This document provides information on exercise and movement for individuals with Parkinson's disease. It discusses the importance of engaging in exercises that promote a wide base of support and lateral weight shifting rather than straight line walking. Functional exercises that can be carried over to daily living are recommended. Imagery techniques are also suggested to activate brain plasticity and rehearse healthy biomechanics. Nutritional supplements that may benefit brain function and stress relief are outlined. References are provided from experts in the fields of kinesiology, neurology, nutrition and myotherapy.

1. Liberty Science LLC
Vera Shury, B.A., I.C.F.T.,S.D.,A.C.H.M.
Rehabilitation Anthropology
Fitness TherapyCopyright 2012

2.  Adult bones can be remodeled by applying
weight -resistance at the correct angles
 Walking> It is important to strike with the heel;
knee straight > longer steps >
 keeps hamstring long
 Glutes do not get activated during walking
(especially with small steps)
 2.5 mph is the usual walk/run transition
 To get dopaminergic effect 8min-30min 3X week
 Or squats (1 legged) 12-20 reps, 2-3sets 3X week

3. Process of adding
new bone in
response to:
-Damage
-Changing
patterns of stress
-Increased loads
Record of your life

4.  Osteon
 Resists stress
best when
aligned parallel
to force
 Must adapt
and change
with behaviors

5.  Periosteum
 Membrane
lining outer
surface of bone
 Progenator cells
for osteoblasts
 Nutrient supply
and nerves
Attached to bone via sharpey’s fibers

6. Wolff’s Law
∆ mechanical environment ∆ structure
(primary function of bone is to be stiff):

7. MECHANICAL PROPERTIES
Stress (s) = force/area =F/A
Strain (e) deformation =∆L/L
positive strain (+) is tension
negative strain (-) is compression

8.  The ground fights
back…..

9. Why do you flex your knee when you run?

12. Running =strong gluts
Sprinting (anaerobic): >5-6 m/s
Endurance running (aerobic) <5-6 m/s
(typical “jog” = 3-4 m/s)
Squats = strong quads

13. 50
100
150
200
250
300
EnergyCost(Joules/meter)
1 2 3 4 5
Typically, we switch to a run above 2.5 m/s
Speed (m/s)
walk
run

14. Triceps=The power to lift the body
^ from chair & turn in bed
2 moves to build strength
Triceps dip
French press

15. Extensors of elbow (Triceps brachii)
Long head
Lateral head
Medial head
Tendon
superficial deep
Infraglenoid
tubercle
Post. humeral shaft
--> olecranon
process

16. Use nectar to lubricate the throat before
swallowing pills
For difficulty swallowing use chin down
(cookie swallow)
• make sure to follow with another swallow of
nectar to assure the bolus is past all the
“involuntary “ movement triggers
To increase swallow & amplitude say:
Good Cookie (G,K)
All the vowels A,E,I,O,U,
Push Back, (P,B) for lips
Push tongue into cheeks
12-20repetitions for 3sets, 3X week
Low octave and low tone cannot be heard by the
human ear!

17. Salivation
Salivary glands:
Parotid
Sublingual
Submandibular
(+ various accessory glands: anterior lingual, labial, buccal, palatal)
Functions: breaks down some of the starch and fat; acts as a lubricant

18. Swallowing/Deglutition
Nasopharynx
Oropharynx
Laryngeo-
pharynx
Soft palate
Upper
esophageal
sphincter to the stomach
to the lungs

19. tongue
genioglossus geniohyoid
body
root
epiglottis
Vallecula
(space)
hyoglossus
palatoglossus
palatopharyngeus
styloglossus

20. DEGLUTITION
STAGE I (voluntary)
1. Tongue contacts palate, sweeps
posteriorly, pushing back bolus
(intrinsic muscles)
2. Hyoid elevated and stabilized by
suprahyoid muscles
3. Bolus pushed into oropharynx (velleculi)
by elevation/retraction of posterior tongue
(m. styloglossus);
Palatal arches stiffened (m. palatoglossus)
GH
MH
SH
D

21. DEGLUTITION
STAGE II (involuntary)
4. Induced by bolus in valleculae
5. Soft palate elevated (levator palati) & tensed
(tensor veli palatini); upper esophageal sphincter
constricted
6. Hyolaryngeal complex elevated and protracted,
opening upper esophogeal sphincter.

22. DEGLUTITION
STAGE III (involuntary)
7. Trachea closed
8. Epiglottis depressed (folds downward) 150°
in 1/15th sec.
9. Middle pharyngeal constrictors compress
bolus through the upper esophageal
sphincter.

