Living Well With Parkinson’s disease: The

Best Interventions to Promote Health and

Quality of Life

Gwyneth Holzman
May 22, 2020

Independent Research
Dr. Melissa Kiehl
Abstract

As Parkinson’s disease becomes more and more prevalent in today’s society, the need to

research how those diagnosed can promote their health and well-being is vital. Research

indicates that in order to combat this neurodegenerative illness, it is crucial to maintain one’s

overall health by exercising often, eating a nutritious and balanced diet, and seeking help from

medical professionals including physical and occupational therapists. With an effective support

system in place, it seems as though people with Parkinson’s can work towards slowing the

progression and extending their life expectancy. If successful, this research can inform those

suffering from Parkinson’s of the best ways of boosting their physical and mental wellness along

with their quality of life, and it is expected that they will live a longer and better life. By doing

extensive research and conducting valuable interviews, it was possible to form sufficient

conclusions of what people with Parkinson’s should incorporate into their lifestyles. Supporting

general health with healthy exercise and eating habits, finding beneficial coping mechanisms,

building an encouraging community, and attending physical and occupational therapy have been

proven to be excellent ways to boost the health and quality of life of patients. These results

indicate that it is only in one’s best interest to include these things in their life in order to see

changes in terms of relieving symptoms, slowing the progression, and a better quality of life.

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Introduction

Parkinson’s disease (PD) affects somewhere between seven and ten million people

worldwide and is the second most prominent neurodegenerative illness (“Parkinson's disease

statistics”, n.d.). Today, it has no known cure and unfortunately, possesses an unsettling

prognosis. According to the Parkinson’s Foundation, a team approach is an excellent way to

address Parkinson’s. Although no two people have the same experience with PD, it is fair to

express that exercising more frequently, maintaining a healthy diet, and attending both

occupational and physical therapy are the best interventions to slow the progression of this

deadly disease. This paper will investigate this said team approach, clarify how exercise can

promote health and quality of life, highlight the advantages of a nutritious diet in terms of

relieving symptoms, exhibit the ways in which occupational therapy introduces independence,

and reveal the benefits of attending physical therapy.

Parkinson’s is a neurodegenerative disease that appears when 80% of the

dopamine-producing neurons in the brain are damaged (Sutherland, D. P., n.d.). Moreover, the

neurotransmitter, dopamine, is released by the substantia nigra stimulating the corpus striatum to

help the body move properly. However, if there is an inadequate amount of dopamine, the corpus

striatum causes failure to walk properly, write correctly, reach accurately, and inability to

complete other basic tasks (“An Overview of Parkinson’s”, 2009). Specifically, the most typical

symptoms include tremor, shuffling gait, expressionless face, changes in speech, moving in a

rigid or slow manner, changes in handwriting, constipation, mood, behavior changes, and a

stooped posture. This disease is more common in males and in those over the age of fifty (Smith,

2016). Why these neurons begin to deteriorate is unknown, thus Parkinson’s is considered an

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idiopathic disease. Because a direct cause has not been found, the cure for Parkinson’s has not

yet been discovered. Parkinson’s disease can be treated with a variety of different medications

such as enzyme inhibitors, cholinesterase inhibitors, anticholinergic drugs, and ones that supplant

dopamine (“An overview of Parkinson’s”, 2009).

Review of Literature

Although pharmacological treatment is effective for relieving symptoms, there are sundry

other interventions that can help promote health and quality of life in PD patients. Exercise not

only helps patients to maintain balance, mobility, and succeed with everyday tasks, but it is also

proven to have a neuroprotective effect. Researchers at the University of Southern California

determined, using mice’s brains, that although exercise did not produce more dopamine, the

existing dopamine was used more efficiently. This occurred because the substantia nigra and the

basal ganglia were able to receive the dopamine messages in a different manner

(“Neuroprotective benefits of exercise”, n.d.). Secondly, nutrition plays a significant role in the

treatment of Parkinson’s disease. Patients with PD should, like everyone, maintain a nutritious

diet with lots of whole foods and drink enough fluids to stay hydrated. However, there are

special recommendations for those with Parkinson’s to help combat symptoms. Eating foods

with antioxidants is important because they protect cells, some examples of these foods include:

fruits, vegetables, grains, nuts, and dark chocolate. Next, lots of fluids and fiber-rich foods are

critical to avoid a prominent symptom of PD, constipation. Additionally, steering away from

caffeine and alcohol is crucial because PD patients often have low blood pressure. Thirdly, it is

important for PD patients to attend physical therapy because it improves strength and promotes

range of motion. Additionally, physical therapy can improve the quality of life for patients by

