Finding Energy with Parkinson’s<br />Sierra Farris, PA-C<br />Neurological Physician Assistant<br />Certified Clinical Exe...
Fatigue & Parkinson’s<br />Earliest reference to fatigue 1967, first papers on fatigue in PD published 1993 <br />“a sense...
Understanding General Fatigue<br />Mental – Neuroconnections<br />and Neurotransmitters<br />Physical – Mass - Physiologic...
Understanding General Fatigue<br />difficulty initiating and sustaining mental and physical tasks<br />Reduced focus or at...
Understanding General Fatigue<br />Loss of power<br />Associated with sedentary life-style <br />Motor inefficiency<br />H...
Fatigue - PD Symptom or Side Effect?<br />Medication side effects can be elusive<br />Fatigue<br />Tiredness<br />Sleepine...
Fatigue and PD Symptoms<br />Mental <br />Physical<br />More energy to initiate and sustain mental and physical tasks<br /...
Confounding Factors<br />Fatigue is more common if:<br />Decreased leisure physical activity<br />Excessive Daytime Sleepi...
Analyze and Prepare<br />Extreme Example…But,<br />Parkinson’s related fatigue can feel like you are literally climbing a ...
Comprehensive Approach to Gain Energy<br />Nutrition<br />Supplements<br />Hydration<br />Rest<br />Exercise<br />Mindfuln...
Comprehensive Approach to Gain Energy<br />Record some details for your doctor<br />When and  Severity<br />Associated fac...
Medical Search for Contributing Factors<br />Anemia – Complete Blood Count<br />Thyroid Function<br />Nutritional labs B12...
Is there a pill to fight fatigue?2009 World Congress Reports<br />Dr. Stocchi, Italy<br />Azilect showed benefit for fatig...
Modafinil(®Provigil)<br />Modafinil improved Excessive daytime sleepiness but not fatigue in a small PCT 2010 (n=13)<br />...
Fatigue Fighting – Energy Promoting Exercises<br />Yoga<br />TaiChi<br />Dance<br />Aquatic Therapy<br />Trekking Poles<br...
Energy Foods and Nutrients<br />Antioxidants<br />Anti-inflammatory Fats<br />Good Carbs, Protein<br />Fluids<br />Grazing...
Energy Conservation<br />Proper body mechanics (posture)<br />Plan ahead<br />Pace yourself<br />Scheduled rest time<br />...
Exercise and L-dopa<br />Moderate exercise increases clinical efficacy of L-dopa<br />No alteration in pharmacokinetics of...
Worksheet<br />Every Victory Counts <br />Essential Information and Inspiration for a Lifetime of Wellness<br />@Sierra Fa...
Proper Footwear<br />@Sierra Farris 2011<br />
Strength<br />@Sierra Farris 2011<br />
Flexibility<br />@Sierra Farris 2011<br />
Endurance<br />@Sierra Farris 2011<br />
Take Time to Assess<br />@Sierra Farris 2011<br />
Assist Device<br />@Sierra Farris 2011<br />
Companions<br />@Sierra Farris 2011<br />
The top ten guesses will win an Every Victory Counts manual – Essential Information and Inspiration for a Lifetime of Well...
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Finding Energy with Parkinson's

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Patient educational presentation reviewing fatique and comprehensive strategies to find more energy.

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Finding Energy with Parkinson's

