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Getting active to actively fight Parkinson’s

Keeping fit and active can be life-changing for Parkinson’s patients, with the global group PD Warrior making this a possibility.

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PD Warrior
PD Warrior use a range of aerobic and strength-based exercises to help those who develop the condition

There are a number of methods used to treat Parkinson’s, but one emerging solution could also be the simplest.

Getting Parkinson’s patients moving and active is rapidly being recognised as one of the best possible treatments available.

A number of studies have shown the benefits it can have for those with the disease, with the Parkinson’s Foundation highlighting exercise as one of the most accessible ways to help.

One group putting this research into practice is PD Warrior, a foundation based on offering fitness classes for those at all stages of the condition.

From Australia to Europe, the support network is helping patients all over the world by showing them the benefits exercise can bring.

Those who get involved are introduced to the ‘10 week challenge’ where they take part in three classes a week that involves workouts specifically designed to help relieve their symptoms.

Alistair MacFarlane is an exercise specialist who got involved in the PD Warrior programme in 2016 having previously worked with patients with a variety of health conditions.

He helps run the group’s Bristol outlet and he explained to NR Times about what makes the course so unique.

“The PD philosophy is exercise which is specifically targeted, based on power, amplitude and high effort level,” he said. “That was what really attracted me to it, as it was quite different to what had been done before with Parkinson’s patients.

“When I was previously working with people with Parkinson’s, it was very much low level stuff, low intensity with just gentle movement and this was quite the opposite.

“We rely on big movements and pushing people to their limits as much as you can. The great thing about it is that they’re finding they’re able to do things they never thought they were capable of.”

Any sort of movement for these patients is always beneficial, with PD Warrior proving this in a number of forms.

The ten week challenge teaches ten specific exercises that patients can continue with, but the group also gets people moving in other ways such as dance classes and strength training.

Those that finish this course then graduate onto the group’s follow on classes where they can continue their development.

After completing the PD Warrior training course, Alistair helped bring the programme to Bristol in 2018 and has seen the impact it has had.

“We were expecting maybe a year down the line of doing the PD Warrior exercises, we may see some changes and improvements in some areas but we were seeing this after just ten weeks.

“To actually see some improvements in the speed of patients doing exercises or seeing their dexterity improve, as well as quality of life, we were just blown away by that.

“That’s why it’s such an exciting thing, it’s why I love working in this area and these improvements may be because of their physical condition or maybe because of their confidence.”

This confidence and support is another key reason why initiatives like PD Warrior receive such a good take up.

Often after a Parkinson’s diagnosis most patients are left worried and confused as to what the future holds.

The misconceptions around the condition lead a lot of people to think life is over for them, but showing them what they can do and connecting them with others who are in a similar position is vital to living a longer, happier life.

“As soon as somebody gets a diagnosis, they can tell them exercise is something you can do straight away. 

“We’re finding that helps a lot of people, especially those who are fairly young when they get a diagnosis and may not know anybody that has Parkinson’s.

“So actually they then get to meet other people who have had similar experiences and we find that support group is really helpful for them.

“The courses are run as a group of eight, so we keep it nice and small to build a really nice network, a group where they’ll get to know each other quite well.”

These results have led to large numbers taking up the scheme, with Alistair saying the ten week challenge courses are often over booked.

The events of the last year have also helped make made it more accessible, with a number of classes moving online to help people in any location.

The programme is now in eight countries, meaning the improvements exercise can bring to Parkinson’s patients is being felt across the world.

“More and more research is coming out saying exercise is so beneficial for people with Parkinson’s,” Alistair said. “So that’s music to my ears as an exercise specialist that I can work with these people and get some great results.

“It’s not a cure, we never say it is. What it aims to do is slow down the progression of Parkinson’s. 

“That’s what we tell people, we aim for people to achieve that so they can live their lives longer and better with their Parkinson’s diagnosis rather than being affected in that way that comes to be quite debilitating.”

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Osteoarthritis: breaking the cycle

Medical technology company Ottobock shares its expertise on approaches to the condition.

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Sponsored feature

Why is Cartilage Important?

