Another Possible Exercise Bonus: Preventing Parkinson’s

Amy Norton wrote . . . . . . . . .

Regular exercise has a long list of health benefits, and a new study suggests another one could be added: a lower risk of Parkinson’s disease.

The study, of nearly 99,000 French women, found that those who were most physically active day to day were 25% less likely to develop Parkinson’s over three decades, versus women who were more sedentary.

That does not prove that exercise, per se, is responsible, the researchers said. At the same time, they say it’s unlikely that the link reflects “reverse-causation” — women in the earliest stages of Parkinson’s being less likely to exercise.

That’s because the study assessed the women’s exercise habits for up to 20 years before their Parkinson’s diagnosis.

And since regular exercise clearly has benefits anyway, the findings could be seen as another motivator to get moving, said senior researcher Dr. Alexis Elbaz.

“Physical activity has beneficial effects on many body systems, including the bones, heart and lungs,” said Elbaz, a research professor at the French national research institute INSERM in Paris. “And our findings show that physical activity might also contribute to preventing or delaying Parkinson’s disease.”

Parkinson’s disease affects nearly 1 million people in the United States, according to the Parkinson’s Foundation.

It is a brain disease that gradually destroys or disables cells that produce dopamine, a chemical that helps regulate movement and emotional responses.

The most visible symptoms of Parkinson’s are movement-related — tremors, stiff limbs and coordination problems — but the effects are wide-ranging and can include depression, irritability and trouble with memory and thinking skills.

In general, researchers believe the disease arises from a complex interaction between genetic susceptibility and environmental factors.

But only a handful of modifiable risk factors have been linked to Parkinson’s — including a history of head trauma and job exposure to pesticides or heavy metals. If exercise is protective, that would make it one of the few ways to help prevent the disease.

“This is important because it represents a possible prevention strategy for a disease that has no cure and has a severe impact on quality of life,” Elbaz said.

The findings — published May 17 in the journal Neurology — are based on just under 99,000 French women who entered a national health study in 1990. At the outset and then every few years, they answered questionnaires on their lifestyle habits and medical history.

That included questions gauging vigorous exercise, such as playing sports and running, as well as daily activities like walking, climbing stairs and household chores. The researchers gave each activity a score called a metabolic equivalent (MET), then multiplied each activity’s MET by its frequency and duration.

In other words, it was a complicated measure.

Because of that, Elbaz said, it’s not clear whether any particular types of exercise are related to lower Parkinson’s risk.

Over three decades, 1,074 study participants developed Parkinson’s. The risk, researchers found, was lowest among women who’d been most physically active in the past 10 years — even with factors like age, weight and diet taken into account.

The one-quarter of women who were most active had a 25% lower risk of Parkinson’s compared to the one-quarter who were least active.

The problem is that Parkinson’s typically has a long “prodromal” phase — a period when people may have certain symptoms, but the disease has not yet fully manifested. So it’s possible that some women in that phase of the illness curtailed their activities.

To account for that, the researchers looked back at the participants’ exercise habits for up to 20 years before any Parkinson’s diagnosis. They found that exercise was still tied to a lower risk, though the strength of the connection was less.

There is reason to believe exercise could be protective, Elbaz said. Other research has shown, for example, that exercise can help shield brain cells from the ravages of oxidative stress — one of the mechanisms involved in Parkinson’s.

Dr. Michael Okun, national medical adviser to the nonprofit Parkinson’s Foundation, called the findings “significant and important.”

He noted that a handful of past studies have tied exercise to lower Parkinson’s risk in men only. (Men have a higher rate of Parkinson’s than women do.)

Okun said this new, large study suggests that both men and women may want to consider “lifelong” exercise as a way to reduce Parkinson’s risk.

That long-term aspect is important, Elbaz said. The women in this study were 49 years old, on average, at the outset, and it was their activity levels in the previous 10 to 20 years that mattered in their Parkinson’s risk.

“So it’s important to exercise early in life to be able to prevent or delay the incidence of a neurodegenerative disorder such as Parkinson’s disease,” Elbaz said.

Source: HealthDay






Physical Activity Crucial for Post-stroke Recovery

After a stroke, physical activity can be pivotal to successful recovery. People who spend four hours a week exercising after their stroke achieve better functional recovery within six months than those who do not, a University of Gothenburg study shows.

The study, now published in the scientific journal JAMA Network Open, is based on data concerning 1,500 stroke patients in 35 Swedish hospitals. The participants were grouped according to their poststroke patterns of physical activity.