23. DEGLUTITION
STAGE IV (involuntary)
10. Down the hatch… (inferior pharyngeal
constrictor pushes bolus into esophagus

24. ADduction of vocal foldsABduction of vocal folds
Thyroid rotation:
tense vocal foldsMOVEMENTS
Aretynoid
rotation:

25. ADduction of vocal foldsABduction of vocal folds
Thyroid rotation:
tense vocal foldsMOVEMENTS
Aretynoid
rotation:

26. QUANTAL SPEECH
F1
F2

27. Vowels

28. Consonants
[p] [d] [g]

29. Configuration selectively boosts sound pressures
30- to 100-fold in the 2-3kHz range
Db & Frequency
Most conversation occurs in this narrow range

31. Hair cells very similar to those in the cochlea

33. Sense linear accelerations

35. VS “Is Walking a line contraindicated for balance
with PD”
 “ I wouldn’t say it is contraindicated, but other
balance options are better to address the deficits.
 Since they have a narrow base of support already,
practice balance in ways to promote wide base,
lateral and backwards weight shifting.
 Make it functional for best carryover. Tandem
stance would be ok,
> again reinforcing wide or normal width base and
rocking.
> :)” Becky Farley Ph. D. BG

36. Collecting information from light

37. The amygdala is an important part of the brain in
neurological conditions>
Smell can help determine spatial location with
both nostrils intact.
Smell can help learning (memory)
Smell ability can be enhanced with intensity &
training while covering other senses.
2 days made a difference in an experiment>
chronic condition interference probably 50% more

42.  Imagining the movement as done by elite
athletes such as Olympians do to train
 Activate the plasticity of your brain
 Imagine rehearsing movement in a strong
healthy neuromuscular correct bio-mechanic
movement

43.  As much fruit (min 4 daily)
 Salad as Main Dish
 Vary greens to the max
 Few starchy(-corn, -potatoes)
 Beans, legumes (1 cup daily)
 Lean fish (twice weekly + 1 egg )
 Flaxseed daily (1 T)
 Nuts + seeds (1 oz Raw)
 Mushrooms(phytochemicals)
 Beef , turkey, chicken, fish
 Broccoli has the highest level protein
Romain based, dressing on side
Blue berries, straw, mellon
Broccoli, peas, kale, brussel
Butternut –acorn squash
Eggplant, beans
Flounder, sole, salmon
Or walnuts, soybeans
Pecan, walnuts, macadamia
Great flavor
12 oz max a week
Nutrition Supplements
recommended

44. Brain Function
Depends on adequate intake of :
Short-term Memory
Vitamin B12, vitamin C, Vitamin E
Performance in Problem-solving tests
Riboflavin, folate, vitamin B12, vitamin C
Mental Health
Thiamin, niacin, zinc, folate
Cognition
Folate, vitamin B6, vitamin 12, iron, vitamin E
Vision
Essential fatty acids, vitamin A
Neurotransmitter synthesis
Tyrosine, tryptophan, choline Omega 3
Magnesium, DHA, polyphenols, vitamin D
 Glutamate, estrogen, glutathione, cytosine, Selenium, CoQ10, WATER/ELECTROLYTES
 Osteo 8 for osteoporosis rebuilding (Chinese Herb) clinical trial supported
 There are daily minimum requirements and Tolerable Upper Level intakes per day.
 I need age and weight to provide a personalized complete list of daily nutrient intake

45.  Nutritional Stress Relief (Natural and
Homeopathic )
 To help calm the nervous system: taurine, glycine,
and GABA (Zeff, 2007);
 “Rescue Remedy” flower essence tincture:
(Casler, 2010) available in health food stores like
Warehouse Vitamins.
 Herbs: Valerian, passionflower, or hops and
chamomile (Zeff, 2007)
 A New science measures Organic Acids in Urine,
Specimen can be sent in by mail at
www.Metametrix.com/organix (Casler, 2010)

46.  Anthropology 324 The Human Machine Professor David Raichlen University of Arizona
 Argue, John. Parkinson's Disease & The Art of Moving. Oakland: New Harbinger Publications, Inc.,
2000. 95-99, 126-131.
 Farley Ph. D BG, Koshland GF, Prior MM (2004) Learning Big™ decrease bradykinesia in the upper
and lower limbs in people with Parkinson’s disease. Program No. 874.11. 2004 Abstract Viewer and
Itinerary Planner. Washington, DC: Society for Neuroscience, Online.
 Hatfield, Frederick C. Fitness: The Complete Guide. Rev. 7th ed. Santa Barbara: International Sports and
Sciences, 2001. 2.7-2.14,15.1-15.16.
 Bose MD, Sue. Sleep and Parkinson’s Disease Lecture to APDA. 2004.
 Montesorri, Maria. The Absorbent Mind. Oxford: ABC-CLIO Ltd., 1988. 130-135.
 Yessis Ph. D., Michael. Kinesiology of Exercise. Columbus: McGraw-Hill, 1992. xi, 3,17,22,49,123,146.
 Pearl, Bill. Keys to the Inner Universe. Pasadena: Physical Fitness Architects, 1982. 28-30.
 Prudden, Bonnie. Myotherapy: Bonnie Prudden's Complete Guide to Pain-Free Living. New York: Dial
Press, 1984. 75, 82.
 Fuhrman, M.D. Joel. Eat to Live, Hachettebookgroupusa.com
 Parolisi, NCCAOM Diplomat O.M. parolisi1@wbhsi.net
 Ackerly, MD Mary, mypassion4health.com marymd@mypassion4health.com
 Vera Shury is program director of PARKINSON’STRENGTH™, a program offered by Liberty Science LLC and
based upon the philosophy developed by John Argue in conjunction with Stanford Comprehensive Movement
Disorder Center and the Department of Neurology at Kaiser Permanente. Vera can be contacted at
vshury@libertyscience.com