I have been working with a gentleman with Parkinson’s for 12 year. I had actually worked with him already when he was diagnosed, and we have stayed together all those years. He is now severly disabled by Parkinson’s, and I train him at home with the assistance of another person for his safety.
You do not indicate the progression of the disease and how it manifests itself with the client you have in mind.
Looking back at how I worked with my client (always with the approval of other health care providers), my main goal was to develop as much strength, flexibility and balance as possible. When walking is getting difficult, it can often still be performed on a treadmill that assists in movement. Stretching is very important because Parkinson’s sufferers sit more and more because moving becomes difficult. And because of that, posture becomes compromised with rounded shoulders and a head forward position.
Kepp in mind that clients with Parkinson’s often have no control over the way their bodies move, and asking them to perform precise exercises can become quite frustrating.
I teach Pilates myself but I probably would not use it beyond some very basic instruction on core engagement. Even if the client can still get onto the floor, I would do as much standing as possible and only resort to sitting as necessary.
Another point to consider: I only train my client for 30 minutes and have done so for a long time because the typical hour of personal training can be too demanding. As the diesase progresses, prepare yourself for frequent cancellation on short notice. Medication needs to be adjusted from time to time, and you may need to change the exercise approach then. A person with Parkinson’s can feel okay in the morning and all of a sudden feel so weak or out of control that he cannot kep the appointment.
You will eventually watch your client having falls, and you can only hope that it is not under your supervision. Every fall has negative consequences. A final thing to remember: no matter what you do, you will watch things get worse over time, and it is a heart-breaking experience.
Hi, I haven’t found any information on Parkinson’s Disease and pilates, however, there is information through the ACSM regarding the disease.
I am currently working with two individuals living with PD one is 87 the other 78 and hold current certifications through STOTT PILATES. However, I use the guidelines established by the ACSM when working with those who are living with clinical conditions.
You can find their guidelines in “ACSM’s Exercise Management for Persons with Chronic Disease and Disabilities.”
For your information, the above-mentioned textbook was written “with the assumption that the reader 1) has a strong working knowledge of exercise science, and 2) that he is she is using the information to supplement a solid foundation in clinical exercise science for conditions outside his primary expertise.”
I mention this as working with individuals living with clinical condtions is within my scope of practice and I wouldn’t want to give the impression that working with individuals with clinical conditions is simply a matter of purchasing a book and following the guidelines. I am simply suggesting resources where you can learn more about the pathophysiology, the effects on exercise response, the effects of exercise training, medications used in the treatment of PD, recommendations for exercise testing and programming.
In the world of clinical exercise physiology problem-oriented exercise management is the approach used by exercise clinicians. This approach uses evidence-based medicine as its backbone. Following are websites you can visit to find studies, if any, Parkinson’s disease and pilates.
All the best!
Agency for Healthcare Research and Quality (AHRQ) www.ahrq.gov/clinic
American College of Physicians Journal www.acponline.org/journals/acpjc/jcmenu/htm
Center for Evidence Based Medicine www.cebm.net
Center for Research Support, TRIP Database www.tripdatabase.com/index.html
Clinical Evidence, BMJ Publishing Group www.clinicalevidence.org
Cochrane Database of Systematic Reviews www.cochrane.org
Database of Abstracts of Reviews of Effectiveness www.crd.york.ac.uk.crdweb/
Effective Health Care www.your.ac.uk/inst/crd/ehcb.htm
Essential Evidence Plus www.essenetialevidenceplus.com
Evidence-Based Medicine www.evidence-basedmedicine.com
Institute for Clinical Systems Improvement www.icsi.org
National Guideline Clearing hours www.guideline.gov
National Health Service Center for Reviews and Dissemination
Primary Care Clinical Practice Guidelines http://medicine.ucsf.edu/resources/guidelines
U.S. Preventive Services Task Force (USPSTF) www.ahrq.gov/clinic/uspstfix.htm
Too, the Michael J. Fox Foundation might be a resource you can tap into. According the the ACSM the “MJFf has recently funded a number of clinical trials on exercise and PD.
I wish you the best.
I have found that the Parkinson’s Disease Foundation is the best source of up to date multi-method delivery of information. See http://www.pdf.org/en/exercise.
One of the presenters of a teleconference session I attended through PDF was both a physical therapist and a Pilates instructor. They seem to support various modalities. I believe PDF provides an exellent newsletter, blog and education reading.
Bottom line- keep our clients moving and keep them strong. 50% of a PD clients functionality is about exercise and 50% meds. I work with my PD clients minimally 2x’s a week, to 4x’s, depending on their ability to work on their own, for one hour. We do strength exercises, fear of falling drills, rapid execution drill, freeze drills, practice speech, and stretch.
I commend your efforts and that of your client. It is a rewarding niche.
If you have any further need for assistance, you may contact me directly. See my IDEA profile.
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