I'm "The Fall Prevention Lady" and I've been a certified personal fitness trainer for nearly ten years and a competitive athlete my entire life. As a result, I know the importance of continuous program evaluation in order to progress and meet fitness goals. Program evaluation is even more important when working with a person who has Parkinson's Disease.
I have worked with all stages of this progressively degenerative neurological disorder and I have to say that this disease moves at an unpredictable pace, greatly due to effective medication management. As a result, some people demonstrate more symptoms than others. The classic symptoms are the Parkinson tremor characterized by rigid and stiff movements, imbalance due to shuffling stride, soft voice, poor posture.
Regardless of prognosis, some days are better than others.
This is the case for everyone when it comes to exercise but it is particularly true of those living with a progressively degenerative disorder. This is why it is important to have as much baseline data as possible so when a person is having a bad day, you can look back on numbers and visualize the progress even though it doesn't feel like much has been made.
I was working with a dear client the other day when she became visually upset. She wimpered, "I need to hear some encouraging words. I don't feel like I'm improving. I'm doing all these exercises and I still can't do this. I still feel imbalanced, I'm not improving." What is wrong with me?
I silently held her hand before gently reminding her that she is living with a progressively degenerative disorder. She cried, "Well that doesn't make me feel any better". I said, "Wait a minute, hold it. Maybe it's time we changed our perspective"......
I asked her if she had gotten worse in the past four months. She said no.
I asked her if she can get out of the chair easier than she used to. She said yes.
I asked how many chair stands she was doing each day. She smiled and said, "I try to do 10 chair stands each day".
I reminded her about our first visit and how she could barely get out of the chair once.
I said, "So you're not improving, huh"? She paused in thought. I suggested she change her perspective from what she CAN'T do to what she can do. How you look at a situation can influence your mood, your confidence, your outlook. I also reminded her that she wasn't getting any worse.
"But I don't feel stable walking through the house and I have to use this stupid cane".
I reminded her that she may not ever feel as confident as she used to while walking but she's making smarter decisions now. I reminded her about her limits of stability and that once we practiced within those limits, she quit putting herself in unsafe situations. The result? No more falls resulting from reaching beyond her sense of stability.
When she changed her perspective and looked at the things she CAN do, she agreed that she was moving better and and felt stronger. My dear client may not be improving how she had hoped (perhaps returning to pre-Parkinson's ability levels?) but I had to remind her that she wasn't getting any worse and that she is successfully maintaining her independence. This is why it's important to revisit original fitness goals and modify as necessary. Keep the goals realistic and attainable so a person feels competent and able.
She smiled at me through her tears. I am so proud of this dear woman. She is so hard on herself that she doesn't celebrate her successes. Well, that's my job. I celebrate her. I adore her. She is a true survivor and a mentor not only for those living with Parkinson's but also for anyone who takes life for granted.
Coincidentally, I will be speaking at the Parkinson's Association of Northern California's (PANC) support group this Friday, April 26, 2013 at the Carlton Plaza in Sacramento, CA.