The results show that increased or maintained physical activity, with four hours’ exercise weekly, doubled the patients’ chances of recovering well by six months after a stroke. Men and people with normal cognition kept up an active life relatively more often, with better recovery as a result.

Positive programming from exercise

The researchers have previously succeeded in demonstrating a clear inverse association between physical activity and the severity of stroke symptoms at the actual onset of the condition. These new findings highlight the importance of maintaining a healthy, active lifestyle after a stroke.

The first and corresponding author of the study, Dongni Buvarp, is a researcher in clinical neuroscience at Sahlgrenska Academy, University of Gothenburg. Besides her research internship, she is a resident doctor at an initial stage of specialist training at Sahlgrenska University Hospital.

“Physical activity reprograms both the brain and the body favorably after a stroke. Exercise improves the body’s recovery at the cellular level, boosts muscle strength and well-being, and reduces the risk of falls, depression, and cardiovascular disease. Regardless of how severe the stroke has been, those affected can derive benefits from exercising more,” she says.

Knowledge and support vital

“Being physically active is hugely important, especially after a stroke. That’s a message that health professionals, stroke victims and their loved ones should all know. Women and people with impaired cognition seem to become less active after stroke. The study results indicate that these groups need more support to get going with physical activity,” Buvarp says.

One weakness of the study is that, with a few exceptions, the researchers were unable to study the participants’ degree of activity before the stroke. The patients included were treated in Sweden in the period from 2014 to 2019.

Source: University of Gothenburg





Have Arthritis? Take a Swing at Golf for Better Health

Steven Reinberg wrote . . . . . . . . .

Could golfing be good medicine for arthritis?

Yes, according to researchers who found that for people with osteoarthritis, golfing lowered psychological distress and improved general health when compared with the general population.

“Golf is a health-enhancing source of physical activity, particularly for older adults,” said lead researcher Brad Stenner, an occupational therapist at the Alliance for Research in Exercise, Nutrition and Activity at the University of South Australia, in Adelaide. “Golf is fun, affordable and a sport for life, with clear physical and mental health benefits.”

For people with osteoarthritis (often called the “wear and tear” form of arthritis), golf helps maintain joint range of motion, strength and endurance, and contributes to mental health and well-being. Playing golf is also associated with lower levels of chronic diseases, such as diabetes, obesity and heart disease, Stenner said.

“We found that golfers both with and without osteoarthritis had higher quality of life and, significantly, lower levels of psychological distress, which is an indicator of anxiety and depression,” he noted. “Golf appears to help improve well-being via a number of factors, including exercise, community, friendship and a sense of belonging.”

Many people with arthritis stop playing sports altogether, but the impact of arthritis on playing golf is unknown, Stenner said.

“Our study looked at benefits for those with arthritis, not factors that may be barriers. It would appear from our findings at least, that those with osteoarthritis can continue to play golf given its relatively low impact on the joints, and enjoy the benefits of doing so,” he added.

For the study, Stenner and his colleagues surveyed 459 golfers with osteoarthritis. More than 90% of golfers rated their health as good, very good or excellent, compared with 64% of those in the general population who didn’t golf, the investigators found.

Moreover, among people with osteoarthritis, 22% of non-golfers reported high to very high levels of psychological distress, compared with just 8% of golfers.

The report was published recently in the Journal of Science and Medicine in Sport.

It may seem counterintuitive that physical activity can help reduce pain and improve the well-being of people suffering from osteoarthritis, but that’s exactly what doctors recommend, said Dr. Ariel Goldman, an orthopedic surgeon at Northwell Health in Great Neck, N.Y.

“Because osteoarthritis … is a degenerative disease of the cartilage in the joints, which provides gliding and shock absorption, you wouldn’t expect patients to have better reports of their pain if they’re more physically active,” he said.

“But actually patients with arthritis who play golf have lower reports of arthritic pain than those that don’t, and that goes along with other studies that show that more activity allows patients to deal with their osteoarthritis better,” Goldman explained.

Regular physical activity can help improve pain, quality of life and reduce risk factors such as obesity, he added.

Golf is a relatively low-impact sport and can play a role in maintaining mental health and overall well-being, especially if you walk the course and don’t use a golf cart, Goldman advised.

Other low-impact activities that may have the same benefits as golf include yoga, Pilates, tai chi, bowling, pickleball and just taking a walk, he said.