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increasing balance and coordination, and by decreasing fatigue, pain, immobility, and weakness

(“Physical and occupational therapy for Parkinson's disease”, n.d.). Similarly, occupational

therapy and the utilization of assistive devices can help patients regain independence and adapt

to living with Parkinson’s. Some patients can no longer get dressed or bathe by themselves and

are very dependent on their caregivers. Therefore, occupational therapy and assistive devices

help to restore self-reliance in patients because “our self-worth and -esteem are frequently tied to

our ability to take care of ourselves, and the sense of independence this implies” (Herz, n.d.).

Parkinson’s disease is becoming more and more prevalent in today’s society, “In the

United States, it is estimated that up to 100,000 new cases are diagnosed each year, joining the

1.5 million Americans who currently have Parkinson’s Disease” (Sutherland, D. P., n.d.). So

many people suffer from Parkinson’s and thus, it is relevant to investigate the best ways to slow

the progression of this deadly disease, especially because there is no known cure.

For everyone, exercise is an important part of being healthy; however, it is especially

significant for those who suffer from Parkinson’s disease. For people with Parkinson’s,

exercising is crucial because it can stimulate neuroplasticity. Neuroplasticity describes the

process in which the brain forms new neural connections and modifies the way it functions in

order to fight the symptoms of injury or disease (Shiel, W. C., Jr., n.d.). This is essential for PD

patients because of the deterioration of dopamine-producing neurons. Physical activity is

valuable to patients because “the more someone with Parkinson's exercises, the more they are

rewiring those pathways and strengthening the mind-body connection” (Miller, B., 2020). These

new neural pathways can aid patients to recover from the brain damage of Parkinson’s.

Moreover, exercising keeps the brain sharp and promotes this process to function efficiently,

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‘“The neuroplasticity created from exercise in patients with Parkinson’s disease may actually

outweigh the effects of neurodegeneration,’ says Padilla-Davidson” (“Fighting Parkinson’s

disease with exercise and diet,” n.d.). Exercise will encourage neuroplasticity and if the brain is

constantly changing, patients will be able to combat symptoms and live well with Parkinson’s by

adapting to new issues.

Not only does exercise promote neuroplasticity in patients, but it relieves symptoms.

Common symptoms of Parkinson’s such as changes in gait, difficulty with balance, decreased

range of motion, weakness with grip, and struggles with motor coordination can be improved

with different forms of exercise. Patients could participate in yoga, boxing, Tai Chi, treadmill

training, biking, and more to improve their symptoms. Anything that encourages a patient to be

active rather than sedentary will ultimately be advantageous to their health. 2.5 hours of exercise

per week had positive results for patients because it slowed the progression of immobility and

poor quality of life (“Neuroprotective benefits of exercise”, n.d.). Boxing and cycling are two of

the most beneficial and popular forms of exercise for patients. Programs such as Rock Steady

Boxing and Pedaling for Parkinson’s challenge patients to work hard in order to lessen, reverse,

and delay their symptoms. When PD patients reduce the symptoms, they find huge

improvements in their daily life, “Some of our boxers see improvement in their balance and gait,

which results in fewer falls at home. Some boxers are able to swallow their pills whole for the

first time in years. Some are able to amplify their voice more and speak more clearly. Some are

able to button the buttons on their shirts again” (Miller, B., 2020). Exercising is one of the best

and easiest ways to relieve symptoms and have better function.

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 Additionally, exercise is optimal for patients with Parkinson’s disease because it slows

the progression. ‘“Exercise can make the greatest impact on the course of your disease, says

Denise Padilla-Davidson, a ​Johns Hopkins physical therapist​ who works with patients who have

Parkinson’s disease. “Movement, especially exercises that encourage balance and reciprocal

patterns [movements that require coordination of both sides of your body], can actually slow

[the] progression of the disease,’ she says” (“Fighting Parkinson’s disease with exercise and

diet,” n.d.). Staying active on a regular basis helps the body to fight Parkinson’s and reduce the

speed of the progression.

