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Science & Medicine: Exercise is medicine for people with Parkinson's disease

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Roberto Martinez
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TPR

For those who have Parkinson's disease, exercise is medicine. UT Health San Antonio Assistant Professor of Physical Therapy, Anjali Sivaramakrishnan, PhD, PT specializes in neurological rehabilitation, and she tells that to all of her Parkinson's patients.

Now, she's trying to figure out why.

Anjali Sivaramakrishnan, PhD, PT Assistant Professor, Department of Physical Therapy School of Health Professions The University of Texas Health Science Center at San Antonio
David Constante
Anjali Sivaramakrishnan, PhD, PT
Assistant Professor, Department of Physical Therapy
School of Health Professions
The University of Texas Health Science Center at San Antonio

Sivaramakrishnan says Parkinson's disease is a neurological disorder that causes the reduction of a chemical in the brain known as dopamine, which, in turn, causes problems with movement. Exercise may improve function because it increases the amount of certain proteins in the blood, known as neurotrophins.

“We call them neuroprotective proteins,” Sivaramakrishnan said. “So it would actually slow the death of the cells that produce that chemical dopamine.”

Sivaramakrishnan is leading a study that uses exercise and virtual reality games to give the brain a dopamine boost. The games involve everyday activities that challenge their balance.

“Like dodging obstacles, reaching for a virtual kitchen shelf, kickboxing,” she said. “And they also need to think in order to anticipate what's coming next.”

Some of the study participants do high intensity exercise, while others are assigned to do stretching exercises. Sivaramakrishnan is looking for either an improvement in symptoms or for disease progression to slow down.

“What I hope to learn is what is the exact mechanism by which this works,” Sivaramakrishnan explained. “How does this combination produce the effects that it's producing?”

Her team will assess patients for changes in cognition, walking, balance, and blood-based biomarkers — including those neuroprotective proteins that preserve dopamine in the brain.

“We're also looking at circuits between the brain and the muscles, between the spinal cord and the muscles” she said. “We want to see where we are seeing the maximum changes, and is that relating to any changes in function?”

And that, Sivaramakrishnan says, could lead to a better understanding of Parkinson's disease, and more effective treatments.

Science & Medicine is a collaboration between TPR and The University of Texas Health Science Center at San Antonio, about how scientific discovery in San Antonio advances the way medicine is practiced everywhere.