Exercise
is Medicine

September NEWS LETTER

“Movement is a medicine for creating change in a person's physical, emotional, and mental states.”
Carol Welch

Spinal cord injury (SCI) and exercise:
The spinal cord is the major conduit through which the brain sends motor commands to the body and receives sensory information. SCI refers to damage to the spinal cord resulting from trauma (e.g. motor vehicle accidents or falls). SCI usually results in impairment of motor and sensory function, as well as autonomic function, like sweating and heart rate control. Two factors determine the functions impaired and the severity of impairment:

1) The location of the injury. The higher the spinal cord injury, the more function is impaired. Tetraplegia refers to injury in the neck region and typically results in impairment of arm, trunk and leg function. Paraplegia refers to injury below the neck and while trunk and leg function is impaired, arm function is preserved.
2) The completeness of the injury. When injury does not damage the full thickness of the spinal cord, some connections with the brain remain intact and some function can be preserved. The amount of function preserved is highly variable.

How does exercise help?

People with movement impairments, including people with SCI, are among the most physically inactive members of society. This profound physical inactivity leads to secondary complications of health, fitness and function. Considerations when exercising are that most frequently paralysed muscles are the large, lower-limb muscles, meaning that only the smaller muscles of the arms and shoulders can be used to stimulate the heart and lungs. People with tetraplegia may also have a reduced exercising heart rate due to impaired autonomic innervation. Nonetheless, research shows that aerobic exercise improves cardiorespiratory fitness and reduces the risk of cardiovascular disease. It may also reduce the incidence of urinary tract infections, a common problem in people with SCI. Resistance training improves strength of non-paralysed muscles and may improve strength of partially-paralysed muscles (and bones) as well. Most importantly, exercise intervention can enhance functional independence and is associated with greater life satisfaction, decreased depression/ anxiety and increased quality of life


Parkinson’s disease and exercise
Parkinson’s disease is a debilitating disorder affecting nerve cells in a part of the brain that produce dopamine. The nerve damage affects the brain’s control of the muscles, which causes shaking, increased muscle stiffness, slowed movements and balance problems. Parkinson’s to a degree affects some mental abilities, especially behavior and may cause anxiety and depression. The incidence increases with age. Drugs can control the symptoms in most patients to an extent, but unfortunately the disease worsens with time.
Why is exercise important?
People with Parkinson’s disease often become very inactive which causes loss of fitness. This can worsen the effects of the disease itself and can lead to secondary complications such as heart disease, osteoporosis, insomnia, constipation and depression. Inactivity can increase the risk of falls in patients with Parkinson’s, who are already at increased risk of falling. The tendency to fall and consequent injuries can eventually result in loss of independence and early admission to nursing homes. People often live with Parkinson’s disease for a long time, which has profound implications for the care and treatment of individuals, and has significant impact for their families and the health-care system. By increasing fitness, exercise protects against many complications of the disease. For example, better mobility may improve quality of life and prolong independent living. Exercise may also have positive effects on mood and improve their brain function and make drug therapy more effective. It also provides a means by which individuals can actively participate in the management of their disease. Some studies have shown that increased exercise reduces the death rate in people with Parkinson’s disease. Intensive exercise improves both heart and lung (aerobic) fitness and muscle control and function. This exercise reduces the increased muscle rigidity and slowed movements caused by the disease, and also increases hand coordination. Programs of resistance (weights) training increase muscle mass and strength, and also improve walking speed and distance. Balance training (alone or combined with resistance training) can improve balance and stability and increase quality of life.
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