Patients with Parkinson’s disease lack a neurotransmitter in the substantia nigra called

dopamine which controls movement and speech (Brookshire, 2017). However, exercise has

proven to stimulate dopamine in the brain, “One clue is that animals with an experimental form

of the disease have higher levels of dopamine - the brain chemical that's deficient in Parkinson's -

if they're made to exercise” (Morning Edition, 2015). A study done at the University of Southern

California investigated dopamine levels in mice’s brains. Exercise did not specifically produce

more dopamine, however, the existing dopamine was able to be used more efficiently. This

happened because the substantia nigra and the basal ganglia were able to receive the dopamine

messages in a different manner (“Neuroprotective benefits of exercise”, n.d.). In another project,

‘Habitual Exercisers Versus Sedentary Subjects With Parkinson’s Disease: Multimodal PET and

fMRI Study,’ it was determined that when exercising, the brain releases higher levels of

dopamine which contributes to better motor function and capability in patients. This study

investigates two groups of PD patients: one group of 17 people who exercise consistently and the

other group including 9 people who are sedentary. PET scans were utilized before and after

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exercising within a stationary cycle to investigate the release of natural dopamine. The results

determined that those who exercise frequently and consistently have a larger release of dopamine

than the sedentary group (Inacio, P., 2018). If exercise can strengthen dopamine release,

exercise will prove to be incredibly advantageous for patients because it will improve both health

and quality of life in patients.

Lastly, exercise is an excellent intervention for patients with Parkinson’s because it

boosts mood and lessens stress. Exercise can regulate mood and this is especially crucial in the

50% of PD patients who also suffer from depression. Because of the reduction of serotonin, a

brain chemical contributing to happiness, depression is common in Parkinson’s patients.

Exercise can be a beneficial treatment method for coping with depression (Burgess, 2017).

Patients can improve their mood by engaging in exercise because “it can make one feel happier,

sometimes referred to as a “runner’s high” and may reduce stress” (Alila Medical Media, 2018).

Similarly to exercise, diet is a key factor of healthy living that must be maintained

whether one is suffering from Parkinson’s or not. Consuming a balanced diet with lots of fruits

and vegetables is beneficial to one’s health (Diet & nutrition., n.d.). In general, eating healthy is

crucial to one’s well being as “A poor diet may lead to increased oxidative stress, which could

impede the antioxidant defense system. In contrast, a well-balanced diet rich in a variety of

foods, including numerous servings of vegetables and fruits (especially those containing

nicotine) and moderate amounts of omega-3 fatty acids, tea, caffeine, and wine may provide

neuroprotection” (Seidl, S. E., Santiago, J. A., Bilyk, H., & Potashkin, J. A., 2014). Sometimes,

simply maintaining a hearty diet is not enough; Diets such as the Mediterranean Diet and the

Fodmap diet can often provide much relief for patients with PD.

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 Maintaining a nutritious diet is advantageous for patients because it is able to relieve

various symptoms. A common symptom of Parkinson’s is constipation, however, drinking more

fluids and consuming foods high in fiber such as fruits, vegetables, legumes, whole-grain breads,

and cereals can help manage this issue (“Diet & nutrition,” n.d.). Additionally, low blood

pressure is typical of Parkinson’s patients, but drinking more fluids, consuming a larger amount

of salt, and avoiding caffeine and alcohol can be very beneficial (“Diet & nutrition,” n.d.).

Not only does a healthy diet relieve symptoms, but it also stimulates dopamine

production. As mentioned prior, patients with Parkinson’s disease have an insufficient amount of

dopamine due to its degeneration. Phenylalanine is an amino acid that aids in creating essential

signaling molecules including dopamine, with the help of tyrosine (Tisley, 2018). Thus, eating

foods that have high levels of phenylalanine such as nuts, bacon, legumes, lentils, chickpeas, and

more can assist in producing dopamine (Talk Parkinson's Disease, 2018). Additionally,

dopamine levels can be increased normally by consuming less saturated fat. Some evidence

shows that eating large amounts of saturated fats causes dopamine signaling to become

interrupted (Julson, 2018).

