later on.

Carl: Great point made there. Everybody can benefit from exercise. I'm a prime example of somebody who can certainly benefit from more exercise. With Parkinson’s patients, once they're diagnosed, maybe you could talk a little bit about how they go into treatment and at what point is this something they should be doing right away or they want to get settled into some of their other treatment and what's the best course of action?

Dana: Personally, I would recommend the sooner I get to see you, the better. When I get to see you or any physical therapist going through the LSVT Big program, it will help lessen the severity of the decline in the disease. The sooner that you're moving and trying to counteract those awful symptoms, the better.

Carl: Do you call them patients or clients?

Dana: I just call them participants. They're really family to me. We've been together for about three months now. It is in a class setting. We meet three times a week. We meet Monday, Wednesday, and Friday, but I also have people I meet with one on one who can't really keep up in a class setting. They need more specialization, one on one, people that are in wheelchairs that have Parkinson’s and can't move as well as some of the other people that are in the class, so I do meet with them one on one and they see a great benefit even though they are in a wheelchair or whatever it may be.

Carl: Even within a class population, there's probably a real difference of abilities and different stages of the disease.

Dana: Definitely. We've got guys and gals in there that actually suffer from the tremors a little bit more or some people that have the smaller gait so they're walking a little bit more shuffled of bent over or we have people whose physically there but mentally they're not as up to par as everybody else. In the class setting, we actually do more cognitive exercises so we’re working the brain, not just the body, but we’re working the brain and moving, so we’re doing multitasking. We’re talking really loudly because a lot of times in Parkinson’s disease they tend to lower their voice just a little bit. A lot of times, you won't be able to hear them, so we speak really loudly when we do different exercises. Today, for warm up, we walked up and down the room yelling, counting 1, 2, 3 as we walked and that helps, even people with a smaller gait, it makes their gait a lot bigger. It’s super interesting to see and it’s really exciting to see the improvements that we have seen already.

Carl: Before we talk more about the class, how might someone get to your class? Are they referred to it by their physician? How are you getting the participants in the class?

Dana: It depends. We've had some people referred from physical therapy because physical therapy is right next door to our fitness center. They're actually in the fitness center, so they go through that program and then they come to us. We also have gotten some people from the doctors saying the fitness center has this program, you should go to it, and other things are just advertising. They see something in the paper about our Parkinson’s program, they come in, all they have to do, if they have any other questions, is contact me from the fitness center and we can get you plugged it. We typically do free class sessions for you to come to check out the class and see what it's all about before you dive in. We do offer that.

Carl: How long does a class last for the participants?

Dana: It's an hour-long class, like I said, three times a week.

Carl: Once they get to class, as you said, you'll have a variety of folks in different stages of the disease and different abilities and you tailor it so everyone can participate. Talk about some of the exercises. You mentioned the gait work and walking and shouting to get them talking louder. Talk about some of the other things that you're doing and why you're doing them.

Dana: I’ll talk a little bit about what I'm certified in, Parkinson’s wellness recovery or PWR. What that program is it’s actually developed by the same lady who developed the LSVT Big program. That’s the physical therapy program that a lot of Parkinson’s patients go to after they've been diagnosed or whatever it may be, but the same lady that developed that developed the program that I'm certified in. With this program, it has a little bit more real-world carryover. We do four basic power moves as what it's called. We do the PWR up, the PWR rock, the PWR twist, and the PWR up. Again, PWR meaning Parkinson’s wellness recovery. We do those four basic power moves, we do them standing, we do them in the chair, but we also do them on all fours, on our stomachs, and on our backs, so that way we can get around. If we happen to fall onto the floor, how can we get up? If we're lying in bed, how can we roll over? Those four basic PWR moves have a purpose.

The PWR up really helps with posture because a lot of times when people get older, but when they have Parkinson’s, they tend to have that stooped posture where they're bent over. The PWR rock works on weight shifting, a lot of times with Parkinson’s patients, they have freezing episodes where they get stuck in a position and they can't move. With that weight shifting, they learn to transfer their weight from one side to the next and then get moving again. It also helps with any type of transitioning. We do the twist for working the trunk rotation, so that helps with rigidity, which is the stiffness of muscles, so that helps with that or any movement such as closing the door, going to reach for your seatbelt, whatever it may be in that trunk. Step obviously we’re working on the bigger steps to get over a curb or to get out of a car. That’s what we use as our base for all of our classes. I typically work on just those PWR moves on Mondays. Our Wednesday classes are typically more strength based classes, so we add those PWR moves plus the traditional weights that you find in the gym and I add those cognitive exercises such as when you step with your left foot, you're going to say a number, but when you step with your right foot, you have to yell out a letter or something like that, something to make them think a little bit more. Our Friday class is more working on their gait. We do bicycle exercise because that repetitive movement is really good for people with Parkinson’s. Stuff like that is typically what we do in those classes.

Carl: At any time, do you have family members that participate in the classes also?

Dana: We don’t have them participate. We do have them sit and watch and learn. We have a husband and wife that comes in almost every single class and the wife is there every single time and she’ll sit and watch and her husband is the one with Parkinson’s. She's just part of the group like everybody else is because everybody will talk to her just like she's part of the group as well.

Carl: I would guess that some of these folks when they go home, if they have a family member that’s able to help them with these exercises or knows what they should be doing, that would have to be helpful.

Dana: Exactly. They get to see that it's a more hands-off program. I'm not there to say let me help you up. It's that you're on the floor, I'll tell you how you can move your leg in a certain position to get you off the floor, but you need to learn how to do this yourself because what happens if I'm not there or somebody is not there. You do need to learn how to do that on your own so that way you can live a better life.

Carl: More independent. That’s always great. Do you have a range of ages? This isn't just an old person’s disease. I'm sure there are young folks that have Parkinson’s as well. Do you have a variety of ages?

Dana: The average age for people with Parkinson’s is about 60. It’s more common in males than females. In our class, we've got people anywhere from 60 being our youngest right now to 70s and I work with somebody who’s about 85 years old. It’s really good for anybody I think, especially as we get older. This whole program can be good for anybody.

Carl: Say the name of the program again.

Dana: Our program is called Partners in Parkinson’s, but I'm certified through Parkinson’s wellness recovery so that might be a little confusing.

Carl: But the name at the Riverside fitness center is Partners in Parkinson’s. If folks want to try to contact you, how can they do that?

Dana: They can either come into the fitness center and ask for Dana, which is myself, or they can just give us a call and ask for me or shoot me an email. I've got business cards or anything at the front desk that they can give out.

Carl: The program has been going on for three months?

Dana: Three months. We just started in March.

Carl: Are you seeing success stories already in that time?

Dana: Yes. Even within the first two months, I had an older lady who was on the floor and she said she can't get up, how am I supposed to get up? We do use a chair to assist. Two weeks later, she can get on and off the floor without a chair, without any assist – she does it on her own. That's the biggest and quickest thing that I've seen. There are other things such as I'm able to tie my show, put my socks and shoes on by myself for the first time in such and such years.

Carl: That independence and allowing folks to be able to do that has to be very rewarding for you.

Dana: I love it.

Carl: And certainly, wonderful for them as well. Dana Mercer from the Riverside health and fitness center. We appreciate you joining us.

Dana: Of course. Thank you for having me.