Parkinsons Disease, Strength and Neuromuscular Orthotics

A new article  "demonstrates that moderate intensity progressive resistance training, 2-3 times per week over 8-10 weeks can result in significant strength, balance and motor symptoms gains in people with early to moderate Parkinson's disease."
This is interesting because neuromuscular orthotics and oral orthotics designed to treat Dystonias can also increase strength and balance.  The PPM or Pure Power Mouthguard was shown to increase strength and balance in highly conditioned athletes.  I have personally had experience in treating people with Parkinson's who "instantly improved"  with an oral appliance..
Dr Brendan Stack has the most experience in the country.  Google "brendan stack video parkinsons" and you will find several videos on treatment of Parkinsons and other movement disorders.
Visit www.thinkbetterlife.com to learn more about treatment in my Highland Park office.

12.

Clin Rehabil. 2015 Feb 17. pii: 0269215515570381. [Epub ahead of print]

Effectiveness of resistance training on muscle strength and physical function in people with Parkinson's disease: A systematic review and meta-analysis.

Chung CL1, Thilarajah S2, Tan D3.

Author information

Abstract

OBJECTIVES:

To systematically review the evidence investigating the effectiveness of resistance training on strength and physical function in people with Parkinson's disease.

DATA SOURCES:

Seven electronic databases (COCHRANE, CINAHL, Medline ISI, Psycinfo, Scopus, Web of Science ISI and Embase) were systematically searched for full-text articles published in English between 1946 and November 2014 using relevant search terms.

REVIEW METHODS:

Only randomized controlled trials investigating the effects of resistance training on muscle strength and physical function in people with Parkinson's disease were considered. The PEDro scale was used to assess study quality. Studies with similar outcomes were pooled by calculating standardized mean differences (SMD) using fixed or random effects model, depending on study heterogeneity.

RESULTS:

Seven studies, comprising of 401 participants with early to advanced disease (Hoehn & Yahr stage 1 to 4), were included. The median quality score was 6/10. The meta-analyses demonstrated significant SMD in favour of resistance training compared to non-resistance training or no intervention controls for muscle strength (0.61; 95% CI, 0.35 to 0.87; P <0 .001="" 0.001="" 0.08="" 0.21="" 0.64="" 0.75="" 95="" abstracttext="" and="" balance="" but="" ci="" confidence="" for="" gait="" life.="" motor="" not="" of="" p="" parkinsonian="" quality="" symptoms="" to="">

CONCLUSION:

This review demonstrates that moderate intensity progressive resistance training, 2-3 times per week over 8-10 weeks can result in significant strength, balance and motor symptoms gains in people with early to moderate Parkinson's disease.

© The Author(s) 2015.

KEYWORDS:

Parkinson’s disease; Resistance training; meta-analysis; systematic review

Chicago / Highland Park Migraine Relief: Acupuncture: As Effective AS Drugs In Migraine Prevention

A new article in Headache describes Acupuncture as being "At least as effective as medication for migraine prevention".

Migraines and Chronic Headaches destroy our day to day quality of life.  My new office in Highland Park is dedicated to the relief of chronic pain, headaches and migraines and the treatment of sleep disorders.  Think Better Life is a division of Chicagoland Dental Sleep Medicine Associates. Visit my website www.thinkbetterlife.com

Acupuncture works on the same principles as trigger point injections and Neuromuscular orthotics, that is it treats Migraines as an Input /Output or I/O error where neuro information fed into the brain changes brain chemistry through the neurons and creates pain.
Trigger points in muscles have an 80% correlation to classical acupuncture points and are extremely effective in relieving all types of chronic pain. Experience has shown that eliminating myofascial trigger points not only relieves the referred muscle pain but also decreases or eliminates frequency and severity of migraines. When there is less nociceptive (painful) neurological input to the brain the Trigeminal-Vascular system does not produce migraines and other autonomic cephalgias such as cluster headaches .
The Neuromuscular Orthotic created utilizing Neuromuscular Dentistry is specifically designed to eliminate nociceptive input from the Trigeminal Nervous System which is the cause (partial of fully) of all headaches.
I frequently show patients easy acupuncture points that can be utilized with acupressure for treatment of their headaches and migraines.

