Category Archives: Blogs

Search for the Cure to the Common Fall

CBC’s ‘The Current’ today (March 29, 2018) had a long discussion of aging and falling.  Here is the link to listen to the full show.  The section on falling starts just after the 46:00 point in the show.

I don’t know how long this link will be active but if it’s broken, you may also be able to get to the show by going the website at http://www.cbc.ca/radio/thecurrent and then selecting the Podcasts option.

I found the article interesting and particularly pertinent for parkies.  Here are some highlights taken from this story.

 

Good balance is the key to preventing falls.

Falls are one of the main reasons seniors get hospitalized.

Roughly one in five seniors that fall and fracture a hip die because of it.

“Once you’re down and hurt, the road back is long and difficult.”

“Improving balance and strength are factors that can help prevent falls.”

“New research is starting to shed more light on the brain-body connection.”

 

Around the 50:00 mark of the episode.

Anna Maria introduces research by Dr. Manuel Montero Odaso, Professor of Medicine and Geriatric Medicine at Western University studying the relationship between cognitive ability and falling.

Falls related to multitasking.

Brain exercises may help guard against falling.

Dual task training with tablets.

Exercises also improve cognition.

About 55 minutes into the episode, they talk to Drew of the Active Protective company that has create the ‘SMART BELT’, an air bag for the hips.

Dr. Montero indicates that hip protectors can work in specific situations but in general use there were unexpected results such as an increase in pelvis fractures.

Technology is welcome but must be proven in clinical trials.

Take home message:

  • Too much focus on injury.
  • Fractures are only 1 to 5 percent of results of a fall.
  • There are psychological effects: fear, depression, lack of engagement in activities.
  • Spiral of depression, less activity, more falls, often leading to placement in nursing homes.
  • In nursing home you will see a lot of people with both dementia and falls.

Exercises are good for mechanisms related to muscles and for the brain.

 

Around 1:00:45 point in the episode.

There’s a tape of a physiotherapist in the Netherlands about the safest way to fall (make yourself ’round’).

Around 1:01:40 point in the episode.

Anna Maria introduces Barbara Adams, a physiotherapist in Nova Scotia who has been teaching patients how not to fall for three decades.  She is also a Conservative MLA.

Most falls happen quickly — no time to think and fall correctly.

Natural instinct is to flail out arms and legs.

For a senior, a fall can be the difference between life and death.

Twenty percent chance of death from blood clots or pneumonia from broken hip.

Anything that puts you in bed has risk — breathing and circulation slow down.

Biggest misconception is that a fall is embarrassing — pick them up and move on.  Fall is a sign of physical and cognitive issues.  Never look at trying to prevent the next one.

Gave talks at Atlantic Balance and Dizziness Centre.  Start each talk with “I watched you all walk into the room and I know which of you is going to fall this year.”

Biggest misconception is that it’s an accident.

Outcome measures.  A good one is standing on one foot. You and I should be able to stand on one foot for 30 seconds without sway.  A senior should be able to do it for 10 seconds.

10 seconds on both feet — low chance of falling.  Less than 3 seconds — going to have a fall unless using proper aides.

Other outcome measures:

  • gait speed
  • step length

Fall causes fear that leads to less movement. Fear of addiction to pain meds can lead to stopping there use and then not walked because of the pain.

Health Care in NS funding in-house aides to avoid building nursing homes. Aides do work for patients so they become more sedentary.

Need to look at house. Furniture usually too low and too soft.  How much does one have to reach for dishes.

Senior with shoulder pain probably from using arms too much to stand up.

Vision controls 70% of balance so good lighting helps.

A senior is supposed to walk between 6000 and 8500 steps per day which is 60 to 85 minutes of walking.

Seniors are cocooned in their home: “The sitting disease.”

“The number one reason seniors are falling is that they sit too much.”

Three favourite exercises:

  • Walk, walk, walk.
  • Functional reach.
  • Squat — sitting to standing.  You and I: 5 times in less than 10 seconds;  Senior: 5 times in less than 17 seconds.

 

 

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Dr. Jonathan Squires on Medication Management in PD

HeadWay, aka the Victoria Epilepsy & Parkinson’s Centre, recently sponsored a talk by Dr. Jonathan Squires on medication management in PD. A copy of his slides are available as a PDF at the following link:

The Art of Medication Management in Parkinson’s including Minimizing the Risk of Motor Fluctuations

There are a total of 63 slides in the presentation so I have created a short table of contents to help you find a section more quickly:

SECTION PAGE
PARKINSON’S DISEASE 101 3
HOW IS PARKINSON’S DISEASE DIAGNOSED? 6
SYMPTOMS OF PARKINSON’S DISEASE 7
PROGRESSION OF PARKINSON’S DISEASE 17
TREATMENT OF PARKINSON’S DISEASE 18
MOTOR COMPLICATIONS OF PARKINSON’S DISEASE 36
MOTOR FLUCTUATIONS 37
WEARING OFF 38
OFF-PERIOD DYSTONIA 42
DELAYED KICKING IN 43
FREEZING OF GAIT 44
NON-MOTOR FLUCTUATIONS 45
THE ROLE OF LEVODOPA 51
WHAT CAN YOU DO ABOUT BOTHERSOME SYMPTOMS? 53

Cognition, Memory & Yoga

Laura Frey, who runs the Nanaimo Yoga class for persons with PD, recently forwarded the following link to me: Cognition and Memory in Parkinson’s Disease and Yoga: An Interview with Richard Rosen.

Richard Rosen is a California Yoga teacher who has adapted his program as a result of his PD diagnosis. The interviewer starts by asking:

What has been your personal experience with how yoga can affect cognitive function and memory?

Richard’s answer begins:

As soon as you’re diagnosed with Parkinson’s disease (PD), if you’re not already a yoga student, get yourself to a yoga class…

That’s pretty powerful. Read the whole interview – there’s lots more interesting insight and several links at the end of the interview for those wanting to dig deeper. And underneath the interview window is a whole new blog, Yoga for Healthy Aging, to explore.

This Old Parky is Amazing.

John Schappi is his name. He was diagnosed with PD at age 80 in 2009. In 2010, he started his blog, Aging and Parkinson’s and Me, that won healthLine’s 2016 Blog of the Year award in the category of Best Parkinson’s Disease Blogs. In total he has written over 1200 posts and is still going strong with almost 100 in 2016.

These are not quick one-liners either. The one’s that I looked at are well thought out and content a wealth of information and links to other information.

Here are some of my favourites from the few dozen that I have looked through so far. (Maybe someone will organize these into multi-volume set with table of contents and index.)

My Parkinson’s HoneyMoon is Over. What Now?

In which he lists the proven therapies that have helped him the most. One of them has its own blog post from 2013 and is called: “BIG” Exercises for Parkinson’s.

Drumming for Parkinson’s

This is the post that I found when I was looking for information on drumming and PD. He didn’t know much about drumming before but he certainly does his homework.

Good Relationships Are Key to a Happy Life. Loneliness Kills

John talks about how relationships are what keep more people healthy, not money or stuff.

John’s blog is an amazing resource and, courtesy of the blogspot framework that it is built on, fully searchable. I will definitely be referring back to it in future posts.

Enjoy!

Kevin