The human body is made up of complex yet incredible systems, sometimes, even leave doctors and scientists confounded. One such system is the neurological system with billions of nerve cells or neurons. When the neurological system experiences problems, one can have difficulties in moving, speaking, swallowing, breathing, or learning. According to the doctors, there are over 600 neurologic diseases viz migraines, degenerative diseases, epilepsy, brain tumours and meningitis to name a few.
Parkinson’s disease: a big neurological disorder
Parkinson’s disease is a nervous system disorder that affects movement, starting with a barely noticeable tremor. The disorder also commonly causes stiffness or slowing of movement and the face may show little or no expression in the early stages. Your arms may not swing when you walk and speech may become soft or slurred. The symptoms of Parkinson’s disease worsen as the condition progresses over time.
Causes of Parkinson’s disease
In Parkinson’s disease, certain nerve cells (neurons) in the brain gradually break down or die. Many of the symptoms are due to a loss of neurons that produce a chemical messenger in your brain called dopamine. When dopamine levels decrease, it causes abnormal brain activity, leading to impaired movement and other symptoms of Parkinson’s disease.
- Viral infections like Encephalitis.
- Injury to basal ganglia
- Destruction or removal of dopamine in basal ganglia
- The presence of Lewy bodies, an important clue to the cause of Parkinson’s disease.
Symptoms of Parkinson’s disease
- Tremor
- Slowed movement (bradykinesia)
- Rigid muscles
- Impaired posture and balance
- Loss of automatic movements
- Speech change
- Writing changes (Micrographia)
Pathophysiology of Parkinson’s disease
The basal ganglia are a group of structures found deep within the cerebral hemispheres. The structures generally included in the basal ganglia are the caudate, putamen, and globus pallidus in the cerebrum, the substantia nigra in the midbrain, and the subthalamic nucleus in the diencephalon.
Degeneration of dopamine neurons is particularly evident in a part of the substantia nigra called the pars compacta (The pars compacta is a portion of the substantia nigra, located in the midbrain). Significantly, the loss of dopamine in the pars compacta increases the overall excitatory drive in the basal ganglia,* disrupting voluntary motor control and causing the characteristic symptoms of PD.
Complications of Parkinson’s disease
- Thinking difficulties
- Depression and emotional changes
- Swallowing problems
- Chewing and eating problems
- Sleep problems and sleep disorders
- Bladder problems
- Constipation
Role of Yoga in Management of Parkinson’s disease
The following Yogic practices may be useful for managing PD. The program starts with loosening practices (15 minutes), Asanas – physical postures (15 minutes), Yogic breathing (10 minutes), meditation (15 minutes), and finally, relaxation in the corpse posture (5–10 minutes). This makes an integrated Yoga module to be practiced for approximately 60 minutes, once daily for 3–5 days weekly, depending on the individual’s capacity and comfort.
The details of yoga programs are as follows
Loosening Yoga practices (Shithilikaranavyāyāma)
- Loosening of fingers (Anguli shakti vikāsaka)
- Loosening of wrists (Manibandha shakti vikāsaka)
- Loosening of elbow (Kaphoni shakti vikāsaka)
- Shoulder rotation (Skandha tathā bāhumula shakti vikāsaka)
- Drill walking (Pādasancālana)
- Bending (front and back, side-ways and rotation, Grivā shakti vikāsaka)
- Half butterfly (Ardha titali āsana)
- Full butterfly (Purna titali āsana)
- Ankle bending (Gulphashaktivikāsaka)
Yogasana for Parkinson’s disease
- Tree pose (Vrikshāsana)
- Half waist rotation pose (Ardhakatichakrāsana)
- Hand to foot pose (Pādahastāsana)
- Eagle pose (Garudāsana)
- Triangle pose (Trikonāsana)
- Twisted pose (Vakrāsana)
- Fish pose (Matsyāsana)
- Cobra pose (Bhujangāsana)
- Locust pose (Salabhāsana)
- Upside down seal (Viparithkaraniāsana)
- Wind-releasing pose (Pavanmukthāsana)
Breathing exercises for Parkinson’s disease
- Hands in and out breathing
- Ankle stretch breathing
- Hand stretch breathing
- Hare breathing (Shashānkāsana Prānāyāma)
- Tiger breathing (Vyaghrah Prānāyāma)
- Dog breathing (Svāna Prānāyāma)
- Sectional breathing (Vibhāgiya Prānāyāma)
- Alternate nostril breathing (Anuloma Viloma Prānāyāma
- Bellow breathing (Bhastrikā)
- Humming bee breathing (Bhrāmari)
Diet for management of Parkinson’s Disease
- Nutrition adjustments can help ease some of PD’s most common symptoms, both of a motor and a non-motor nature.