All patients who are receiving acupuncture for headaches or migraines and are not receiving complete relief should consider trying a Diagnostic Neuromuscular Orthotic to eliminate nociception that causes headaches and migraines.

The PubMed Abstract is below:
Headache. 2015 Feb 16. doi: 10.1111/head.12525. [Epub ahead of print]
Acupuncture for Migraine Prevention.
Da Silva AN1.
Author information

Abstract
BACKGROUND:
Migraine is a complex and multifactorial brain disorder affecting approximately 18% of women and 5% of men in the United States, costing billions of dollars annually in direct and indirect healthcare costs and school and work absenteeism and presenteeism. Until this date, there have been no medications that were designed with the specific purpose to decrease the number of migraine attacks, which prompts a search for alternative interventions that could be valuable, such as acupuncture.
METHODS:
Acupuncture origins from ancient China and encompasses procedures that basically involve stimulation of anatomical points of the body.
RESULTS:
This manuscript reviews large and well-designed trials of acupuncture for migraine prevention and also the effectiveness of acupuncture when tried against proven migraine preventative medications.
CONCLUSION:
Acupuncture seems to be at least as effective as conventional drug preventative therapy for migraine and is safe, long lasting, and cost-effective. It is a complex intervention that may prompt lifestyle changes that could be valuable in patients' recovery.
© 2015 American Headache Society.
KEYWORDS:
acupuncture; alternative medicine; prevention

HEADACHE RELIEF with SPG Blocks Dr Shapira treats Wisconsin Patients for Migraine and Chronic Headache Patients

The SPG Block or Sphenopalatine Ganglion Block is a safe and effective treatment to for chronic tension headaches and migraine.  It is possible to prevent headaches entirely.   The Sphenopalatine Ganglion is a Parasympathetic Ganglion adjacent to the back of the nose that can be blocked with cotton tipped applicators and lidocaine.

Sphenopalatine Ganglion Blocks are also effective in treating TMJ Disorders.

Neuromuscular Dentistry combined with trigger point injections or spray and stretch techniques combined with SPG Blocks can give headache patients their lives back.

http://www.ihateheadaches.org/blogs/illinois/labels/migraine%20treatment%20SPG.html

http://www.24-7pressrelease.com/press-release/good-news-for-chicago-and-north-shore-headache-patients-i-hate-headachesorg-founder-opens-highland-park-lake-forest-office-to-serve-lake-county-northern-cook-county-and-chicago-headache-patients-398930.php

Treating and Preventing Migraines: Episodic vs Chronic New Article in Headache March 2015 Describes Barries to Optimal Treatment and Prevention

There is a new article "eadache. 2015 Mar;55 Suppl 2:103-22. doi: 10.1111/head.12505_2.

Episodic and chronic migraine headache: breaking down barriers to optimal treatment and prevention." in Headache that describes the problems in finding optimal treatment.

In my experience the diagnosis of episodic or chronic migraine can actually harm the patient.  As headaches are classified it then limits the treatments that physicians offer.  I frequently find that wrong assumptions as to the cause of headaches is often the largest deterrent to successful treatment.  

The following video is a patient with severe headache that was relieved in just a few minutes time with Ttrigger Point Injections and muscle stretch.  The orgin was Myofascial Pain but the symptom was headache or migraine. When I saw this patient the first time she had been in constant excruciating pain for every minute of every day for 22 years.

