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"Stand Up, Sit Less, Move More"


Nicolaas I. Bohnen, MD, PhD

    

 Parkinson disease (PD) is a clinical syndrome consisting of a variable combination of the four 'cardinal' features of resting tremor, rigidity, bradykinesia, and postural instability. Among these motor features, postural instability and gait disorder (PIGD) symptoms are a significant cause of disability. Patients with more severe PIGD problems may develop 'fear-of-falling,' and as a result become more sedentary. This may lead to decreased muscle strength and 'deconditioned' postural reflexes. PIGD motor dysfunctions in PD – which are generally the least responsive to dopaminergic therapy - incline many patients towards a sedentary lifestyle with increased risk for the negative consequences of physical inactivity. A vicious cycle of worsening parkinsonism and increasingly sedentary behavior may explain decreasing physical activity in advanced PD.  It is plausible that lack of physical activity worsens motor symptom severity in PD independent of the degree of loss of dopamine neurons in the brain.

    Recent studies in exercise physiology show that levels of non-exercise physical activity (NEPA) appear to have an independent effect on health outcome in the general population. In other words, a person who meets recommended weekly exercise guidelines may still be at risk of negative health effects if the remainder of the week consists of sedentary behavior. The independent negative effect of sedentariness may be a possible explanation why recent exercise trials in PD, despite improved test performance, did not demonstrate improvements in disability and quality of life in PD. We recently completed a study showing that higher levels of NEPA -but not relatively isolated bouts of more strenuous exercise activity- were associated with significantly less severe motor symptoms in Parkinson disease even when accounting for the loss of dopamine neurons in the brain. Active "Stand Up, Sit Less, Move More" intervention strategies may be useful in reducing the sedentary lifestyle in PD and improving patient functionality.


Click here to view the paper


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"Non-exercise physical activity can attenuate motor symptoms in #Parkinson disease. http://t.co/W1pjWGiZLZ"        
        — Nat Rev Neurology (@NatRevNeurol) September 2, 2015

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News Articles About This Paper


Everyday activity more beneficial than occasional strenuous exercise for Parkinson’s disease 

New University of Michigan research finds people with Parkinson’s disease may want to consider attempting to do the dishes, fold the laundry and take strolls around the neighborhood in their quest to control their symptoms.

                

New University of Michigan research finds people with Parkinson’s disease may want to consider attempting to do the dishes, fold the laundry and take strolls around the neighborhood in their quest to control their symptoms.



The New Prescription for Parkinson’s: Puttering


People with Parkinson’s are no exception. A recent paper from The University of Michigan shows that more everyday physical activity, perhaps more so than vigorous exercise, is associated with less severe motor symptoms. The Michael J. Fox Foundation supported the study.



Cutting sedentary behaviour helps combat Parkinson's symptoms: study

Parkinson's patients often become sedentary because of motor symptoms such as gait, balance problems or falls

Frequently dubbed “the new smoking,” sitting (or sedentary behaviour) has become recognised as a significant health risk, particularly among those who already have health problems


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