Parkinson’s Disease and Complementary and Alternative Medicine
Options from the Field of Complementary and Alternative Medicine
A Community Consciousness and Brain Health Essay.
Studies from the field of CAM show promising results for people with Parkinson’s disease who use physical / occupational therapy, Integrative Manual Therapy, OMT, Chiropractic.
Looking for ways to improve his flexibility, a 35-year-old man found himself researching the Complementary and Alternative Medicine (CAM) options for Parkinson’s disease.
A 68-year-old woman, looked for a way to control her tremors and had never reacted well to medications. A 76 year old runner found the Parkinson’s disease (PD) medication worked for his tremors but the restless leg syndrome was getting worse. Another man’s daughter was a massage therapist and always talking to him about nutrition.
Each person is looking for a drug-free, surgery-free way to manage their Parkinson’s disease and other symptoms. Each wants to live life to its fullest.
A variety of CAM practitioners are looking at the symptoms of Parkinson’s disease and have done studies on the benefits of physical therapy, occupational therapy, chiropractic, osteopathic manual therapy, Integrative Manual Therapy, Qigong, Alexander Technique and music therapy.
Last year, an osteopathic pilot study focused on the affect of Neuromuscular Therapy (NMT). They found NMT, a form of massage therapy can improve motor symptoms in PD. They recommended that future studies examine whether the beneficial effects can be sustained past 5 weeks or with less frequent NMT, thus making treatment more affordable. (Svircev, 2005).
In a 2002 Journal of the American Osteopathic Association article, Rivera-Martinez found people with Parkinson’s disease had a significantly higher frequency of bilateral occipitoatlantal and occipitomastoid compression. (Rivera-Martinez, 2002).
The occipitoatlantal joint is the space between the base of the head and the first vertebrae at the top of the neck. This is the area which covers and protects the midbrain with the substantia nigra (most affected in Parkinson’s) and the basal ganglia (responsible for the coordinating and fine tuning movements).
Rivera-Martinez continues, “over subsequent visits and treatments, the frequency of both strain patterns were reduced significantly to levels found in the control group. (Rivera-Martinez, 2002).
Three years earlier, Wells found “in the treated (osteopathic manual therapy) group of patients with PD, statistically significant increases were observed in stride length, cadence, and the maximum velocities of upper and lower extremities after treatment. There were no significant differences observed in the control (sham treatment) groups. The data demonstrates that a single session of an OMT protocol has an immediate impact on Parkinsonian gait. Osteopathic manipulation may be an effective physical treatment method in the management of movement deficits in patients with Parkinson’s disease.” (Wells, 1999)
Chiropractic care has also shown benefit. In one study, chiropractors discussed a “60-year-old man diagnosed with Parkinson’s disease at age 53 after a twitch developed in his left fifth finger. He later developed rigidity in his left leg, body tremor, slurring of speech, and memory loss, among other findings.” The study concluded, “Upper cervical chiropractic care aided by cervical radiographs and thermal imaging had a successful outcome for a patient with Parkinson’s disease. (Elster, 2000).
Physical therapy and occupational therapy studies are also showing positive results and improvement in function.
Formisano, et al. noted “it is not easy to assess the role played by physical therapy due to the difficulty of an objective evaluation; our results, however, show an improvement in the functional performance of patients and suggest the usefulness of physical therapy associated with drug therapy in a comprehensive treatment for PD. (Formisano, 1992).
A Cochrane study reported on two trials with a positive effect from occupational therapy, “however the improvements were relatively small. (Deane, 2002).
In an investigation of the affect of regular Qigong exercise on Parkinson’s symptoms, researchers noted,
“Qigong is an exercise therapy based on the principles of Traditional Chinese Medicine. The exercises combine the practice of motion and rest, both guided by mental imagery. The movements or postures are thought to promote an “energy flow” along meridians, that are not related to anatomic structures.” They reported a beneficial affect of Qigong for gait imbalances and joint problems. The Qigong exercises used in their study “can be classified as active physiotherapy using low-energy exercises with sustained movements of limbs, trunk, face and tongue as well as breathing coordination and can be adapted to special needs. Researchers evaluated the outcomes with the Unified Parkinson’s Disease Rating Scale motor part. (Schmitz-Hübsch, 2006).
A study on the effects of Integrative Manual Therapy on Parkinson’s disease symptoms found substantial functional improvements with 60 hours of treatment.
A 62 year old man diagnosed four years ago with PD made improvements in virtually all assessed categories. Notable gains include a 48.6% improvement in total United Parkinson’s Disease Rating Scores. Another neurologist’s test, the Schwab and England scores changed from 70% to 80% of normal function. The Up & Go Test and 10 Meter Walk showed improvements in walking speed and stride length. Lung capacity readings (a spirometer measurement) improved from 2800 cc to 3300 cc. The PDQ-39 subjective questionnaire showed a 67% improvement in symptoms. The Medical Symptoms Questionnaire (MSQ) score improved 51.3%. The McGill Pain Questionnaire showed a 73.3% decrease in pain, primarily back and hip pain. (Burnham, 2006).
These changes are significant given the medical systems expected 3.1% annual increase in the UPDRS motor scores and a 3.2% decline in Hoehn and Yahr staging levels. (Alves, 2005).
In a systematic review researchers found four clinical trials of Alexander technique (AT), a process of psychophysical re-education, which met their inclusion/exclusion criteria. The studies results are promising and imply that AT is effective in reducing the disability of patients suffering from Parkinson’s disease and in improving pain behavior and disability in patients with back pain. (Ernst, 2003).
One of the randomized controlled clinical trials looked at 93 people with PD and compared Alexander technique to massage therapy and no additional intervention.
“The Alexander Technique group improved compared with the no additional intervention group. The Alexander Technique group was also comparatively less depressed post-intervention on the Beck Depression Inventory, and at six-month follow-up had improved on the Attitudes to Self Scale.” Researchers concluded, “There is evidence that lessons in the Alexander Technique are likely to lead to sustained benefit for people with Parkinson’s disease.” (Stallibrass, C., P. Sissons, et al. (2002).