  1. 1. Finding Energy with Parkinson’s<br />Sierra Farris, PA-C<br />Neurological Physician Assistant<br />Certified Clinical Exercise Specialist<br />Sponsors Northwest Parkinson’s Foundation and Teva Neurosciences<br />@Sierra Farris 2011<br />
  2. 2. Fatigue & Parkinson’s<br />Earliest reference to fatigue 1967, first papers on fatigue in PD published 1993 <br />“a sense of tiredness, no energy, total body give out”<br />“infuriating and awful feeling” <br />debilitating <br />frustrating <br />exhaustion <br />heaviness<br />@Sierra Farris 2011<br />
  3. 3. Understanding General Fatigue<br />Mental – Neuroconnections<br />and Neurotransmitters<br />Physical – Mass - Physiologic - Biochemical<br />@Sierra Farris 2011<br />Use It or Lose It<br />
  4. 4. Understanding General Fatigue<br />difficulty initiating and sustaining mental and physical tasks<br />Reduced focus or attention<br />Reduced motivation<br />Every movement is with effort<br />Causes Vary<br />@Sierra Farris 2011<br />Mental <br />May respond to targeted treatment<br />
  5. 5. Understanding General Fatigue<br />Loss of power<br />Associated with sedentary life-style <br />Motor inefficiency<br />Higher energy cost to move <br />Not related to muscle overuse (exercise)<br />@Sierra Farris 2011<br />Physical<br />Responds to rest nutrition exercise<br />mindfulness<br />
  6. 6. Fatigue - PD Symptom or Side Effect?<br />Medication side effects can be elusive<br />Fatigue<br />Tiredness<br />Sleepiness<br />Drowsiness<br />Lightheadedness<br />Low blood pressure <br />@Sierra Farris 2011<br />
  7. 7. Fatigue and PD Symptoms<br />Mental <br />Physical<br />More energy to initiate and sustain mental and physical tasks<br />Depression and Anxiety<br />Insomnia<br />Every movement is with effort<br />Tremor<br />Stiffness <br />Slowness<br />Posture<br />Dyskinesia<br />Off Time<br />@Sierra Farris 2011<br />Improves with rest nutrition exercise<br />medication<br />mindfulness<br />
  8. 8. Confounding Factors<br />Fatigue is more common if:<br />Decreased leisure physical activity<br />Excessive Daytime Sleepiness<br />Lower frequency vigorous physical activity<br />Less time doing routine tasks<br />Lower blood pressure<br />Lower aerobic capacity<br />Longer time from sit to stand = routine tasks<br />@Sierra Farris 2011<br />
  9. 9. Analyze and Prepare<br />Extreme Example…But,<br />Parkinson’s related fatigue can feel like you are literally climbing a mountain every day. <br />@Sierra Farris 2011<br />
  10. 10. Comprehensive Approach to Gain Energy<br />Nutrition<br />Supplements<br />Hydration<br />Rest<br />Exercise<br />Mindfulness<br />Stress Reduction<br />Medical Evaluation<br />@Sierra Farris 2011<br />
  11. 11. Comprehensive Approach to Gain Energy<br />Record some details for your doctor<br />When and Severity<br />Associated factors<br />Cramps or RLS<br />Prior night’s sleep<br />Prior two days of tasks<br />Meals and Fluids<br />Exercise log<br />Blood Pressures<br />@Sierra Farris 2011<br />
  12. 12. Medical Search for Contributing Factors<br />Anemia – Complete Blood Count<br />Thyroid Function<br />Nutritional labs B12, protein, iron, electrolytes<br />Infection – (Bladder)<br />Anxiety and/or Depression<br />Insomnia<br />Stressors<br />Medication Side Effects<br />@Sierra Farris 2011<br />
  13. 13. Is there a pill to fight fatigue?2009 World Congress Reports<br />Dr. Stocchi, Italy<br />Azilect showed benefit for fatigue over a 9 month study<br />DBPC N= 1176 PWP<br />P<0.01 Significance over placebo <br />Dr. Ferreira, Portugal<br />19 trials reviewed<br />Azilect only drug associated with decreased risk of fatigue<br />@Sierra Farris 2011<br />
  14. 14. Modafinil(®Provigil)<br />Modafinil improved Excessive daytime sleepiness but not fatigue in a small PCT 2010 (n=13)<br />@Sierra Farris 2011<br />
  15. 15. Fatigue Fighting – Energy Promoting Exercises<br />Yoga<br />TaiChi<br />Dance<br />Aquatic Therapy<br />Trekking Poles<br />Wii<br />Walking<br />Single leg stance<br />Tandem Stance<br />Tandem Walk<br />Corner Standing<br />Posture Exercises<br />Hiking<br />Wall Climbing<br />@Sierra Farris 2011<br />
  16. 16. Energy Foods and Nutrients<br />Antioxidants<br />Anti-inflammatory Fats<br />Good Carbs, Protein<br />Fluids<br />Grazing better than one large daily meal<br />Magnesium, Calcium, Potassium<br />What does your food pyramid look like?<br />@Sierra Farris 2011<br />
  17. 17. Energy Conservation<br />Proper body mechanics (posture)<br />Plan ahead<br />Pace yourself<br />Scheduled rest time<br />Prioritize activities<br />Limit environmental impacts<br />2008 MS Study – Mastery over the environment<br />@Sierra Farris 2011<br />
  18. 18. Exercise and L-dopa<br />Moderate exercise increases clinical efficacy of L-dopa<br />No alteration in pharmacokinetics of L-dopa Muhlack et al 2007<br />During exercise, growth hormone concentration is increased<br />No change in L-dopa levels Miller et al 2007<br />@Sierra Farris 2011<br />(Egypt J. Neurol. Psych. Neurosurg., 2004, 41(1): 141-150).35min cycling (15m post drug)<br />
  19. 19. Worksheet<br />Every Victory Counts <br />Essential Information and Inspiration for a Lifetime of Wellness<br />@Sierra Farris 2011<br />
  20. 20. Proper Footwear<br />@Sierra Farris 2011<br />
  21. 21. Strength<br />@Sierra Farris 2011<br />
  22. 22. Flexibility<br />@Sierra Farris 2011<br />
  23. 23. Endurance<br />@Sierra Farris 2011<br />
  24. 24. Take Time to Assess<br />@Sierra Farris 2011<br />
  25. 25. Assist Device<br />@Sierra Farris 2011<br />
  26. 26. Companions<br />@Sierra Farris 2011<br />
  27. 27. The top ten guesses will win an Every Victory Counts manual – Essential Information and Inspiration for a Lifetime of Wellness with Parkinson’s disease by Dr. Monique Giroux and Sierra Farris PA-C. Must be present at the September 10, 2011 Team PD Kilimanjaro event in Shoreline. <br />Registration @ NWPF.org<br />@Sierra Farris 2011<br />How many steps does it take to climb Kilimanjaro?<br />
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