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Parkinson's disease

From MayoClinic.com

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Movement Disorders


If you've received a diagnosis of Parkinson's disease, you'll need to work closely with your doctor to find a treatment plan that offers you the greatest relief from symptoms with the fewest side effects. Certain lifestyle changes also may help make living with Parkinson's disease easier.

Eating a healthy diet
Eat a nutritionally balanced diet that contains plenty of fruits, vegetables and whole grains. These foods contain natural antioxidants that help protect against free radical damage. They're also high in fiber, which is important for helping prevent constipation.

If you take a fiber supplement, such as psyllium powder, Metamucil or Citrucel, be sure to introduce it gradually and drink 8 to 10 glasses of fluid daily. Otherwise, your constipation actually may become worse. If you find that fiber helps your symptoms, use it on a regular basis for the best results.

In addition, avoid drinking excessive caffeine and alcohol and try to reduce your consumption of fats — especially saturated fats. Foods that contain saturated fat include red meat, milk, cheese, ice cream, and coconut and palm oils. Try to restrict your total fat intake to less than 30 percent of your daily calories, with no more than 10 percent coming from saturated sources.

Considering vitamins and supplements
Early studies seemed to show that high doses of vitamin E could delay the onset of severe Parkinson's symptoms, but this effect wasn't born out in later clinical trials. New research does indicate, however, that having adequate amounts of folate, also known as folic acid or vitamin B-9, may help protect against Parkinson's and other neurologic disorders, although this has yet to be confirmed.

Researchers are also conducting clinical trials on the nutritional supplement coenzyme Q-10, a powerful antioxidant that's believed to repair a defect in the mitochondria that occurs in people with Parkinson's disease. Mitochondria are structures within the cells that are involved in energy production. If you're interested in supplementing your diet or learning more, talk to your doctor or pharmacist.

Eating and swallowing carefully
You may have difficulty swallowing in the later stages of Parkinson's disease. To help make eating and swallowing easier:

  • Take small bites of food and chew each mouthful thoroughly.

  • Swallow each mouthful before putting more food into your mouth.

  • Try chopping food in a food processor or blender to make it easier to eat.

  • Take your time eating. Use a warming tray under your plate so your food doesn't get cold before you're done.

Regular exercise is extremely important for people with Parkinson's disease. It helps improve mobility, balance, range of motion and even emotional well-being. Your doctor or physical therapist may recommend a formal exercise program, but any physical activity, including walking, swimming or gardening, is beneficial. In fact, some studies have shown that weight-bearing exercises, such as walking, jogging and dancing, may be more helpful than physical therapy for people with Parkinson's disease.

Keep in mind that your energy level may go up and down, and you'll sometimes need to pace yourself. If you're tired, try doing one part of your routine at one time of day and adding another segment later. Also, choose a time to exercise when your medicines are working well and you feel strong.

Be sure to stretch before and after you exercise. Stretching warms up your muscles, helps prevent stiffness and improves your flexibility and balance.

Walking with care
Parkinson's disease can disturb your sense of balance, making it hard to walk with a normal gait. These suggestions may help:

  • If you notice yourself shuffling, slow down and check your posture. It's best to stand up straight with your head over your hips and your feet 8 to 10 inches apart.

  • Buy a good pair of walking shoes. Avoid running shoes.

  • Practice taking long steps and exaggerate lifting your legs and swinging your arms.

  • If you become stuck in place — known as freezing — rock gently from side to side or pretend you're stepping over an object on the floor.

Avoiding falls
In the later stages of the disease, you may fall more easily. That's because Parkinson's disease affects the balance and coordination centers in the brain. In fact, you may be thrown off balance by just a small push or bump. The following suggestions may help:

  • Ask your doctor or physical therapist about exercises that improve balance, especially tai chi. Originally developed in China more than 1,000 years ago, tai chi uses slow, graceful movements to relax and strengthen muscles and joints.

  • Wear rubber-soled shoes. They're less likely to slip than shoes with leather soles.

  • Remove all area rugs from your home and make sure carpeting is secured firmly to the floor.

  • Install handrails, especially along stairways.

  • Keep electrical and telephone cords out of the way.

  • Install grab bars around your tub and beside the toilet.

Dressing can be the most frustrating of all activities for someone with Parkinson's disease. The loss of fine motor control makes it hard to button and zip clothes, and even to step into a pair of pants. A physical therapist can point out techniques that make daily activities easier. These suggestions may also help:

  • Allow plenty of time so you don't feel rushed.

  • Lay clothes nearby.

  • Choose clothes that you can slip on easily, such as sweat pants, simple dresses or pants with elastic waistbands.

  • Look for clothes and shoes with Velcro fasteners, or replace buttons on clothes you have with Velcro.

Even in the early stages of Parkinson's disease, your voice may become very soft or hoarse. To communicate more easily:

  • Face the person you're talking to, and deliberately speak louder than you think is necessary.

  • Practice reading or reciting out loud, focusing on your breathing and on having a strong voice.

  • Speak for yourself — don't let others speak for you.

  • Consult a speech-language pathologist who is trained to treat people with Parkinson's disease.


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