Diet also plays a significant role in the medication taken for PD. Typically, patients with

Parkinson’s disease take the medication entitled Levodopa. This medicine is “a protein building

block, so it competes for absorption with other proteins,” (“Diet & nutrition,” n.d.) and when

taken with high-protein meals, can work less efficiently. This can be avoided by taking the

medication on an empty stomach. Levodopa can also have trouble absorbing when taken with

iron supplements. Secondly, common medications taken for Parkinson’s can leave patients

feeling dehydrated. Dehydration can cause fatigue, confusion, balance issues, weakness, and

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kidney issues. Thus, drinking plenty of fluids during the day is crucial to avoid this (“Fighting

Parkinson’s disease with exercise and diet,” n.d.). It is essential for PD patients to be aware of

the effects their diet has on the medication they are taking for the most effective outcome.

Moving onto the significance that occupational therapy (OT) plays in PD patient’s lives:

OT can promote independence for a better quality of life. Being self-sufficient is a large factor in

one’s well-being. Often, having to rely on a caregiver can be debilitating, thus prolonging

self-reliance is crucial for a positive quality of life. Occupational therapy focuses on teaching

new ways to adapt to different mobility changes in order to still be able to do certain tasks. This

helps patients regain independence (Parkinson Disease Care New York, 2017). Moreover,

learning how to do a task or skill in a new way that is accustomed to a patient’s mobility and

range can be very liberating because they have newfound independence. OT can teach patients

the modifications they can apply to activities that they struggle within daily life, such as cooking,

writing, grooming, and using the toilet, while experiencing the crippling symptoms of

Parkinson’s (“Physical and occupational therapy for Parkinson's disease”, n.d.). This helps

patients to stay involved with their daily activities and avoid feeling reliant on others.

Similarly to regaining independence, occupational therapy is essential for patients

because it enables them to participate in everyday activities. Occupational therapists work to

make patients comfortable with activities that are completed as a part of everyday life, such as

climbing out of bed, bathing, and getting dressed (Parkinson Disease Care New York, 2017). The

longer a patient is able to be engaged and maintain their lifestyle, the better their quality of life

will be. It is essential that patients do not give up important activities due to their diagnosis, “So,

whatever people find meaningful and relevant, either things they have to do day-to-day like eat,

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dress, groom, cook, grocery shop, things like that all the way to things they find engaging like

playing golf or visiting with friends, reading books, all of those things are considered occupation

and we believe that those things are therapeutic. So, if people give up engaging in meaningful

occupation and meaningful tasks, then all of the therapeutic benefits of those activities will be

lost, be it motor function, range of motion, cognition, vision” (Wood, J., 2020). Staying involved

is vital to living well with Parkinson’s because it not only improves the quality of life, but it

helps patients avert living a sedentary lifestyle.

Additionally, occupational therapy can introduce assistive devices to patients who feel

that they would benefit their lifestyle. There is a sundry of devices that help patients stay

engaged in daily necessities when they can no longer do the task themselves. Electric

toothbrushes and razors of various sizes and weights can be beneficial for patients because they

require less effort and precision. Bathing can become quite difficult for someone who has trouble

balancing, thus, a rubber, non-slip bath mat, shower chair, and tub bench are very helpful.

Adapting to using the bathroom can be done with an elevated seat, grab bars, and a commode

frame. Getting dressed is another everyday task that may require some assistive devices such as

button aids, sock aids, long-handle shoehorn, and “lace locks.” It is helpful to get dressed

carefully, without rushing, while sitting or laying. In the bedroom, rugs can be very dangerous

for patients due to their lack of balance and great risk of falls. Furniture risers can assist patients

in getting into and out of bed easily. Gait belts are often utilized by caregivers to help a patient to

stand up from sitting or assisting them to walk. In the kitchen, adaptive cutting boards, weighted

knives, utensils with built-up handles, and pot stands can be advantageous. The Liftware device

steadies the hand, decreasing spills. In addition, a dycem and plate guard are other kitchen aids

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for patients. Although it is important to try to have a patient do the task themselves for as long as

possible, in order to maintain manual dexterity and fine motor coordination, assistive devices can

be a very helpful tool for patients.

In addition to attending occupational therapy, it can be extremely beneficial for patients

to see a physical therapist as well. Engaging in physical therapy often helps patients learn how to

proceed after being diagnosed; They learn what the best way to exercise is based on their

conditions, “It is my strong belief, and the belief of Movement Disorder Specialists, that one of

the first orders of business after a PD diagnosis is to see a physical therapist and to continually

work with a physical therapist. Parkinson's Disease is a movement disorder so the more someone

with PD can work with an expert on how to move, the better” (Miller, B., 2020). Learning the

best ways to stay involved in physical activity is necessary because it helps patients relieve

symptoms, stay engaged in daily life, and most importantly, stay safe when they exercise. Seeing

a physical therapist can be very valuable to the patient “so they [can] get the right dosing because

the research suggests that for Parkinson’s and even for the aging brain, that exercise is really

medicine. So, just like we want to take our medicine in the proper dose, we want to take our

exercise in the proper dose” (Wood, J., 2020). Once the patient knows the best way to move,

they can stay healthy by exercising in the best way while staying as safe as possible.

