Pillars of Parkinson's Rehab- Neuro Note 2

          The OT Potential Podcast, hosted by Sarah Lyon OTR/L, highlights the 50 most influential journal articles published that are related to Occupational Therapy. Sarah, alongside a research librarian, have worked to feature the articles that can be the best resources for fellow OT's. Sarah explains that about 1,000 articles are posted per year. Sarah and the librarian have narrowed down the 50 "most cited" out of 4,923 articles. Sarah's podcast breaks down the message of each journal article and how it can impact the field of OT.
          The podcast that I chose is called "Pillars of Parkinson's Rehab". The first pillar should come as a confidence booster to OT's. It states that rehabilitation intervention for Parkinson's is most effective when it is "goal-based." That is just a small part of our OT Toolbox that we use everyday and should reassure OT's that are treating client's with Parkinson's that they are probably already on the right track. The journal article outlines mirroring, virtual reality and imagery as helpful to the treatment as well. The pillar that I found most interesting and is seen as the most beneficial relates to exercise. Sarah explains the pillar as "exercise-induced neuroplasticity."
Exercise-induced neuroplasticity is the term that we use to describe the impact hat aerobic activity can make on the progress of a disease. Neuroplasticity is the way that our nervous system can reorganize connections and reroute a message after damage has been made. Dr. Lancaster's visual example of neuroplasticity explains the concept in a realistic way. Imagine you're driving home and see a large pot hole in the road ahead (Memphis drivers, sound familiar?). You can continue driving and come to stop once you hit the pot hole or you can change directions, shift lanes, or make a turn. This is what our signals from the brain are able to do after a neurogenerative disease like Parkinson's has made its mark.
           Sarah explains that research shows that those with Parkinson's that were treated with an intense exercise program, 2 times per day for 5 weeks, showed a significant decrease in a need for medication for 12 months. Levadopa, described as the gold standard medication for Parkinsons, can mask and maintain symptoms but does not hinder the progression of the disease. Exercise however, is proven to slow the progression of the disease and allow individuals to maintain gait, balance, and coordination for longer. The article outlines the benefits of aerobic exercise like dancing, kickboxing, and tai chi. It also provides research pointing to intense and resistance training. Even done just weekly, monthly, or annually, it is shown to better the prognosis of individuals with Parkinsons.
          Had I listened to this podcast before taking this course, I would not have appreciated many of the references such as levadopa, neuroplasticity, dopamine production and motor mirroring. I chose this podcast because it aligns with particular topics that I find interesting. I have always enjoyed running and yoga and have a new-found interest in neurodegenerative diseases. I hope to one day become a certified exercise instructor and am curious about exercise facilities such as "Rock Steady Boxing", designed specficially for individuals facing this disease. I would recommend this podcast to anyone that is pursuing a neuro focus, occupational therapy, or caring for a loved one with Parkinson's. We all know that exercise is good for us but when it is outlined in a way that could slow this disease in it's tracks, it may inspire a certain client or caregiver to think differently!

Reference:
Lyon, Sarah.(2019, July 7.) OT Potential Podcast: Pillars of Parkinson's Rehab. [Audio Podcast]. Retrieved from https://www.stitcher.com/podcast/ot-potential-podcast.