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Last updated: 08 April 2020

EPDA ExerciseCast

In April 2020, ahead of World Parkinson's Day 2020, the EPDA launched our own online video exercise programme – the EPDA ExerciseCast. The programme started as a response to the lockdown situation created by the COVID-19 pandemic, which has forced millions of people – including people with Parkinson's – to stay indoors in isolation.

EPDA Board member and respected physiotherapist Josefa Domingos, together with speech and language therapist John M. Dean, produced this series of videos to help people with Parkinson's exercise from the comfort of their own homes.

Episode 1 – The body speaks & spells

In this session, we will progressively challenge our body, our brain and our voice. We will associate the vowels of the alphabet to one movement and the consonants to another movement. Then we will repeat each movement while spelling out words and sentences accordingly.

If needed, use the detailed descriptions of the exercise in the assignment .PDF file below to help you follow the video. You can also use the instructions later, without watching the video, to exercise following the music you prefer. Create new sentences and send it to us or to other people with Parkinson's to help them exercise!

Episode 2 – What happened to Monday?

In this session, we will use the days of the week to progressively challenge our motor and cognitive skills. We will be mimicking exercise-based movements while keeping attention to the days of the week that will be spoken out loud and displayed onscreen. You will be progressively challenged to divide and alternate your attention to focus more on your voice, on your movement or on both.

If needed, use the more detailed descriptions of the exercise in the .PDF file worksheet below to help you follow or better understand the video. You can also use the audio file without watching the video for an additional workout.

Episode 3 – Punchalicious! Can I punch you now?

In this session, boxing, cognitive and fun exercises are merged into one higher-intensity training session that will challenge your capacity to talk, think and move.

We will grab our 'kitchen gloves' to exercise and fuel your competitive side, keep you engaged, and get you in the fighting mode. Let’s also take a peek on how this approach can be uniquely applied with a small group with people with Parkinson's.

If needed, use the more detailed descriptions of the exercise in the .PDF file worksheet below to help you follow or better understand the video. You can also use the audio file without watching the video for an additional workout.

Episode 4 – Moving for something new

In this session movement, voice and cognitive exercises will be integrated progressively into a rhythm-based training session. While performing three distinct amplitude-based movements, stay attentive to the changes imposed by the three different music patterns.

Escape your routine for a moment with an upbeat video that is recommended for those recently diagnosed with Parkinson's, but does not exclude possible adaptations for anyone who is living with the condition.

If needed, use the more detailed descriptions of the exercise in the .PDF file worksheet below to help you follow or better understand the video. You can also use the audio file without watching the video for an additional workout.

Episode 5 – Shall we dance?

In this session, we will focus on dance as a form of exercise. There will be three dance activities that will integrate progressive challenges. This session was designed for those who want to push themselves physically a bit more – while still being fully accessible to adapt for everyone.

Regardless of your level of difficulty, all exercises can be done in a seated version.

Get prepared for a vigorous, stimulating, and energetic 10-minutes dance session!

If needed, use the more detailed descriptions of the exercise in the .PDF file worksheet below to help you follow or better understand the video.

Live sessions

Are you interested to see how Josefa and John's exercise method works in the practice? Then watch these live session videos – featuring people from different countries in the world doing the exercise classes and interacting with Josefa and John in real time!

You can also watch all the videos together in our EPDA ExerciseCast YouTube playlist

Episode 1

Episode 2

  • Live session 1 – featuring John, person living with Parkinson's for 11 years, who had DBS surgery 3.5 years ago
  • Live session 2 – featuring Jill, person with Parkinson's diagonsed at the age of 50

Episode 3

  • Live session 1 – featuring Idelta, Rui Camilo and Rui Couto from Portugal

Episode 4

Videos in Portuguese

  • Live session 1 – Rui, 38 anos com Parkinson juvenil
  • Live session 2 – E se os familiares e cuidadores participassem nas sessões de exercício?
  • Live session 3 – Aula de Boxe para doentes Parkinson com Idelta e João

What is the EPDA ExerciseCast project?

The EPDA ExerciseCast is a web-based exercise programme that offers people with Parkinson's exercises that are challenging and surprisingly fun by combining voice, movement and cognition tasks. It is based on the work of physiotherapist Josefa Domingos and speech language pathologist John M. Dean, both specialised in working exclusively with Parkinson's for over 15 years.