- For example, if you experience digestive difficulties, especially constipation (which is very common in PD), try to drink more fluids, and increase your fiber intake with fruits and vegetables such as kiwi, apples, prunes, dates, figs, radishes, berries, nuts and beans.
- If drinking more water leads to urinary incontinence or urgency, increase your fluid intake by eating foods with a high water content. These include tomato, cucumber, radish, celery, broccoli and grapefruit.
- If you struggle with weight loss or loss of appetite — both common in PD — try increasing your calorie intake by eating nuts and foods that contain healthy fats, like coconut and avocado. To stimulate your appetite, try bitter greens like collard and beet greens, or spicy foods.
- Fatigue and sleep difficulties are also common symptoms of PD. When eaten during the day, sweets briefly boost energy, but make you sleepy later. When eaten in the evening, they may keep you awake. When reaching for a snack, try foods that offer a balance of protein and fat, like nuts or avocado, or whole-grain complex carbohydrates.
How Yoga helps in Parkinson Disease
- Yoga for Parkinson’s focuses the mind, strengthens and lengthens muscles, helps coordination and balance, improves posture and relaxes both the body and mind.
- Poses that lengthen and relax muscles to counter rigidity.
- It is helpful to practice variations of salabhasana (locust) to counter the round shoulders and forward projection of the head that often accompany Parkinson’s, this helps with core strength and opens the shoulders and chest.
- Seated and floor-based postures to provide a steady foundation for those who find balance a challenge.
- It is a good idea to modify and adapt postures with straps, blocks or cushions to make postures more accessible and comfortable.
- Breathing practices to relax the body and balance the mind, stimulating the parasympathetic nervous system (the side of the nervous systems that conserves energy and calms)
- Practices that distract the mind from Parkinson’s tremors, such as chanting and meditation
- The issue of mobility has important implications for falls in PD. Yoga participation can improve functional mobility and how a person with PD walks. Standing Yoga poses target the hip extensor, knee extensor and ankle plantar flexor, which support center-of-mass during walking and may improve overall stability.
- Balance training is an important component of PD therapy, as 40 percent of nursing home admissions are preceded by a fall. Research shows yoga-related improvements in balance (tandem, one-leg) and an associated reduction in fear of falling; this can also help keep people with PD active in their community.
- Gains in lower-body strength occur for PD patients following Yoga practice and are associated with improved postural stability. Yoga requires isometric contraction (i.e., the joint angle and muscle length do not change) of specific muscle groups to stabilize the body as one performs the postures, and may mimic isokinetic contractions (i.e., variable resistance to a movement performed at constant speed) when performing controlled systematic movements from one pose to the next. These mechanisms may be the reason why yoga improves muscular strength.
- Improvements in flexibility and range of motion (ROM) are important since rigidity is a common clinical manifestation in PD. Research shows improvements in flexibility/ROM of the shoulder, hip and spine. Stooped posture is characteristic in PD and can be related to short spinal flexors and weak spinal extensors; improved shoulder and spinal flexibility from Yoga supports a more upright posture. Greater hip mobility from Yoga may translate into improvements in shuffling gait experienced by many living with PD.
- The psychosocial benefits associated with Yoga are important for disease management, as they are not often addressed with conventional dopaminergic therapy. Yoga can offer group support, improved confidence and self-efficacy. The calming effect of Yoga (by enhancing parasympathetic output) may lessen perceived stress, enhance relaxation, and benefit sleep in PD.
