PARKINSON’S PILOT
ECU physical therapy students design exercise program for people with Parkinson’s disease
One of the ironies of Parkinson’s disease, which is marked by an increasing inability for sufferers to control their movements, is that movement helps to stave off the disease’s progression.
What makes the disease even more insidious is the tendency for those diagnosed with Parkinson’s to be driven inward, both physically and socially, compounding the disease’s effects.
Dettor, an eastern North Carolina native, said working at the student-run clinic makes a difference for patients in the region.
Physical therapy students from East Carolina University’s College of Allied Health Sciences have undertaken a pilot service project, as part of a course led by Christine Lysaght, a clinical assistant professor of physical therapy, to help those with Parkinson’s in eastern North Carolina gain some measure of control over their disease and have a space to build friendships and share their frustrations and successes with other Parkinson’s sufferers.
A sense of disconnection was one of the most obvious impacts of the COVID-19 pandemic for everyone. The inability to get out of the house created major setbacks for Amy Wedge’s patients with Parkinson’s. Wedge, a physical therapy clinical instructor, said the patients she sees in her clinical practice returned to therapy with “significant declines” which inspired her to propose an exercise class for people with Parkinson’s as a project for students in Lysaght’s class.
“I had patients who were able to walk and turn on the treadmill before the pandemic, which is really hard, and now are having multiple falls at home, following their return to treatment,” Wedge said.
Preventative measures
The gold standard of treatment for patients with Parkinson’s is to begin physical therapy as soon as possible after diagnosis because exercise works as a preventative measure and prevention is far easier than recovery, Wedge explained.
As part of their course work, students in the Doctor of Physical Therapy program set out to design a pilot exercise program that would get people with Parkinson’s moving – but also having fun while exercising. And probably most importantly, to provide opportunities for patients to share experiences with one another and engage in fellowship, which the disease has a habit of undermining.
“You can prevent a lot of the problems for people with Parkinson’s if they’re able to be active and exercise safely,” said Keri Price, a student from Shelby, adding this was a limiting factor for the pilot exercise class. One man was turned away from the pilot program as the progression of his illness made one-on-one physical therapy more appropriate.
Price said she gets a lot of satisfaction from the long-term, hands-on aspects of physical therapy.
“In other medical professions, a lot of times, they have limited opportunities to follow up, whereas with physical therapy, you see them on a weekly basis. You set goals, and you can actually make a difference in the way someone lives their life,” Price said.
Sue Wright, from Greenville, was diagnosed with Parkinson’s about three years ago but assumes that she developed the disease many years prior to her diagnosis after understanding the symptoms.
Coming to terms with her diagnosis has been tough, she said, particularly the side effects of the medications she was prescribed.
“In the afternoons I can be sick as a dog with nausea,” Wright lamented. “I mean, I never had nausea like that when I was pregnant with my kids. I can still function, but I’m miserable.”
Exercise helps, though, especially with balance, which is a particular problem for people with Parkinson’s. Currently, there is a lack of exercise programs in eastern North Carolina for people with Parkinson’s disease.
During an hour-long exercise session in November, the College of Allied Health Sciences students led patients through a series of gross motor movements, like hitting large rubber balls with pool noodles and alternating between throwing a scarf through the air and bouncing a tennis ball to one another. The students selected the exercises to challenge the patients both physically and neurologically because Parkinson’s has a deteriorating effect on the body’s nervous system. A number of studies have shown that exercise improves executive function; helps with balance and fall risk; and sleep and overall quality of life.
Keeping motivated
Lynn Tuhacek, from Greenville, said that the exercise group gives her motivation to keep moving and improving instead of sitting still and withdrawing. The program’s exercise and camaraderie helps to alleviate the difficulty in coping with the disease.
“I retired a few years ago and I didn’t retire to sit in a chair,” said Tuhacek, who prided herself on walking several miles a day after work. “I told them ‘I don’t care about my voice. I don’t care about the handwriting. I just want to be able to walk.’”
ECU student Keri Price assists Lyn Tuhacek with an exercise during the clinic.
Tuhacek had battled through a series of medical concerns – spinal surgery and being hit by a drunk driver. The fallout and recovery offered cover for the Parkinson’s symptoms that were slowly developing over the past 10 years, but at a point she asked neurological specialists to rule out Parkinson’s, which they weren’t able to do.
“Then you just deal with it,” Tuhacek said. “But to me it minimized life. For a while it was diminishing. And then I thought, ‘Well, fight back a little bit.’”
Tuhacek was able to get physical therapy in Greenville with therapists who knew about ECU’s programs. Those therapists recommended the student-led pilot exercise program, which Tuhacek calls “wonderful.”
Isolation is the other major effect of a Parkinson’s diagnosis, which was compounded in recent years by COVID-19 related social distancing restrictions. Both Wright and Tuhacek applaud the pilot exercise program for being a safe space for follow travelers on the Parkinson’s path to commiserate and take solace in the awkwardness and frustration that the disease inflicts on the body.
“It’s just nice to be with other people and have somebody else that understands your problems,” Wright said. “I’ve got the wiggles now so standing up to put my earrings in, I have put my elbows down on the counter and it might take five minutes. Or I might give up and not wear them that day.”
Dedicated students
Wedge was impressed by her students’ dedication and motivation to make the most of the pilot program.
“They created a home exercise program for a day that we weren’t here and video recorded it because people do better with visual learning,” Wedge said. “Parkinson’s affects attention and motivation so having somebody in front of you doing the exercise with you, actually improves movements.”
Physical therapy student Paxton Dettor is from eastern North Carolina and chose ECU because she has Pirate alumni in her family and values the university’s mission of service.
“We really see a lot of need and the students who participate in the student-run clinics make a difference,” Dettor said. “We see a lot of people who don’t have insurance or are not insured well, who get a lot out of our services because they are pro bono.”
Wedge was visibly proud of Dettor and Price during a recent exercise session, peeking around the doorframe to watch student and patient interaction in one of the College’s large classrooms turned exercise space.
“The mission statement of the university is to serve, and this is definitely a way of providing service,” Wedge said. “They made the flyers, they contacted local neuro-physical therapists, they designed the program mentorship.
“They’re doing a great job.”
Wedge said the hope is to expand this pilot exercise class in the future to meet the needs of those with Parkinson’s disease in eastern North Carolina.
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