Watch the video and then go www.thinkbetterlife.com testimonial page to see her first video. 

https://www.youtube.com/watch?v=-VA-amBnd8A

According to the article there are only five strategies for preventing episodic migraine and one  for preventing chronic migraine.  This fact is based on the idea that drug therapy is the method of preventing migraines.   " Five US Food and Drug Association strategies are approved for preventing episodic migraine, but only injections with onabotulinumtoxinA are approved for preventing chronic migraine. Identifying persons who require migraine prophylaxis and selecting and initiating the most appropriate treatment strategy may prevent progression from episodic to chronic migraine and alleviate the pain and suffering associated with frequent migraine. "

5.

Headache. 2015 Mar;55 Suppl 2:103-22. doi: 10.1111/head.12505_2.

Episodic and chronic migraine headache: breaking down barriers to optimal treatment and prevention.

Lipton RB1, Silberstein SD.

Author information

Abstract

Migraine is a common disabling primary headache disorder that affects an estimated 36 million Americans. Migraine headaches often occur over many years or over an individual's lifetime. By definition, episodic migraine is characterized by headaches that occur on fewer than 15 days per month. According to the recent International Classification of Headache Disorders (third revision) beta diagnostic criteria, chronic migraine is defined as "headaches on at least 15 days per month for at least 3 months, with the features of migraine on at least 8 days per month." However, diagnostic criteria distinguishing episodic from chronic migraine continue to evolve. Persons with episodic migraine can remit, not change, or progress to high-frequency episodic or chronic migraine over time. Chronic migraine is associated with a substantially greater personal and societal burden, more frequent comorbidities, and possibly with persistent and progressive brain abnormalities. Many patients are poorly responsive to, or noncompliant with, conventional preventive therapies. The primary goals of migraine treatment include relieving pain, restoring function, and reducing headache frequency; an additional goal may be preventing progression to chronic migraine. Although all migraineurs require abortive treatment, and all patients with chronic migraine require preventive treatment, there are no definitive guidelines delineating which persons with episodic migraine would benefit from preventive therapy. Five US Food and Drug Association strategies are approved for preventing episodic migraine, but only injections with onabotulinumtoxinA are approved for preventing chronic migraine. Identifying persons who require migraine prophylaxis and selecting and initiating the most appropriate treatment strategy may prevent progression from episodic to chronic migraine and alleviate the pain and suffering associated with frequent migraine. 

© 2015 American Headache Society.

KEYWORDS: 

chronic migraine; diagnosis; episodic migraine; iontophoretic transdermal system; onabotulinumtoxinA injection; treatment

PMID:

 

25662743

 

[PubMed - in process]

LAKE FOREST: TENSION HEADACHES, CHRONIC DAILY HEADACHE, MIGRAINE, CLUSTER HEADACHE AND CHRONIC MIGRAIN

Diagnosis of a particular type of headache is often the worst event for a headache patient.  All headaches are multifactorial and there are many aspects to prevention and treatment.  Unfortunately once the headaches are labeled many patients experience their doctors wearing Blinders and all diagnosis and treatment decisions are outside of the blinders are never considered.  At my new office in Highland Park I take an open approach to chronic pain.  The labels do not help and often interfere with treatment. Visit www.thinkbetterlife.com the website for my HighlandPark office.

There is one common thread to almost 100% of all chronic headaches, the involvement of the Trigeminal Nerve. There is no universal agreement on the sequence or causes of headaches but there is agreement that there are various triggers to most headaches.

Effective Treatment to Prevent, Treat and Eliminate the spectrum of headaches should include a primary Trigeminal Component.

Our nervous system has a Somatic Division which is divided into Sensory and Motor Nerves and an Autonomic component which has a Smpathetic and Parasympathetic components.

