A chronic, progressive disease that causes movement and postural problems, Parkinson’s disease (PD) is caused by a shortage of a chemical produced by the brain called dopamine, which is responsible for transmitting messages across nerve pathways in the brain. When there is not enough dopamine available for the brain to send these messages, voluntary muscle movement and coordination are affected. Gait disorders are a hallmark of PD. A slow, short-stepped, shuffling, forward-stooped gait with asymmetrical arm swing and tremor (shaking), muscle rigidity, and the loss of postural reflexes characterize the condition. During the early stages of PD, shaking is isolated to the hands. Other symptoms include slowness in ambulation and dressing, difficulty getting out of a chair, and difficulty in starting movements.
First and foremost, the client should discuss his or her plans to walk the dog with a healthcare provider. The timing of medication and the affects of exercise on the how the medication is metabolized are important considerations for the client. Because of the disease’s affects on balance and gait, walking could be a significant challenge for someone with PD. If your client experiences an exacerbation while walking, it could be immobilizing, even dangerous. Therefore, you might suggest that the client only walks the dog when you are available to assist during a training session so that you can be a walking companion. Furthermore, walking with a balance aid, such as a cane or walking stick, can help with ambulation. You will also want to make sure that the dog is well behaved and not at risk for getting excited, pulling on the leash, and causing a disruption in the client’s balance.
Regular participation in exercise may protect against PD. Because PD is a chronic progressive disorder, sustained exercise is necessary to maintain benefits. Thus, adherence to an exercise program is an important issue for clients with PD. The following tips are helpful for clients with PD:
• Incorporate relaxation and flexibility: Relaxation techniques appear to be very helpful in reducing tremors. Begin relaxation in the supine position and gradually progress to sitting and standing. Flexibility exercises also are an important part of the exercise program. Clients with PD will exhibit a great deal of muscle tightness and may need some assistance with flexibility routines.
• Take precautions to deal with lack of balance: Since balance is a major problem for people with PD, take every precaution to assure that the exercise environment is safe and that there is a minimal risk of the client falling. Always be in close contact with the client in case he or she loses balance. Balance exercises must be an integral part of the exercise program. Both static and dynamic balance exercises should be incorporated into the routine while sitting and standing.
The following links can give you more information on exercising with this special population:
• Michael J. Fox Foundation for Parkinson’s Research
• Parkinson’s Disease Foundation