Bones that come in contact with other bones are covered by cartilage at their contact points. Cartilage does not have blood vessels – it is supplied with nutrients through movement of the joint. That’s why regular exercise is so important!

Cartilage ensures that the joint surfaces move against each other in the most efficient way and with little friction. It absorbs shock, cushioning the joint, and distributes the forces acting on the joint.

If cartilage is damaged and its gliding properties are affected, it can no longer serve its purpose and the joints range of movement can become limited.

Typical Progression of Osteoarthritis

When osteoarthritis of the knee develops due to joint malalignment, an accident, advancing age, obesity or excessive strain, the damaged cartilage is no longer able to properly fulfil its function.

This results in pain and re­duced mobility. The affected patient instinctively assumes a relieving posture to reduce strain on the knee.

However, this often leads to new prob­lems in other places, such as the hip, and reduces the supply of nutrients to the cartilage, for which movement is required – sparking a vicious circle.

The cartilage develops cracks and begins to break down. At the same time, the bone thickens at the site of the damage.

When the cartilage layer is completely worn away, the affected bones come into direct contact and rub against each other causing joint pain and inflammation.

The thickest joint cartilage is located behind the kneecap (patella). This is an area of high stress. Osteoarthritis occurring in this area is known as patellafemoral osteoarthritis

Signs and Symptoms

There are several common symptoms that signal knee osteoarthritis. They can occur individually or together. However, with the initial onset, you may not notice any of these symptoms

When symptoms appear they usually occur in the following order:

  • Cracking in the joint
  • Pain during load bearing activities, such as carrying a heavy object
  • Pain during every day activities, such as climbing the stairs
  • Reduced mobility
  • Swelling and inflammation

Non-Invasive Treatments

Joint specific exercises: with regular exercise mobility can be maintained and muscle strengthened, ensuring the cartilage is supplied with the nutrients it needs.

Temperature: with acute inflammation, cold relieves pain and reduces swelling. Heat relaxes the muscles and tendons and increases the flow of nutrients. Heat may only be applied when the joint is not inflamed.

Creams: various over the counter products are available at your local pharmacy including gels and creams that can help relieve pain.

Orthopaedic devices (braces and supports): these are applied externally to the knee, reducing pain and improving mobility.

Lifestyle: living a healthy lifestyle can help to combat osteoarthritis. A healthy diet and an active lifestyle reduces the chance of obesity, putting less stress and strain through the knee joints.

Orthotic Options

An orthotic fitting is a key component in the treatment of osteoarthritis. It can provide the following:

  • Pain relief
  • Support daily activities
  • Support during activities that affect the joint, whether at work or during sports

Did you know?

An osteoarthritis patient takes an average of around 1,200 tablets a year to manage pain. But this can lead to damage to the stomach, bowel and liver.

An orthosis from the Agilium line is therefore a good alternative. It’s worth-while for anyone with knee osteoarthritis to test the effectiveness of the orthoses themselves.

The Agilium Line

The braces in our Agilium line are designed specifically to target the symptoms of osteoarthritis of the knee.

Each works in a different way to address the various characteristics of osteoarthritis of the knee. At the same time, we placed great emphasis on their comfort and suitability for daily use.

The Agilium Freestep, the Agilium Reactive and the Agilium Softfit are used to treat unicompartmental osteoarthritis of the knee.

The Agilium Patella is used for patients with patellofemoral arthritis.

The Agilium Freestep is used to treat OA, although it is not applied directly to the knee. Instead is worn on the foot, right inside the shoe! For targeted relieve, it alters the load-line of the knee – the point where the body weight impacts the cartilage.

The Agilium Softfit is a pull on knee brace with a textile base and single upright that stabilises and relieves the knee using a three point force system to offload the affected compartment (side) of the knee.

The Agilium Reactive also uses a three point force system to offload the affected compartment (side) of the knee. However, the innovative closure system in the upper calf provides comfort while sitting without compromising the stable position when standing.

The Agilium Patella combines a textile structure and stabilising component with a dynamic re-alignment mechanism enabling it to maintain the central alignment of the knee cap, reducing pressure behind the knee cap.