Attending physical therapy can improve the quality of life for patients by increasing

balance and coordination, and by decreasing fatigue, pain, immobility, and weakness (“Physical

and occupational therapy for Parkinson's disease”, n.d). Physical therapists work hard to ensure

that patients make progress in therapy. This progress can be measured by fewer falls and better

control over their body. Physical therapy essentially has the same benefits as exercise: It

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promotes neuroplasticity, relieves symptoms, slows the disease progression, promotes dopamine

function, as well as improving mood and decreasing stress. It’s additional benefit, though, is that

the exercise prescribed by the therapist will be a perfect fit for the patient. They will be able to

learn what movement will be the most beneficial for them, what will help them reach their goals,

and how to make sure they are staying safe. These professionals can assess the symptoms and

abilities of their patients and form the best exercise plan for them. For example, patients with

weaker balance will learn what exercise is harmless for them to engage in and ensure they will

stay on their feet. Physical therapists are a reliable source for understanding the most optimal

ways to stay engaged in exercise.

Exercising frequently, maintaining a healthy, balanced diet, and seeking help from

physical and occupational therapists are beneficial to living well with Parkinson’s. The severe

symptoms of Parkinson’s disease can be combated by practicing healthy habits to support overall

health. Ultimately, the said interventions will promote both health and quality of life in

Parkinson’s patients. As PD is becoming more prominent in today’s society, it is crucial to

inform the Parkinson’s community of the ways they can fight the disease because “people need

to feel like they have the tools in their tool chest to live well and feel like they’re living ​with

Parkinson’s, not that Parkinson’s has control of them” (Wood, 2020).

Research Methods and Data Collection

By conducting interviews, the researcher was able to determine the most popular and

influential ways for the Parkinson’s community to boost their health and quality of life. The

researcher interviewed five individuals diagnosed with Parkinson’s in an attempt to answer the

research question: “What are the most effective ways of promoting health and quality of life in

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those suffering from Parkinson’s disease?” It was hypothesized by the researcher that by

exercising frequently, maintaining a healthy and nutritious diet, and attending physical and/or

occupational therapy, patients with Parkinson’s can work to improve both their health and

quality of life. By catering the interview questions (See Appendix A) towards finding the best

interventions for those suffering from Parkinson’s, the researcher was able to collect data that

suggested the best ways to cope with this diagnosis. Although every person with Parkinson’s

disease is very unique, it was abundantly clear that there were similarities across responses for

the most effective approaches for coping.

By utilizing descriptive methods, it made it possible for the researcher to analyze patterns

and characteristics in a specific population. In this case, the characteristics being examined were

ways to cope with a Parkinson’s diagnosis and the population was the Parkinson’s community.

The research questions were heavily based on the hypothesis in order to prove or disprove parts

of or the entire hypothesis. Each participant was asked the same five questions (See Appendix

A). The first question addressed the individual’s journey with Parkinson’s including the age of

diagnosis and the coping techniques they use. The second question focused on asking the

individual how they incorporate exercise into their life and if they’ve experienced any substantial

benefits from physical activity. Next, the third question established whether the interviewee

attended physical or occupational therapy and whether they believe it has improved their

well-being. The fourth question investigated the type of diet the individual keeps and if this diet

has affected their health and or quality of life. Lastly, the researcher inspected how the

interviewee has built their support system and who or what that community includes. The

participants in the study were all previously diagnosed with Parkinson’s and most were inferred

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to be very early in their progression. Each individual included in the study was selected from the

Davis Phinney Ambassador program. The researcher chose to interview Rich Wildau on January

17th, Lorraine Wilson on February 23rd, Kevin Schmid on February 22nd, and Judy Freitag on

March 23rd, and Neal Weierbach on March 23rd and each of these interviews were conducted

individually over the phone. It was essential to ask for permission to record each interview for

transcription purposes and after this permission was granted, the researcher used a separate

device to do so. After each interview was complete, the researcher expressed their gratitude by

sending the interviewee an email thanking them for their time. When all of the interviews were

finished, the researcher transcribed them and put the most important details into informative

charts.

