Therapy sees Parkinson’s sufferers dancing away symptoms

by Symptom Advice on May 5, 2012

When Surang Janyasing was diagnosed with Parkinson’s disease five years ago she was devastated. The 55-year-old mid-ranking police officer knew that the disease cannot be cured, and that she would be on medication for the rest of her life, with the probability of deteriorating health.

The main symptoms of Parkinson’s include stiffness of the muscles, shaking and slowness of movement. It mainly affects the way the brain coordinates the movements of the muscles in various parts of the body.

Patients with Parkinson’s have a tendency to isolate themselves and are easily exhausted. The effects of the disease plunged Ms Surang into depression.

“I think of my Parkinson’s as a disease of snobbishness. my body was very stiff, I couldn’t turn to see anyone who called me from behind, and my face was grim from depression. I didn’t have the heart to chat with anyone,” Ms Surang says. “People who weren’t close to me thought that I was a snob.”

Since then Ms Surang has taken three types of medication four times a day. However, she noticed that she wasn’t getting any better. Finally Ms Surang left her job so she could care for her 90-year-old mother. Parkinson’s has made caring for her mother more difficult, and she started to worry what would happen if her symptoms worsened.

But her life changed rapidly after she joined a Thai dancing class organised by a physical therapist who was researching ways to help Parkinson’s sufferers improve their quality of life.

Dr Roongroj Bhidayasiri.

In a dance class on the day of our interview, Ms Surang was lively, dancing with a radiant glow of happiness on her face. Her movements were smooth and close to those of a normal person. Along with Ms Surang, her seven classmates were also moving with the music. some were moving awkwardly and slowly, others had helpers to prevent them from falling. Only one or two were moving as smoothly as Ms Surang.

This group comprises patients from Chulalongkorn Hospital. they were carefully selected to join a programme, which formed part of the doctoral thesis of Surasa Khongprasert, a PhD student at Chulalongkorn University’s Faculty of Sports Science.

Twenty-eight patients participated in the research, all from the Chulalongkorn Centre of Excellence for Parkinson’s and Related Disorders, run by director Roongroj Bhidayasiri.

Fourteen were selected to learn Thai dance while taking medication, while the rest received only the medication. There were three dancing classes held over a period of four years. each lasted three months, and were four or five months apart from each other. The last class was almost a year and a half ago, but the patients still meet from time to time to dance and chat.

The programme started in 2008, when Ms Surasa was looking for a topic for her thesis, and traditional Thai dance caught her attention. She found that the symptoms of Parkinson’s _ such as stiffness and difficulties in movement _ might be helped by the postures and movements of Thai dance.

“I thought it would be a good form of exercise. However, it was not enough to be the topic for a doctorate degree thesis, so I searched for other factors that could enhance the importance of my study,” Ms Surasa says.

There are 108 postures considered as the basic movements of Thai dance, called Tha Mae Bot or Ram Mae Bot in Thai. Ms Surasa chose eight movements that could have beneficial effects for patients, covering muscles from head to toe.

The new PhD holder recently completed her thesis, and her research was rated as “excellent” by the professors overseeing her work. The results are quite amazing. All of the pariticipants’ symptoms improved and they saw improvements in balance, speed of movement, range of motion and ability to shift between different movements.

“Moreover, their quality of life has markedly improved, such as an increase in communication skills and while their depression has lessened,” says Ms Surasa.

TAKING a CHANCE ON DANCE: Parkinson’s sufferer Surang Janyasing has benefited from dance therapy.

The findings from her thesis might help Parkinson’s sufferers in Thailand _ who have been increasing in number in recent years _ to live better lives, according to Dr Roongroj.

There are 60,000 known Parkinson’s sufferers in Thailand. However, Dr Roongroj believes the number is under-reported because of poor record keeping and administrative procedures in some facilities, and there is also an unknown number of sufferers who are not properly diagnosed because of inadequate facilities and staffing in some areas.

The causes of Parkinson’s are still unclear, but interactions between genetic weaknesses and exposure to environmental factors are widely believed to be the main causes. Pesticide exposure is believed to be an especially important environmental risk factor.

The recent report, “A National Registry to Determine the Distribution and Prevalence of Parkinson’s Disease in Thailand: Implications of Urbanisation and Pesticides as Risk Factors for Parkinson’s Disease”, suggested that urbanisation and exposure to pesticides may both be risk factors for the disease in Thailand. The two central provinces of Chai Nat and Sing Buri have the highest prevalence of Parkinson’s and are also reported to use the most pesticides.

