Definition and Symptoms
Parkinson's disease is a degenerative disorder of the central nervous system that often impairs the sufferer's motor skill, speech and other functions. Symptoms include resting tremor, movement slowness, muscle rigidity and/or stiffness, and balance problems. Other possible symptoms include cramped handwriting, decreased facial expression, decreased voice volume/hoarseness, stooped posture, decreased arm swing on the affected side, loss of ability to perform rapid alternating movements, shuffling, turning "en bloc”, fatigue, impaired gross motor coordination, depression, slower reaction time, sleep disturbances, dizziness and fainting, impaired proprioception, pain, constipation, and gait problems.The primary symptoms are the results of decreased stimulation of the motor cortex by the basal ganglia, normally caused by the insufficient formation and action of dopamine, which is produced in the dopaminergic neurons of the brain. Secondary symptoms may include high level cognitive dysfunction and subtle language problems. PD is both chronic and progressive.

Concerns for exercise

• Risk of fall. Most patients with PD present with shuffling gait, and even small obstacles tend to trip them. Gait freezing, characterized by an inability to move the feet, also increase the chance of falling
• Fatigue level
• Dizziness and fainting due to orthostatic hypotension
• Impaired fine and gross motor coordination
• Slowed voluntary and involuntary motor responses (reaction time)
• Dementia (20-40% of patients), hallucinations and paranoia
• Medication effects
• Excessive daytime somnolence due to poor sleeping patterns
• Impaired proprioception
• Pain sensations due to muscle rigidity and compensation patterns

Power Plate and Parkinson's Disease
Power Plate will most likely not have any effect on the disease, but can improve fitness and wellbeing so symptoms are reduced.

• Stability and coordination training on the Power Plate have been shown to improve both intra-muscular and inter-muscular coordination. These two components play an essential role in gait control.
• The Power Plate produces 25 to 50 vibrations per second, causing the muscles to contract reflexively. This high demand of muscle activity will cause more motor units to fire at the right time, at the right speed and with a better synchronization (therefore improving both fine and gross motor coordination as well as reaction time).
• Many clients using the Power Plate report improved sleeping patterns, which may be due to a decreased cortisol level. Power Plate may have positive influence on PD patients’ sleep cycles and reduce daytime somnolence.
• Slowed voluntary and involuntary motor responses (reaction time)
• The tri-dimensional displacement of the Power Plate platform is optimal to improve proprioception and motor control in all planes of motion.
• Pain sensations can be decreased due to the high level of stimulation of the mechano-receptors and desensitization of the pain receptors.
• Power Plate training enhances the response of fast twitch muscle fibers, leading to a higher speed of movement, limiting the chance of falling.
• Power Plate can help diminish muscle stiffness and increase flexibility through stretching modalities performed with vibration.

What to avoid
It is very important not to adopt an aggressive approach to Acceleration Training. Give patients plenty of opportunity to rest, do not progress too fast too soon, avoid unsafe positions that would increase the risk of falling and/or sudden changes of body position (since, because of orthostatic hypotension, these may increase the risk of falling and an exacerbation of tremors). If, while using the Power Plate machine, you feel dizzy, faint, short of breath, or any pain, stop using the Power Plate machine immediately, and consult a physician.