Results and Data Analysis

Below are charts that display each question individually along with the responses of each of the

five interviewees summarized into brief points. In this format, it is very easy to compare and

contrast the answers of the different individuals in order to determine whether the hypothesis

holds true or if there are parts that need to be investigated further.

Figure 1 Can you tell me about your journey from

diagnosis to now? What has helped you cope
with your diagnosis? Moreover, what has
improved your health and quality of life?

Rich Wildau - Diagnosed at age 64 (same age as

father)
- Noticed abnormal swing in right arm
as well as cramped handwriting
- Visited a neurologist
- Concerned about being able to
continue participating in favorite
activities
- Desired a balance between his

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 personal community and the PD
community
- Facial masking was the biggest
challenge because it affected the way
he interacted with others
- Started seeing a Movement Disorder
Specialist
- MDS prescribed Carbidopa/Levodopa
and this medication reduced facial
masking by 75%
- Also on a Dopamine Agonist that
helps the brain use dopamine more
efficiently

Lorraine Wilson - Diagnosed at 62 years old on

February, 2017
- Suspected PD 5-7 years prior
- Saw a family physician and was
referred to a neurologist who
diagnosed her with PD
- Long journey with finding the right
medication
- Started one drug that was not
effective
- Tried doubling the dosage -
still not effective
- Third drug was a success
(Carbidopa-Levodopa for
tremors)
- To cope:
- Keeps a journal/sketchbook
- Mindful exercise
- Zentangle
- Reading
- Getting people involved in
Davis Phinney

Kevin Schmid - Diagnosed with PD in January, 2014

- Values staying involved with people
in the community rather than staying
at home
- Keeps him motivated

Judy Freitag - Diagnosed fifteen years ago

- Fairly slow progression

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 Neal Weierbach - Diagnosed in August of 2018 after
being referred by his neurologist to go
to the University of Colorado Hospital
- To cope:
- Loves to try new things
- Teaching himself how to play
the keyboard
- Likes to be creative by drawing in his
sketchbook

The intent of this question was to gather background and preliminary information about each

interviewee. It was expected to receive information about time of diagnosis, their most

significant symptoms, coping mechanisms, medications, etc. The responses helped to support the

answers to other questions that are more closely related to the research question. In theory, it

gave the researcher sufficient information to understand the interviewee’s experience with

Parkinson’s.

Figure 2 How do you incorporate exercise into your

daily life? How has exercise changed your
Parkinson’s experience? Why is exercising so
essential for patients/what are the benefits?

Rich Wildau - Always has enjoyed exercising

- Biking
- Skiing
- Decided to transition from exercising
alone to exercising in a group setting
- Boxing really helped increase
his flexibility and strength as
well as working on
multitasking
- Joined “Pedal for Parkinson’s”
which is an indoor spinning
class and proved to be an
excellent cardio workout
- Began “Dance for
Parkinson’s” to work on

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 moving in a fluid manner as
well as moving with rhythm
- Vocal exercise is essential and
thus, he incorporated “Tremble
Clefs” into his life
- Exercise is so significant for
people suffering from PD
- Neuroprotective
- Helps maintain balance
and strength
- Improves flexibility
- Reduces freezing and
rigidity
- Creates a feeling of
community

Lorraine Wilson - Movement Disorder Specialist

believes that because she exercised
regularly, it is possible that this
delayed her symptoms and therefore,
her diagnosis
- Participates in an exercise group
- Cadence walking is beneficial
because it helps people with
PD regulate their strides
- Added more strength training and used
Full Body DEXA to measure results
- Increased her lean mass
- Decreased body fat
- Improved bradykinesia on left
side, balanced both sides of
body
- Improved gait
- Exercise has helped with emotional
support

Kevin Schmid - Has a home gym set up in the

basement, tries to get down there
everyday
- Treadmill
- Stretching
- Peloton Bike
- Exercise improves his day and makes
him feel really good
- Produces dopamine

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 - Relieves symptoms
- Enjoys setting big goals for himself
because they give him something to
work for and look forward to