What concerns Dr Roonroj the most is Thailand’s greying population _ the rise in the elderly population and decline in the proportion of children and teenagers. since Parkinson’s is more common among those over the age of 50 that might result in a spike in the number of sufferers.

Parkinson’s is a progressive, neurodegenerative disease that occurs when the neurons within the brain responsible for producing the chemical dopamine become impaired or die. Dopamine is essential for the smooth control and coordination of the movement of voluntary muscle groups. once approximately 80% of the brain’s dopamine-producing cells no longer function, the symptoms of Parkinson’s begin to appear.

“There are four subtle early signs of the disease that should not be overlooked _ permanent loss of smell, chronic constipation, depression and REM

[rapid eye movement] sleep behaviour disorder, or para-somnia. There are reports worldwide indicating that these signs can predict the disease 20 years before the symptoms are clearly seen,” Dr Roongroj said.

But even with the onset of these symptoms, misdiagnoses occur and that can result in the loss of precious time in tackling the disease at an early stage. Ms Surang was also diagnosed with spinal stenosis and was subjected to neck surgery.

“But it didn’t have any affect on my symptoms, so I was transferred to the neurology department to be tested for Parkinson’s,” Ms Surang said.

Once the symptoms of the disease are present, a sufferer’s quality of life declines. The most obvious symptoms are movement-related; these include shaking, rigidity, slowness of movement and difficulty with walking. Later, cognitive and behavioural problems may arise, with dementia commonly occurring in the advanced stages of the disease. Other symptoms include sensory, sleep and emotional problems.

THEORY INTO PRACTICE: Left, Surasa Khongprasert’s research for her doctoral dissertation led to an innovative breakthrough in Parkinson’s treatment.

That’s why exercise is essential for patients with Parkinson’s disease. Medication alone cannot increase body strength to better control the body’s movements, but there are many forms of exercise that can help, such as walking, cycling on a static bike and stretching.

In other countries, ballroom dancing and Tai Chi are being used to help sufferers, and many reports clearly state the benefits when patients participate in certain exercise regimens.

Many researches also point out that music with a lively rhythm helps patients in guiding their movements.

“And, in Thai dance with the music, there are a lot of rhythms of variable or frequency as well. so, we think that Thai dance is a good idea in combination with stretching and balancing exercises, and rhythm guidance. so we developed these classes for the patients,” said Dr Roongroj.

Ms Surasa also pointed out other advantages of traditional Thai dance. besides it being a low impact exercise it can help stretch and move small joints such as finger and toe joints, wrists and also palm muscles with its different postures. and it is also able to help improve balance and prevent joints stiffening.

“Patients have to learn to shift their weight to the rhythm, and traditional Thai dancing can improve a body’s balance and prevent joint stiffening. Sufferers can do just one Thai traditional dance movement, but get the same physical benefit as doing two or three physical therapy-based exercises.”

For example, traditional movements such as Prom-See-Na and Nok-Yoong-Fon-Hang can increase movement around shoulder joints and wrist areas as well as helping to stretch flexor muscles. Sod-Soi-Ma-La exercises the fingers, especially the thumb and index finger.

And Thai dance requires a lot of toe tilting and the movement of legs to the front, side and back which increases leg flexibility.

Ms Surasa’s research has now been completed. The class has been over for months. However, Ms Surang and her friends still meet up once a month to review their progress. Ms Surasa has also given them songs so that they can dance at home.

However, many say they feel better in a class. “I feel a bit lonely when I do it alone at home,” Ms Surang says.

“However, I have my one-year-old nephew to cheer me up while I’m dancing at home. he loves the songs and tries to move along.”

Currently, Ms Surasa and her two advisers, Dr Roongroj and Vijit Kanungsukkasem, the dean of the School of Sports Science at Chulalongkorn University, are trying to publicise the dance programme so it can be used by Parkinson’s sufferers across the country.

Posters with Thai dance postures are being distributed to physical therapy units, and a story about the programme was also published in a local health magazine.

With the hope that her findings can improve the lives of Parkinson’s sufferers, Ms Surasa says she will try to publicise the benefits of Thai dancing as widely as possible.

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ALL THE RIGHT MOVES :Ms Surasa with some of the patients whose lives have been improved by her novel ideas on dance as physical therapy for Parkinson’s sufferers. PHOTOS: COURTESY OF FACULTY OF SPORTS SCIENCE, CHULALONGKORN UNIVERSITY

About the author Writer: Busaba Sivasomboon Latest stories in this category:

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