Bob DeMarco Alzheimer's Reading Room

Wednesday, April 13, 2011

Balance, Gait, and Mobility


When I first came to Delray Beach to take care of Dotty she was falling down all the time...
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This was shocking to me. Dotty was always a big walker. Walking around Brooklyn Heights and Manhattan with Dotty was great fun. Trying to find Dotty in a Mall, not so much fun.

How bad was it? Once I found Dotty laying in the parking lot around 11 PM. She was shaking and perspiring. She couldn't get up. Finally, she fell and broke her pinky finger. We sat in the emergency room on a Saturday for 8 hours before a doctor finally examined Dotty and told me what I already knew. A few days later, they re-broke her finger and put it in cast.

I received the same advice over and over -- put her on walker. Dotty didn't want to go on a walker. My Dotty is a fighter. This was back when the west was very young, and Dotty was at the tender age of 87. Not long thereafter we the gym we went. Dotty for the first time in her life.

Soon, I had Dotty on the treadmill. Low low impact walking. This means slow. I also introduced a stand up, sit down exercise with Dotty that really improved her balance.

Dotty stopped falling. Her balance and gait improved. My little snail is now almost 95, and she is NOT on walker. Period end of sentence - capice?

The study below is related to Parkinson's disease. In my opinion the video is worth watching. I think this applies to any elderly person, particularly to patients with Parkinson's and Alzheimer's.

You wanna keep on truckin? Watch the video and read.

Remember, its your life, and you are responsible for the life of your Alzheimer's patient. You are the one that gets to choose. The word NO is not an option.

Dotty has not fallen once since 1988. She did trip once.

Capice. English translation: do you understand? do you get it?


Low Intensity Treadmill Exercise is Best to Improve Walking in Parkinson's




New evidence suggests that walking on a treadmill at a comfortable speed and for longer duration is the most effective exercise to improve mobility in people with Parkinson's disease. That's according to the first randomized trial comparing three types of exercise training in Parkinson's disease. The late-breaking research will be presented at the 63rd Annual Meeting of the American Academy of Neurology, April 9–16, 2011, in Honolulu.

"Difficulty walking is the greatest cause of disability in people with Parkinson's disease," said Lisa M. Shulman, M.D., with the University of Maryland School of Medicine in Baltimore and a Fellow of the American Academy of Neurology. "These results have important implications for how we manage Parkinson's disease, since low-intensity exercise can be done by most people with Parkinson's, and our patients frequently ask what type of exercise they should be doing."

In this study, 67 people with Parkinson's disease who had problems with walking were randomly assigned to three types of exercise: high intensity treadmill (greater speed, shorter duration), low intensity treadmill (lower speed, longer duration) or stretching and resistance exercises, which included repetitions of leg presses, extensions and curls.

Participants exercised three times a week for three months and were supervised by exercise physiologists at the Baltimore VA Medical Center. They were tested before and after the training with assessments of distance covered in a six-minute walk, walking speed at 10 meters and 50 feet, general fitness and ratings of their Parkinson's symptoms.

Researchers discovered that low intensity treadmill training resulted in the most consistent improvements in gait and mobility.

People who were on the low intensity treadmill training performed better than the two other groups on the distance and speed tests. However, only stretching and resistance training improved the ratings on the Parkinson's disease scale.

"Contrary to evidence suggesting that high intensity exercise is the most effective, our results suggest that a combination of low intensity training and stretching-resistance training may achieve the greatest improvements for people with Parkinson's disease," said Shulman.

The study was supported by The Michael J. Fox Foundation for Parkinson's Research, The National Institute on Aging (NIA) Claude D. Pepper Older Americans Independence Center NIH grant P30-AG02874, VA Rehabilitation Research & Development Maryland Exercise and Robotics Center of Excellence, and the Baltimore VA Medical Center GRECC.

For more information about the American Academy of Neurology and its upcoming Annual Meeting, visit http://www.aan.com.bal

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Original content Bob DeMarco, the Alzheimer's Reading Room