Tamara Dandridge
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Effective coaching motivates participants in a particular therapy modality by optimising people’s engagement, facilitating self efficacy and driving behaviour change. The success of this incudes education, feedback, gaining the person’s buy-in, adherence monitoring, exploring what’s important to the person when goal setting and primarily, making the sessions fun. Creating a fun environment to support people to achieve their goals should include: creating a sense of community, using novel equipment and having a stimulating environment.
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Parkinson’s Disease (PD) is a progressive condition that is caused by a gradual loss of cells in the substantia nigra, located in the basal ganglia/midbrain. This leads to the neurons that produce dopamine to die. Dopamine is a neurotransmitter that plays an important role in regulating movement and motor skills. With the loss of dopamine, symptoms such as rigidity, tremor and balance/gait disturbances appear.
Dopamine loss can occur up 20 years before the above symptoms emerge with the progression of PD being categorised into 3 stages, called the Braak Stages:
· 1-2: autonomic disturbances
· 3-4: sleep and motor disturbances
· 5-6: emotional and cognitive impairment
Diagnosis occurs following an assessment of motor symptoms and responsiveness to PD medications, such as Levadopa. Levadopa converts to Dopamine, and whilst it does not slow the progression of PD down, it can relieve motor symptoms, providing opportunities to explore treatment strategies for some of the physical symptoms of PD such as reduced balance and gait festination.
PD is associated with non-motor impairments also, such as depression, apathy, memory loss and reduced cognitive functioning and thus affecting quality of life. Therefore the role of exercise in the management of PD is a crucial adjunct to medical management as it can help to address motor and non motor impairments.
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PD Warrior is a group exercise program for people with stage 1-3 idiopathic Parkinson’s Disease, that provides neauroactive exercise strategies, using high velocity, large amplitude movement to maintain function, install habitual physical activity into daily life and build community networks and peer support.