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Parkinson’s Disease and Pilates

Research by Ivon Dahl

Throughout 35 years of teaching Pilates to dancers, general and special populations, I have found that the Pilates method has a positive affect on people with Parkinson’s disease. Interestingly, the muscle tremor associated with Parkinson’s disease is also a typical symptom apparent in many Pilates novices’ movements. For the first two weeks of Pilates, your muscles seem to be confused whether to squeeze or relax while performing some of the choreography. This is further exasperated by activating your smaller intrinsic muscles, rather than the larger extrinsic muscles that many peoples' bodies habitually rely on.

The first step in Pilates is to develop your awareness of any excess muscle tension {the tense yet weak muscles} and build your ability to activate deep intrinsic muscles {many adults rely on extrinsic muscle strength for posture and motor skills}. This requires a conscious effort and slow subtle movements, which also strengthens your kinetic memory.

Secondly, understanding the purpose of the Pilates exercise helps you facilitate the proper focus {the purpose of the exercise may not be the same as your immediate goal, but it often serendipitously gets you there}. The hidden treasures of the Pilates method are rarely explained to the Pilates student {whether in a class, video or book}, as technical explanations are usually considered a turn-off. However, to further explore the affects of Pilates on people with Parkinson’s disease, we have to discuss the Pilates principle of Reciprocal Enervation which uses the contraction of one muscle to reciprocally release the opposing muscle as in an active isolated stretch {AIS}. This principle also involves Sherrington’s Law of nerve inhibition which helps quiet the involuntary nerve response associated in Parkinson’s disease. Pilates sophisticated approach is further recognized in another aspect of Reciprocal Enervation which sometimes requires the practitioner to synergisticly engage elongated opposing muscles and not squeeze or totally relax the muscles moving a joint. This results in a beautiful Quality of Movement {one of the Pilates Concepts}; if the Pilates student isn’t in control, a spastic tremor occurs.

After all, “Beautiful moment makes beautiful muscles” and “Practice doesn’t make perfect, it makes permanent”.

‘The Pilates Bible’ has 273 protocols for special populations, please consult it for details on Parkinson’s disease for more information.

PARKINSON'S DISEASE
Is an illness that causes rigidity, or stiffness, but not paralysis nor wasting of' muscles as in polio or AIDS. Rigid muscles can be helped by performing Pilates with regularity. A variety of Pilates exercises are good for the muscles and may help fight the progress of the disease, to keep the body from being twisted out of shape and to prevent the deformities and disabilities of later years. NOTE; the general recommendations and exercise suggestions below are supplementary to the client’s intensive physical therapy.


GENERAL RECOMMENDATIONS

HOME WORK

Standing;
Stand in front of a wall, facing it about 3" away.
Raise arms and reach as high as possible toward the top of the wall.
Lean toward the door and stretch.
With your back to the door, alternate raising legs as high as possible by bending the knee as if marching in place.
Holding on to something secure, squat down as far as possible, bending knees; then come up.

Lying on a Firm Bed or Floor;
Lie on the floor or bed, flat on your back; try to press your body to the floor or flat as possible.
Move your head from right to left as far as possible. Make sure your head, shoulders, back, and knees touch the surface.

PracticTurning;
1) Keep feet spread apart and head high
2) Use small steps and rock from side to side
3) Raise legs from the knees.

If you feel glued to the floor;
1) Lift the head and toes,
2) Bend knees slightly,
3) Rock side to side. Initiate the movement with arm inertia; lift or throw the arms to help propel you forward.

Sitting; sitting down, exercising in a chair, sitanding up

If you become immobilized a few steps before reaching the chair, aim for some object past it.
Pass the chair as closely as possible and as you go by it sit down.

To sit down; bend forward as far as possible and sit down slowly.

To get up; move to the edge of the chair, bend forward and push up vigorously using your arms.
If you have a favorite armchair, raise the back legs with 4" blocks. This will help you to get up easily.

Sitting exercises;

  1. Sitting in a straight-back chair, place your arms behind the chair and bring your shoulders back as far as possible; raise your head up and look at the ceiling.
  2. Sitting in the same chair, grip the ends of a broom or mop stick with both bands, try to raise it over your head until you get it behind your head. Keep head and shoulders as erect as possible.
  3. Sitting in same chair, place one leg at a time on another chair and press the knee straight. Keep it there 15 minutes. Try both legs together.
  4. Sitting in a chair, raise leg up from the knee alternately, as if stamping your feet.

Getting started to Walk;
Don't let people drag you up by your arms, but rather to help you under your aims, or with a slight push on your back.

For Walking;
1) Take as large a step as possible; Place objects out in a straight line. Space them so as to take as long a step as possible. Practice walking over these objects without stepping on them. Raise your toes as you step forward, hitting ground with your heels. Keep legs apart and posture straight. Swing arms and look straight ahead, not at the feet.

2) Walk with 2 lbs. dumbbells in each hand; keep elbows straight.

3) Practice walking sideways and backwards with big steps.

For Getting Out of Bed;
1) Place blocks under the legs of the head of the bed. This will elevate the head of the bed, making it easier to sit up and swing the legs off the bed.
2) A knotted rope tied to the foot of the bed can help you to pull yourself up
3)To get to a sitting position, shift the body down and rock yourself by vigorously throwing your arms and legs toward the side of the bed.

For Using Your Arms and Hands;
1) Practice buttoning and unbuttoning your clothes,
2) Practice cutting food and writing,
3) Squeeze a ball or work with Silly Putty.
4) Tear paper,
5) Take coins out of the pocket,
6) Play the piano,
7) Always try to dress yourself completely. Use shoehorns, elastic laces, or extra-long shoe laces to get a better grip. Dress in the most relaxed and comfortable position, sitting or standing, but make sure you are in a safe position.

To keep elbows straight and shoulders loose, attach elastic bands to a door, place a chair slightly in front. Stretch your arms and shoulders in all directions. By working the elastic bands when seated.

Pilates for tight muscles and poor posture; refer to ‘The Pilates Encyclopedia’
Lie prone on the floor or mat;
1) Turn the head in a ‘Pilates Clock’ or a cervical nod,
2) Swimmer,
3) Swan
For Better Balance; Cadillac; Leg Spring Series;
1) Standing Marching in place,
2) Ballet leg pulls with a leg straight out to the rear,
3) Ballet leg pulls with a leg straight out to the side,
4) Ballet leg pulls with a leg straight drawing a circle,
5) Standing Mermaid; leaning and lunging to both sides to teach how to catch from falling,
6) Standing at the open end of the Cadillac and hold the vertical poles while leaning the hips in a circular motion.

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