The EPDA ExerciseCast brings together people with Parkinson's to exercise – and to share​​ ideas and tips ​to keep well and fit in the challenging and worrying times of the world-wide COVID-19 crisis.

This collection of free exercises is specifically designed to address common Parkinson's issues, and also provides examples of its application to other people with Parkinson's, to their carers and family members.

If you wish to use these exercises within your own networks, all we request is that you credit the EPDA as the content source – please check our copyright policy and email info@epda.eu.com for more information.

For each video, a brief description is also available (as a .PDF and/or audio file form) to make it easier to follow and perform the exercises without the need to watch the video.

Additionally, we also challenge you to perform the exercise tasks and to send us your own video to share with other people via this page. Sharing your experience with others will help motivate them in these difficult times! Help us help others. Help us transforming social distancing into “distant socialising” and making a difference – one episode at a time.

Stay active. Stay positive.

Why use a dual or multitask training approach?

People with Parkinson’s benefit from non-pharmacological interventions, such as physiotherapy and cognitive training, with both physical and cognitive outcomes. Combining these different interventions may be beneficial – positive evidence about dual or multitask training is emerging with regard to older adults and people with Parkinson's.

Dual or multitasking is commonly defined as 'the capacity to simultaneously perform two or more tasks during transfers, ambulation and other gait-related activities'. As such, dual or multitask training refers to training individuals to be able to perform simultaneously two or more tasks; each of these tasks can be performed independently, measured separately and can have distinct goals.

Initial research in this area concluded that 30 minutes once a week for three weeks of multiple-task gait training is feasible in five people with Parkinson's (I-III H&Y, mean age of 61 with a mean of 8 years with Parkinson's)1, and leads to sustained benefits in terms of multiple-task walking velocity, levels of fatigue and anxiety. Later, Brauer and Morris2 showed that one 20-minute dual-task training session in 20 patients increased step length during ambulation on a 10-meter pathway, while simultaneously enabling patients to perform a variety of added tasks. More recently, a randomised clinical trial involving 121 people with early to mid-stage Parkinson's showed that dual task gait improved when compared to a control period without training3. The study implemented two dual-task training programmes, one with consecutive training and one with concurrent (i.e. integrated) dual-task training delivered in the home setting. Importantly, benefits were retained after 12-week follow-up. This novel training program had excellent compliance from people with Parkinson's and did not increase the risk of falls.

There are three main reasons why therapists use dual-task training in clinical practice:

  • to improve dual task performance in daily activities
  • to enhance learning by making activities progressively more complex
  • to enhance motivation and engagement.

The EPDA ExerciseCast with specifically adapted multitask exercise programmes is an excellent example on how to apply this approach to people with Parkinson's and how to facilitate adherence to international guidelines advising therapist to integrate dual-task training into clinical practice.

Sharing the framework for such a programme may offer insights into the development of future research and community exercise care services for Parkinson's that incorporate the complexity of the cognitive challenges in Parkinson's. This ultimately may lead to initial treatment suggestions for those who decide to start or to research such a program for Parkinson's.

References

  1. Canning, C. G., Ada, L., & Woodhouse, E. (2008). Multiple-task walking training in people with mild to moderate Parkinson’s disease: a pilot study. Clinical Rehabilitation, 22(3), 226–233.
  2. Brauer, S. Morris, M., (2009) Can people with Parkinson's disease improve dual tasking when walking?, Gait & Posture, Volume 31(2),229-233
  3. Strouwen, C. , Molenaar, E. A., Münks, L. , Keus, S. H., Zijlmans, J. C., Vandenberghe, W. , Bloem, B. R. and Nieuwboer, A. (2017), Training dual tasks together or apart in Parkinson's disease: Results from the DUALITY trial. Mov Disord., 32: 1201-1210.
  4. Conradsson, D., Löfgren, N., Nero, H., Hagströmer, M., Ståhle, A., Lökk, J., & Franzén, E. (2015). The Effects of Highly Challenging Balance Training in Elderly With Parkinson's Disease: A Randomized Controlled Trial. Neurorehabilitation and neural repair, 29(9), 827–836.
  5. Ghai, S., Ghai, I., & Effenberg, A. O. (2017). Effects of dual tasks and dual-task training on postural stability: a systematic review and meta-analysis. Clinical interventions in aging, 12, 557–577.

Related reading

Articles from Parkinson's Life online magazine

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