Judy Freitag - Participated in a two-year research

project conducted by Professor Daniel
Corcos ten years ago. Experienced
results firsthand.
- Relieved symptoms
- Increased cognitive ability
- Participated in other studies as well
- Does “forced exercise” on her Tandem
Bike
- Hour ride a couple days a week
- Finds that exercise helps the body
keep the muscles from atrophy and
makes them stronger
- Does “Special Parkinson’s Exercises”
for BIG program once a week
- Strengthens and stretches
- Participates in a dance class
- Attends equine therapy
- Goes to speech therapy for voice
exercise
- Strengthens vocal cords
- A typical week for her includes doing
some form of exercise at least once a
day, if not twice
- Claims to be a big advocate for
exercise

Neal Weierbach - Enjoys exercising by lifting weights,

riding his bike, walking the dogs,
working in the yard, boxing class,
yoga class, golf, etc.
- Likes to stay moving and active
- Carpentry work
- Is unsure if exercise has had an effect
on slowing the progression but
definitely thinks it is possible
This question addressed how each individual includes physical activity in their daily life and

whether it has proved to be beneficial for them. It is unanimous that every interviewee enjoys

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exercising and it has had a positive impact on their lives. Exercise has been attributed to better

days, feeling well, and supporting both emotional and physical health. This question is relevant

to the hypothesis because it proves that exercise is definitely a main factor for improving health

and quality of life in PD patients.

Figure 3 Have you ever attended physical or

occupational therapy? If so, how has that
affected your health and/or quality of life?
Have you found that attending PT/OT has
provided you with skills to live well with
Parkinson’s?

Rich Wildau - Has not seen a PT for

Parkinson’s-related issues
- Has not needed the help of an OT

Lorraine Wilson - Has not attended PT or OT

- Is a level 1 on the Hoehn and
Yahr scale

Kevin Schmid - Attended PT/OT in the beginning

Judy Freitag - Has attended both OT and PT for

Parkinson’s
- “Physical therapy helps get over it and
if you want to stay over it, you have to
keep doing it”

Neal Weierbach - Has never attended PT or OT for

Parkinson’s

Two out of five interviewees (40%) have attended physical and or occupational therapy for

Parkinson’s disease. Judy Freitag advocates that this has helped her work through her

Parkinson’s disease. Kevin Schmid attended physical and occupational therapy when he was first

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diagnosed, but has not continued. The majority of the individuals had not ever attended physical

or occupational therapy for Parkinson’s-related issues. It may be possible that because most of

the interviewees seemed to be very early in their progression, they were simply not applicable to

this question. Moreover, Parkinson’s patients who have not progressed very far may not need to

attend physical or occupational therapy yet. This prevented the researcher from being able to

gage whether physical and occupational therapy are a necessary part of life for PD patients.

Figure 4 Has your diet changed since you have been

diagnosed/ Have you decided to eat a
different way? Have you experimented with
certain diets, for example the Mediterranean
Diet or Fodmap diet? Has eating in a different
manner relieved symptoms for you?

Rich Wildau - Always had a good diet, no huge

changes
- Decided to consume less red meat
- Eats mostly chicken, fish, and
vegetarian options
- Eats more organic fruits and
vegetables

Lorraine Wilson - Vegetarian

- Decided to avoid drug interactions
with medication: Rasagiline by
avoiding certain foods
- Fermented foods such as black
olives, pickles, etc.
- Aged cheeses
- Reduced dairy slightly

Kevin Schmid - For the first three years, he was on

Isagenix
- Isagenix 2x/day + a light meal
- Stopped this diet because of
medication: Ropinirole
- The diet was too much protein

20
 which takes away from the
medicine’s effectiveness
- Now, in Sarah King’s “Gut
Health” program

Judy Freitag - Maintains a fairly healthy diet

- Tries to cut out salts, sugars, and foods
that lack nutritional value
- Has lots of fruits and vegetables
- Consumes very little meat
- Is not convinced that this has helped
her PD, but does believe that this has
improved her overall health

Neal Weierbach - Makes an effort to eat less and eat

better
- Gained ten pounds since his diagnosis
and is hoping to lose it
- Has not noticed any effects of
changing his diet
- No change in energy level, etc.

Most of the participants claimed to try to maintain a healthy diet by eating foods with high

nutritional value and attempt to stay away from certain foods. Their diets likely contribute to

improving their overall health, but there is not enough research to support that any specific diet

has a significant effect on the progression or symptoms of Parkinson’s. Moreover, Neal

Weierbach states that he has not noticed any differences in his energy level or other aspects of

his lifestyle because of his diet. Still, it is essential to take care of one’s individual health,

especially when suffering from Parkinson’s and thus, eating healthy is a necessity.

