Key Takeaways from Parkinson’s Disease: Tracking Tools and Prehabilitation
Last Monday, September 19, 2023, Parkinson Wellness Projects (PWP) partnered with Dr. Pamela Hutchison, ND, to host Parkinson’s Disease: Tracking Tools and Prehabilitation. Dr. Hutchison attended the World Parkinson Congress in Barcelona in July, and wanted to share some of the exciting topics that were presented in this virtual seminar. Below are some highlights from her session:
There is a global need for centres of excellence, especially in developing countries.
There is an increasing awareness and emphasis on support for people with Parkinson’s disease (PD) in areas such as exercise and nutrition, mood (e.g. apathy and anxiety), digestive health, and stress management.
For example, most doctors do not refer their Parkinson’s patients to dietitians. This is, in part, because not many patients know that dietitians can help. However, digestive health support could improve the quality of life for people with Parkinson’s disease, especially used alongside genetic testing.
“Hopamine”: The idea that healthcare professionals and people with PD should embrace wellness as a concept instead of simply coping.
There is a clear need for lifestyle support, such as coaching, nursing, occupational therapy, physiotherapy, naturopathic physicians, etc.
Tracking tools related to Parkinson’s disease - which include everything from pen and paper to wearable devices - could address recall bias in monitoring patients. Dr. Bas Bloem, MD, PhD, FRCPE, shared in his session that physical examinations in the office tend to be highly biased.
This is for a number of reasons, such as: physical examinations tend to be sporadic; scores can vary tremendously; and different doctors on different days and seasons can mark down different scores for the same patient. With frequent or continuous monitoring, the validity and reliability of information increases.
Tracking tools can provide more real-world insights.
For example, wearable items could provide higher accuracy than patient self-reporting on areas such as falls and gait freezing.
There is not a one-size-fits-all tool; each tracking choice is highly personalized.
Each person is on their own personal journey with Parkinson’s disease. Certain motor issues can make some tracking apps unusable, and most tracking apps are not designed for people with Parkinson’s in mind. Adding tracking to the day’s activities can also be a new burden, on top of other necessary burdens, such as taking medication.
Recent research shows evidence for a 50/50 split between “body-first” Parkinson’s and “brain-first” Parkinson’s.
“Body-first” Parkinson’s is thought to originate from the gut, and moves up the vagus nerve to the brain. “Brain-first” Parkinson’s, on the other hand, is thought to originate from the brain in the olfactory bulb, and moves through the amygdala and down to the heart and gut.
Pre-habilitation is important. Ryan Duncan, PT, DPT, MSCI, emphasized in his session the importance of taking a proactive approach to treating Parkinson’s disease.
Currently, the typical approach for treating Parkinson’s is rehabilitation (or reactive). Physiotherapists work with their clients to respond to a current symptom or need. Pre-habilitation would look forward in time to see what could be prevented, including falls prevention; gait and postural instability work; strength training for breathing; and pelvic floor training for bladder issues.
Pre-habilitation is especially important in preventing further complications from a fall. Fractures and other injuries could lead to more anxiety about getting outside and doing chores, which raises the risk for social isolation. In certain cases, falls could lead to permanent immobilization, which could speed up the progression of muscle weakness and also increase the risk of social isolation. In other cases, falls that result in isolation could lead to a deficiency in Vitamin D that, in turn, raises the risk of osteoporosis and further fractures.
Dr. Hutchison’s seminar was an opportunity for our participants and their care partners to connect and learn about the latest in Parkinson’s research. Stay up to date with the latest information from PWP events by subscribing to our blog on our website: parkinsonwellness.ca/blog
As founder of Acacia Health Ltd., Dr. Hutchison focuses her practice on supporting people with neurological disorders, mental health concerns, and complex chronic disorders. She is especially passionate about providing care for people living with Parkinson’s disease. Dr. Hutchison also hosts the podcast, The Well Nurtured Brain, which covers everything from nutrition and exercise to sleep and stress management.