Find the appropriate brace with Agilium Select.

Visit our website or go to ottobock.com/agilium-select

If you would like to know more about any of these products please get in touch via orthoticsuk@ottobock.com or visit our website for more information: www.ottobock.co.uk

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News

Masturbation linked to stroke in medical case study

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Doctors in Japan have reported how masturbation sparked a bleed on the brain of a 51-year-old man; as published in the Journal of Stroke and Cerebrovascular Diseases.

Doctors at the Nagoya City University Graduate School of Medical Sciences in Japan explained that the man attended hospital after orgasming, with the sudden onset of a searing headache that lasted for around a minute. This was followed by an intense bout of vomiting.

A CT scan showed an acute subarachnoid hemorrhage in the left hemisphere.

The researchers note that masturbation causes an increase in heart rate, blood pressure, and noradrenaline plasma levels – which are likely to contribute to the risk of splitting a blood vessel in the brain and result in a hemorrhagic stroke.

The man was treated with stents and coiling, two techniques used to bolster the blood vessel and maintain blood flow to the brain, and he went on to make a full recovery.

The study authors say that they found just two other cases of masturbation-linked strokes in other scientific literature.

The Japanese man survived and was discharged after nearly two weeks in hospital in an “excellent” condition.

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Engineers develop ultrasound patch to monitor blood flow

Breakthrough could help to better predict stroke and other cardiovascular conditions earlier.

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Engineers at the University of California San Diego have developed an ultrasound patch that can be worn on the skin. It monitors the blood flow through major arteries and veins deep within the body.

It is hoped that it could help clinicians diagnose cardiovascular conditions faster. It could also help to diagnose blockages in the arteries which could lead to strokes or heart attacks.

The ultrasound patch continuously monitors blood flow as well as blood pressure and heart function in real-time. Assessing how much blood flows through a patient’s blood vessels could help diagnose blood clots, heart valve problems and poor circulation in the limbs.

For many patients, blood flow is not measured during a regular visit to their doctors. It is usually assessed after a patient shows signs of cardiovascular problems.

The patch can be worn on the neck or chest and can measure cardiovascular signals up to 14 centimetres inside the body non invasively with high accuracy.

How the patch works

The patch is made of a thin, flexible polymer that sticks to the skin.

There is an array of millimetre-sized ultrasound transducers on the patch known as an ultrasound phased array.

These are individually controlled by a computer. Another feature is that the ultrasound beam can be tilted at different angles to areas in the body that are not directly below the patch.

It can operate in two modes. In one, all of the transducers can be synched together to transmit ultrasound waves which produce a high-intensity beam that focuses on one spot.

This can be up to 14cm deep in the body.

A wearable ultrasound patch on the skin

The other mode allows the transducers to be programmed to transmit out of sync producing beams at different angles.

In being able to manipulate the beams, it gives the device multiple capacities for monitoring central organs as well as blood flow with high resolution.

When the electricity flows through the transducers, they vibrate while emitting ultrasound waves that travel through the skin into the body.

When they penetrate a blood vessel, they encounter the movement of red blood cells flowing inside. The cell movement changes how the waves are transmitted back to the patch.

This change is recorded by the patch and creates a visual recording of the blood flow. It can also be used to create moving images of the heart’s walls.

The benefits:

Sheng Xu, professor of nanoengineering at the UC San Diego Jacobs School of Engineering said:

“This type of wearable device can give you a more comprehensive, more accurate picture of what’s going on in deep tissues and critical organs like the heart and the brain, all from the surface of the skin.”

Xu added: “This is a first in the field of wearables because existing wearable sensors typically only monitor areas right below them.

“If you want to sense signals at a different position, you have to move the sensor to that location. With this patch, we can probe areas that are wider than the device’s footprint. This can open up a lot of opportunities.”

The researchers say that the easy to use patch could allow patients to wear the patch and monitor the results themselves. It doesn’t depend on a technician to read the results

The next stage

The patch is not yet ready for clinical use. The researchers are currently working on a way to make the electronics wireless as it currently needs a power source and benchtop machine.

Image credit: Nature Biomedical Engineering

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