“This study, like many other studies, shows that low-impact physical activity helps the physical and emotional well-being of patients suffering from osteoarthritis,” Goldman said.

Source: HealthDay





Can Household Chores Be Considered Brain-Boosting Exercise?

Gina Shaw wrote . . . . . . . . .

Mopping floors, cleaning stovetops, dusting, and vacuuming may seem like hard labor, but new evidence may have you thinking differently about housework. A study published in Neurology in 2022 found a link between doing ordinary household chores and a lower risk of dementia. The researchers collected data from more than half a million cognitively normal adults ages 40 to 69, including information about their physical activity (leisure time and housework both counted) and mental activity, such as social interactions. They followed the subjects for an average of 10 years and found that regular housework-related activities were associated with a 21 percent lower risk of developing dementia. (Social engagement and other types of exercise were also beneficial.)

“That’s a pretty significant reduction, on par with what we’ve seen from medical interventions to remove amyloid or reduce blood pressure,” says Sudha Seshadri, MD, FAAN, founding director of the Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases at the University of Texas Health Science Center in San Antonio. “I think the real takeaway from this study, as well as other research, is that we shouldn’t be prescribing a particular kind of exercise or activity, but that overall, not being sedentary is helpful in preventing dementia. Instead of seeing housework as drudgery, we can view things like doing the laundry and changing the sheets as doing something good for our health.”

“When you’re cleaning mirrors or windows or walking around the house with a vacuum, you’re exercising,” says Carolee J. Winstein, PhD, PT, professor of biokinesiology and physical therapy at the University of Southern California in Los Angeles. “You’re moving around, you’re increasing your heart rate and getting your circulation going, and you’re getting out of breath. That doesn’t mean you shouldn’t also try to incorporate more structured forms of exercise into your day. Both are important. But if you didn’t have time to go to the gym today, but you vacuumed and mopped your floors, you’re still investing in yourself.”

The new findings also correlate with a study by researchers in Singapore, published in 2021 in BMJ Open, in which older adults who reported doing a lot of housework had higher scores on attention and memory tests than those who did not. They also had lower risk of falls, as measured by balance and coordination tests.

Given the potential brain health benefits of doing housework, caregivers and loved ones of people in the early stages of cognitive impairment should let them continue with their chores. “It’s easy to think that you’re helping by stepping in and doing the laundry or washing the dishes for them, especially if it takes them longer now,” says Vijay Ramanan, MD, PhD, assistant professor of neurology at Mayo Clinic in Rochester, MN. “But there can be great value in people retaining as much independent function as possible, as safely as possible, including the fact that it helps keep them more physically active.”

To fit more household chores into your day or make the most of the ones you’re already doing, first identify which ones you like. “What you do is less important than whether you’ll keep doing it. It’s not any specific activity; it’s finding consistent good lifestyle habits that will keep you active over time,” says Dr. Ramanan. “Some people may like keeping the kitchen sparkling clean, while others love getting out in the yard and laying down fertilizer and planting flowers.”

Apply exercise principles—like increasing speed, intensity, duration, and number of repetitions—to household tasks to make them more challenging. Mop your floors for 15 minutes instead of 10, for example. “Consider tasks like wiping down the kitchen or the bathroom counters or cleaning the bathroom mirror to be ‘movement snacks,’ and do them more frequently off and on throughout the day,” says Ryan Glatt, a personal trainer and senior brain health coach at the Pacific Neuroscience Institute in Santa Monica, CA.

You can also up your activity after food shopping by putting groceries in smaller bags, so you have to go back and forth between the car and your kitchen.

“If you have a list of daily tasks, think of them as an exercise circuit and try to do them as quickly as possible while still doing them well and safely,” says Glatt. “Put on up-tempo music and work at a faster pace to get your heart rate up.” Dr. Winstein adds, “Remind yourself that what you may have once thought was a grind is actually benefiting your health.”

Stay Safe While Cleaning

To avoid falls or other accidents when doing chores around the house, follow these tips from Carolee Winstein, PhD, PT, professor of biokinesiology and physical therapy at the University of Southern California in Los Angeles.

Turn on the lights. Make sure the area you’re working in is well lit.

Secure your footing. Remove throw rugs that might shift under you as you’re dusting or straightening up. Avoid wet floors. Wear shoes with good traction.

Remain grounded. Don’t use ladders or step stools when working alone.

