Hypomimia/Facial Masking

 - Drink more water! Especially now the temperature is rising, Try to drink a large glass of water 30 minutes before eating and another 30 minutes following a meal.

- Schedule your weekly exercise sessions. In the week Box Positive offers online sessions on Tuesday 10AM, Thursday 6PM (focusing more on strength and flexibility movements) and Saturday 10AM. Or look at YouTube channels like the Brian Grant foundation, Parkinson’s UK, PWR Moves or you may not want ‘Parkinson’s specific’ and find a channel of interest to you. Perhaps create your own programme to enhance that feeling of accomplishment. Write down positive feelings after the session and use this in future to help build routine and positive feelings about exercise. Remember exercise can be disease modifying and it works! I recently left security in a hospital role given the results at Box Positive and the desperate need out there!

- Challenge yourself to use your non-dominant side in activities of daily living, practice being comfortable with being uncomfortable. This could be brushing your teeth with your non-dominant side. We often switch to southpaw when shadow boxing during sessions, to get those neural pathways firing. Learning a new skill is a good way of encouraging neuroplasticity, adapting, and learning new ways of carrying out a task can be a real gamechanger! Of course, complexity can kill motivation so build up the challenges – try not to give up on the exercise sessions too, perhaps let the instructor know if you find a movement difficult & remember feedback is the fuel that drives performance. I always ask for feedback at the end of sessions. I highly value every bit of feedback I get and so will other instructors. 

- Take time to rehearse movements that can be challenging. This may be standing up, turning in bed or getting out of bed. Picture yourself executing the task well beforehand, take time to plan the task, use momentum at certain stages, break down the task or write the stages on a piece of paper e.g. see the dressing cueing strategy (see at the bottom of this page).

- If you are unsure about the medication you are on, whether it is right or whether you need it explaining then call the GP. Explain that you need to speak to someone and don’t fear coming across as a hassle. Healthcare professionals love helping people and if they come across as if they don’t want to help then they should get another job. 

- If taking L-Dopa medication set reminders on the phone.

- Slide sheets and bed levers can help with bed mobility although this should only be considered if sleep is affected or if you are not able to gain strength to get out of bed independently. Talk this through with your physiotherapist or OT first, a good OT will clinically reason why they are thinking of installing aids and whether this will enhance overall quality of life or not. 

Motivational tip to enhance ability:

- If you have had a 1-1 or group session with me Charles you know that I truly believe in taking that strength based approach to create a positive cycle of thinking. The core values of my profession are around engagement and empowerment, I am certainly a solution focused practitioner. It is evident that changing the way you approach situations and thinking “I can” can improve performance. Of course, realistic goals need to be set, one of our champions here demonstrates how building a positive mindset has helped him make dramatic improvements in his ability since taking on a Box Positive mindset: https://www.youtube.com/watch?v=Lx93ANJKuYs 

Tips to help with anxiety or low mood:

- Relaxation strategy – Diaphragmatic breathing has been proven to reduce cortisol levels.

- Headspace or Insight Timer Apps on the phone are great to assist with the point above

-  Let people know that you have Parkinson’s, people shouldn’t judge in fact they are likely to admire you.

- Thought dump – Write down your anxieties!

For people that do not want to attend Zoom sessions here are some useful YouTube channels, keep up that movement at home!:

Tony Jeffries - YouTube For those of you that want to learn more about boxing and boxing specific exercises check out this channel led by Tony Jeffries, he is a 2008 Beijing Bronze medal Olympian and a light heavy 

Fran Sands - YouTube This is another experienced coach that breaks down some boxing fundamental techniques.

The following videos all give some fantastic Parkinson’s specific exercises, perhaps building a programme with a mix of all could be an idea and great use of time. Make sure there is someone nearby if trying anything complex:

https://www.youtube.com/c/parkinsonsuk/videos Parkinson’s UK exercise videos are here if you scroll down the page

https://www.youtube.com/channel/UCpGOaMzOZ4nRXaewyDDslCwA A physio specialising in Tai Chi for people with Parkinson's.

https://www.youtube.com/channel/UCgFeURFj6q0d3iIWKOz8VkA This channel is led by one of the pioneers of exercise for people with Parkinson’s Becky Farley.

https://www.youtube.com/channel/UClG8OYQyEAVELFT1T4XU0WgInvigorate Physical Therapy and Wellness – A really useful channel inspired by Becky Farley and led by a really inspirational lady

(30) PD Warrior - YouTube PD Warrior channel

(30) Start Living Today PD - YouTube A community led by an inspirational lady with Parkinson’s from down south named Heidi Reynolds

(30) LSVTGLOBAL - YouTube Lots of speech exercise ideas on this one 

• Parkinson's is categorised as a movement disorder, however symptoms that are not discussed very often is the impact that diagnosis can have on the mental health of people living with the condition. There is support available at Box Positive for both the person with the condition and for partners. Support can be given by people with lived experience and are more than happy to talk with you.

• Talk about your anxieties, we have a family of people at Box Positive that are willing to offer a listening ear and advice where possible, you can email me on charlesdelve@boxpositive.co.uk or info@boxpositive.co.uk or call me on +44 7980192053. Parkinson’s UK also have a helpline – 0808 800 0303, pick up the phone!

Collect all the clothes you plan to wear and lay them in the correct order for dressing.

SIT DOWN on a chair or the bed, close to your stack of clothes. 

Concentrate on dressing, avoid distracting thoughts.

Imagine yourself changing before starting.

Describe each body movement whilst you are dressing e.g. "Put left hand into the sleeve and pull up”.

"Grip button...find hole...push button into hole...and pull."

Stand to pull up pants/trousers, making sure body is well balanced.

Sit down to do all buttons and fastenings.

REMEMBER! Do only one task at a time.

Concentrate fully on the task.

Describe each movement to yourself as you do it.

(Ana Aragon Parkinson’s OT specialist RCOT Masterclass)