Before discussing more common headaches and migraines lets consider a special group of headaches called the Trigeminal Autonomic Cephalgias that includes Cluster Headaches, Paroxysmal Hemicrania and the SUNCT / SUNA headaches or Short Unilateral Neuralgiaform Headache with Conjuctival Injection. All of these often present with severe sudden onsets and initially should be evaluated with either/or CAT Scans and MRI’s to rule out tumors and/or vascular bleeds. I will discuss these special autonomic headaches in more detail in a future post. These headaches frequently can be prevented and allieved in many cases by Neuromuscular Dentistry and by changing Trigeminal Input with a Diagostic Orthotic. More information can be found at www.ihateheadaches.org and http://www.neurology.org/content/74/11/e40.full

Another special type of headache or cranial pain disorder is Trigeminal Neuralgia or Tic Douloureux known for sudden stabbing pain usually unilaterally in the face. Tic Doulourex is considered one of the most severe types of pain a person can experience earning it the name “The Suicide Pain” because of patients taking their life. Trigeminal Neuralgia will also respond to initial treatment with a Neuromuscular Diagnostic Orthotic though radical (and dangerous) therapy may be required.

Tension headaches, muscle spasm headaches, chronic daily headaches, cervicalgia headaches, sinus headaches, TMJ headaches are some of the names given to pain coming primarily from muscles. I would characterize this group of headaches as MPD or Myofascial Pain and Dysfunction in nature. It is associated with taut muscle band and trigger points. The primary cause of all of these in the head and neck is repetitive strain injuries and are ideally treated with Neuromuscular Diagnostic Orthotics as The First Line of treatment. Correction of underlying orthopedic and functional conditions can lead to a lifetime of better health. This treatment is often called TMJ treatment but that is always an oversimplification.
The postural train goes from the jaws to the feet (or hips when sitting) and changes in one area affect all areas. The terms Cranial Sacral Therapy, Sacral Occipital Therapy, and the fields of Chiropractic Medicine, Osteopathic Medicine Physiatry, Physical Therapy, and Naprapathy are all about treating problems between the reset points. Correction of end points are necessary for long term results.

The three endpoints are the bite including the upper and lower jaws including the TMJoints, the feet when standing and the hips when sitting. It is incredibly important to stabilize end points.

The Jaw is the single most important end-point in regards to headaches. This is because it is home to the majority of Trigeminal Nerve input to the brain. The Trigeminal nerve accounts for over 50% of all input to the brain after amplification by the Reticular Activating System. If Nociceptive (painful) inputs are brought into the brain chronic headaches is a frequent outcome. In computer lingo “Garbage in….Garbage Out” where Garbage is pain. The Trigeminal nerve innervates the teeth, the periodontal ligaments, the jaw joints, the jaw muscles, the tongue, soft palate, uvula, the tensor of the ear drum, the muscle that opens and closes the eustachian tube, the lining of the sinuses and MOST IMPORTANT, the Trigeminal Nerve controls the blood flow to the anterior two thirds of the meninges of the brain. This is the connection to all vascular and neurogenic headaches including previously discussed Autonomic Trigeminal Cephalgias and Trigeminal Neuralgia.

All headaches are basically primary or secondary results of input-output errors of the information the Trigeminal Nerve brings into the brain. This input causes chemical changes in the brain through the synapses. This changes blood flow and muscle function, posture, breathing and more.

The NHLBI of the NIH published a report”The Cardiovascular and Sleep -Related Consequences of TemporoMandibular Disorders"  discussing the wide spread affects of TMJ disorders. www.nhlbi.nih.gov/files/docs/workshops/tmj_wksp.pdf
This should be read by all headache patients.

I n the past I have seen patients who have lived with chronic pain for most of their lives only to find out there was treatment that could relieve their pain.  One patient had continuous headaches for over fifty years in spite of being married to a physician.  After two visits she was out of pain but also very angry.  Why did she have to live with constant headache pain when treatment was so simple.  The reason is what I call circle of knowledge.  There are thousands of excellent, well educated physicians and specialists who love helping patients and stay abreast in their knowledge.  Unfortunately, even the best and brightest don't know what they don't know.  Often, they have seen a failure in one patient and assume it applies to all patients.

Each patient is unique as is the source and causes of their pain.  A good physician listens to their patients, hears what they express and believes what their patients tell them.  Many patients feel like their doctors don't believe them about the severity of their pain which is very frustrating.