The mystery of Parkinson’s highlighted at Hospital Week

Associate Professor Victor Fung has spent the past 25 years at Westmead Hospital working on the enigma that is Parkinson’s disease.

His work was highlighted at an insightful Hospital Week presentation this week.

“It’s been an increasingly growing field in terms of treatment options but there’s still a long way to go,” Dr Fung told The Pulse.

Parkinson’s is one of the most common neurodegenerative disorders in the country, second only to dementia, with around 30 people diagnosed with it every day in Australia.

While around 70 per cent of those with the condition will experience tremor, there are a wide range of motor and non-motor symptoms associated with the disease.

Researchers are working on ways to improve the lives of those with Parkinson’s, in particular in the area of falls prevention.

Ten years ago Dr Fung collaborated with Emeritus Professor of Physiotherapy Colleen Canning and Associate Professor Mark Latt, both from the University of Sydney, in a PhD led by Dr Latt looking at why people with Parkinson’s fall.

“He discovered through very careful work, which has been widely acknowledged, that there are five main reasons why people with Parkinson’s fall,” Dr Fung said.

These included weakness of the legs and a symptom known as freezing of the gait.

“They feel as though their feet are glued to the floor and they go to get started walking but they can’t, particularly when they are turning or moving in complex environments,” Professor Canning said.

The study found that the risk of falling could be mitigated through exercise and physical therapy.

It led to a further collaboration between Dr Fung and Professor Canning in a major clinical trial to determine if they could actually reduce falls through physical therapy.

“In the early days there was no evidence that exercise was an effective intervention but really in the last 20 years we have had an explosion of studies … that have now shown by our work … and by others, that there are a number of really important parameters of mobility that can be improved with exercise,” Professor Canning said.

The two researchers found there was a 27 per cent reduction in falls overall.

“Which given the vagaries of statistical analysis actually wasn’t statistically different from the control group, but when we looked more specifically at people with earlier disease versus those with more severe disease, we actually found the benefit was really significant to people with milder disease,” she said.

Dr Fung, who is the Director of the Movement Disorders Unit at the Department of Neurology, Westmead, uses neurophysiology to measure movement to gain a better understanding of why people with Parkinson’s disease have difficulty with their coordination and mobility.

“It’s really active or dynamic exercises or tasks that help train the brain in terms of balance recovery,” he said.

Professor Canning, who worked at Westmead Hospital as a graduate, said physiotherapists have a big role to play in helping Parkinson’s patients.

“Some exercise is better than no exercise, but it’s very much the case that the more tailored the exercise is to the specific motor or movement problems, but also those additional non-motor problems, the more likely it is to be effective,” she said.

Two of the most effective exercises have proven to be Tai Chi and Tango dancing.

“Just about everyone with Parkinson’s disease needs a balanced exercise program because balance is one of the most significant contributors to falls,” Professor Canning said.