DBS surgery - Dr. Mandybur discussed the decision process with one of his patients, Ann Edelen, at the 2016 Sunflower Rev-It-Up for Parkinson’s Symposium & Expo.
Exercise trains mind & body for Parkinson’s
Inspiring new research supports the necessity of exercise for all people with Parkinson’s disease. The disease damages the dopamine-producing nerve cells in the brain. Physical activity may help to ward off effects and control symptoms of tremors, freezing, rigidity, or slowing speech. "We see it every day in our patients; those with Parkinson’s who exercise can move more normally than those who do not." says Dr. Mandybur.
Tailor your exercise program to your symptoms, overall health, and fitness level. In general, train as vigorously as you can. Exercise to keep muscles strong and flexible, improve mobility, develop body awareness, and increase oxygen to the brain. Because Parkinson's poses an increased risk for falling, consider training with a partner, physical therapist, or trainer.
Tango with a partner? The tango walk, footwork, and functional mobility may help some people with Parkinson’s improve balance and mobility. In Dance for PD® classes, students learn dance fundamentals, such as rhythm, while strengthening, stretching, and building confidence.
Break a sweat? Run, jog, walk, or gait train. A doctor or therapist can help you pick the right type and intensity. Cycle, especially a recumbent cycle. Other options are tandem cycling or cadence-training. Try sensory-based PD SAFEx for improved body awareness.
Breathe and stretch? Exercise in water or in a chair, take a yoga or tai chi class, do yogic (diaphragmatic) breathing daily. Stretch for better flexibility.
Movement—exercise, dance, yoga, and more—trains mind and body. Can exercise take advantage of the brain’s neuroplasticity to repair itself? It may. Some studies suggest that exercise can help maintain old connections, form new ones, or restore lost ones.
When to Consider Deep Brain Stimulation (DBS) Surgery?
Medications used to manage Parkinson’s disease symptoms begin to lose their effectiveness over time. When this happens, patients should be evaluated to find out whether deep brain stimulation (DBS) surgery could help. DBS helps make moving easier – so exercise helps even more.
The timing of DBS surgery is different for each person. If you have severe motor disability despite optimal medications, then surgery should be considered. DBS should not be thought of as a last resort. As Parkinson's disease progresses, DBS is no longer an option if your symptoms don't respond to medication, or if you are severely disabled even in the best "on" state. Unlike other surgeries, DBS is reversible. The implanted stimulator and electrodes can be turned off or removed if necessary.
An article in the August 2011 issue of Archives of Neurology reported that patients treated with both medication and DBS for a period of 10 years had significantly better functional mobility scores than those treated with medication or DBS alone.