Figure 5 How have you built the community that

surrounds you? How does this affect your
well-being?

Rich Wildau - Joined a support group when first

diagnosed with presentations done by

21
 PTs, neurologists, music therapists,
etc.
- Started more of an informal support
group entitled “Coffee &
Conversation” which has 35 people
involved
- Lots of activities available in Boulder,
Colorado

Lorraine Wilson - Spouse (husband)

- Local friends including colleagues
- Davis Phinney Foundation and
Ambassador program
- Various support groups
- Participates in intergenerational
program called “Sidekicks” with
elementary kids and people suffering
from PD
- Art, conversation, etc.

Kevin Schmid - Caregiver (wife)

- Family - two kids and four
grandchildren
- A very supportive community of
relatives and friends who help raise
money for events through the Davis
Phinney Foundation

Judy Freitag - Her friends with PD completely

understand what she is going through
- Loves to get people involved with
exercise classes by carpooling

Neal Weierbach - Chairman of the Board of “The

Unsteady Hand” which is a group that
holds creativity workshops
- Head of support group in Pueblo,
Colorado
- Instead of keeping the chairs
arranged in rows, he took it
upon himself to move the
chairs into a circle for a more
interactive environment
- Tries to get people involved and
motivated through the Davis Phinney

22
 Foundation
- Avoids becoming an introvert by
going out and socializing

The goal of this question was to determine how each individual has built their support system

with activities and people. All five interviewees mentioned participating in at least one activity

or program and how it has improved their well-being. Most of the participants also mentioned

family members including spouses (caregivers). The individuals explained how important it is to

continue socializing and to have friends. Building a community proves to be an essential part of

improving quality of life.

Discussion and Conclusion

The data collected shows that patients with Parkinson’s can work to improve their health

and quality of life by exercising frequently, maintaining a healthy diet, finding enjoyable ways to

cope, building an encouraging community, and attending physical and/or occupational therapy, if

necessary. Although there is insufficient research that connects diet to slowing the progression or

symptoms of Parkinson’s, it is more important than ever to maintain overall health by eating

healthy. Additionally, there is a lack of information in the data collection that supports physical

and occupational therapy being essential to people with Parkinson’s. However, this may be due

to the sample being less diverse than optimal. The hypothesis named exercise, diet, and physical

and occupational therapy as the best interventions for those with Parkinson’s disease. After

completing thorough data collection, it seems that building a community is just as important.

These findings demonstrate that it is critical for people with Parkinson’s to participate in

things that help them to thrive whether it is joining a boxing class or keeping a journal. The data

23
collection supports that the best ways for PD patients to boost their health and quality of life are

exercising, eating healthy, finding fun activities, building a support system, and visiting the

necessary care physicians such as occupational and physical therapists. It is crucial for these

patients to do everything they can to slow the progression of Parkinson’s and to help with their

symptoms. The intention of this research is to encourage people with Parkinson’s to work

towards improving their lifestyle in order to help themselves in the future. Although everyone

with Parkinson’s is different, this data expresses the ways that five individuals believe work best

for them in their experience. Hopefully, this data informs the Parkinson’s community of how

they can better themselves to promote their health and improve their quality of life. The goal is to

live longer and better.

24
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Appendix A:

Personal - Question #1: Can you tell me about your journey from diagnosis to now? What has
helped you cope with your diagnosis? Moreover, what has improved your health and quality of
life?
Exercise - Question #2: How do you incorporate exercise into your daily life? How has exercise
changed your Parkinson’s experience? Why is exercising so essential for patients/what are the
benefits?
Physical Therapy/Occupational Therapy - Question #3: Have you ever attended physical or
occupational therapy? If so, how has that affected your health and/or quality of life? Have you
found that attending PT/OT has provided you with skills to live well with Parkinson’s?
Nutrition/Diet - Question #4: Has your diet changed since you have been diagnosed/ Have you
decided to eat a different way? Have you experimented with certain diets, for example the
Mediterranean Diet or Fodmap diet? Has eating in a different manner relieved symptoms for
you?
Parkinson’s Community - Question #5: How have you built the community that surrounds you?
How does this affect your well-being?

29