Use supports. For balance or support, make use of grab bars or handrails in the shower or bathtub, or railings or banisters in outdoor areas with uneven surfaces like cobblestones.

Time it right. If you take drugs that can cause dizziness, such as blood pressure medications, or if you experience dizziness in general, do not do housework when you may start feeling dizzy.

Know your limitations. If your laundry room is down steep stairs, avoid carrying big loads so you can keep one hand on the railing. Instead, use a small basket and make multiple trips. Consider having the appliances moved to a safer place.

Source: Brain&Life





Whether Physical Exertion Feels ‘Easy’ or ‘Hard’ May Be Due to Dopamine Levels, Study Suggests

Dopamine, a brain chemical long associated with pleasure, motivation and reward-seeking, also appears to play an important role in why exercise and other physical efforts feel “easy” to some people and exhausting to others, according to results of a study of people with Parkinson’s disease led by Johns Hopkins Medicine researchers. Parkinson’s disease is marked by a loss of dopamine-producing cells in the brain over time.

The findings, published online in NPG Parkinson’s Disease, could, the researchers say, eventually lead to more effective ways to help people establish and stick with exercise regimens, new treatments for fatigue associated with depression and many other conditions, and a better understanding of Parkinson’s disease.

“Researchers have long been trying to understand why some people find physical effort easier than others,” says study leader Vikram Chib, Ph.D., associate professor in the Department of Biomedical Engineering at the Johns Hopkins University School of Medicine and research scientist at the Kennedy Krieger Institute. “This study’s results suggest that the amount of dopamine availability in the brain is a key factor.”

Chib explains that after a bout of physical activity, people’s perception and self-reports of the effort they expended varies, and also guides their decisions about undertaking future exertions. Previous studies have shown that people with increased dopamine are more willing to exert physical effort for rewards, but the current study focuses on dopamine’s role in people’s self-assessment of effort needed for a physical task, without the promise of a reward.

For the study, Chib and his colleagues from Johns Hopkins Medicine and the Kennedy Krieger Institute recruited 19 adults diagnosed with Parkinson’s disease, a condition in which neurons in the brain that produce dopamine gradually die off, causing unintended and uncontrollable movements such as tremors, fatigue, stiffness and trouble with balance or coordination.

In Chib’s lab, 10 male volunteers and nine female volunteers with an average age of 67 were asked to perform the same physical task — squeezing a hand grip equipped with a sensor on two different days within four weeks of each other. On one of the days, the patients were asked to take their standard, daily synthetic dopamine medication as they normally would. On the other, they were asked not to take their medication for at least 12 hours prior to performing the squeeze test.

On both days, the patients were initially taught to squeeze a grip sensor at various levels of defined effort, and then were asked to squeeze and report how many units of effort they put forth.

When the participants had taken their regular synthetic dopamine medication, their self-assessments of units of effort expended were more accurate than when they hadn’t taken the drug. They also had less variability in their efforts, showing accurate squeezes when the researchers cued them to squeeze at different levels of effort.

In contrast, when the patients hadn’t taken the medication, they consistently over-reported their efforts — meaning they perceived the task to be physically harder — and had significantly more variability among grips after being cued.

In another experiment, the patients were given a choice between a sure option of squeezing with a relatively low amount of effort on the grip sensor or flipping a coin and taking a chance on having to perform either no effort or a very high level of effort. When these volunteers had taken their medication, they were more willing to take a chance on having to perform a higher amount of effort than when they didn’t take their medication.

A third experiment offered participants the choice between getting a small amount of guaranteed money or, with the flip of a coin, getting either nothing or a higher amount of money. Results showed no difference in the subjects on days when they took their medication and when they did not. This result, researchers say, suggests that dopamine’s influence on risk-taking preferences is specific to physical effort-based decision-making.

Together, Chib says, these findings suggest that dopamine level is a critical factor in helping people accurately assess how much effort a physical task requires, which can significantly affect how much effort they’re willing to put forth for future tasks. For example, if someone perceives that a physical task will take an extraordinary amount of effort, they may be less motivated to do it.

Understanding more about the chemistry and biology of motivation could advance ways to motivate exercise and physical therapy regimens, Chib says. In addition, inefficient dopamine signaling could help explain the pervasive fatigue present in conditions such as depression and long COVID, and during cancer treatments. Currently, he and his colleagues are studying dopamine’s role in clinical fatigue.

Source: The Johns Hopkins University