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Table tennis, a rediscovery
PingPongParkinson - the name says it all - a program that I paid no attention to in 2019 when I was diagnosed with Parkinson's. Revolving too much around myself, hoping too much for classical medicine with its numerous drugs, I paid no attention to non-drug therapies. It was only over time that I learned that movement was good for me and that it didn't matter what kind of movement it was.
It started with extensive walks and Nordic walking, later Tai Chi and the usual workout programs in the gym were added. As good as it was for me, I didn't really like anything and the way from the armchair to the sneakers was often difficult or not even started.
In 2021, on the occasion of my complex therapy in Bad Göggingen, I discovered a table tennis table in the fitness room and immediately the pictures from my childhood and youth came to mind, in which we played table tennis regularly and with great joy in the garage in winter and in the garden in summer . Lo and behold, not only cycling but also table tennis does not seem to be forgotten....
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The path was actually already mapped out. It began with small matches in the Munich parks, which thankfully are well equipped with table tennis tables and ends today with me as head of the Upper Bavaria region for PingPongParkinson eV and the journey is certainly not over yet.
At the end of May I attended my first table tennis tournament, the PingPongParkinson German Open 2022 in Bad Homburg, and I can say that in recent years I have never felt so comfortable and fit as during these 4 days in Bad Homburg.
I am not able to judge why table tennis in particular has such a positive effect on me and obviously on others as well. There will be many reasons, the type of movement maybe, the game itself, the friendly competition, the feeling of togetherness, the knowledge and understanding of the needs of the "opponent", whatever it may be - there is a lot of research on this topic already - I can only warmly recommend it to everyone. Look at the site www.pingpongparkinson.de when and where the next regional group trains and just try it out.
Incidentally, some may object that his degree of impairment would not allow such a sport. I can only reply: Far from it, just look at the video impressions I brought from Bad Homburg and you will see that the severity of the impairment only plays a minor role and, above all, does not detract from the joy of playing.
via PingPongParkinson
Who or what is PingPongParkinson?
The PingPongParkinson Germany e. V. is the nationwide association of individuals and self-help groups who volunteer to take care of people with Parkinson's and their families using table tennis.
The association was founded on February 02.02.2020nd, XNUMX. Honorary members are Jörg Roßkopf and Nenad Bach.
The focus of PPP's activities is to offer information and mutual exchange to those affected and their families. Table tennis has proven to be ideal for this.
The concept of PingPongParkinson is based on the fact that it wants to offer table tennis for everyone with Parkinson's, regardless of their personal abilities, i.e. from beginners to world champions.
Even if there is currently no scientific evidence, all those affected who have tried it are sure: the progressive worsening of the symptoms of Parkinson's disease can be caused by playing table tennis as a physical Therapy be slowed down.
And there's more
Table tennis as self-help?
Sounds unusual at first glance. But it isn't!
Many of the potential symptoms of Parkinson's, apathy, fatigue, depression, anxiety, hypersalivation, incontinence, tremors, and restricted mobility can cause social withdrawal.
Social isolation is generally associated with a deterioration in health. In pwp (individuals with Parkinson's disease), the effects of loneliness and social isolation on the severity of Parkinson's disease are even greater than under the influence of stress.
dr Indu Subramanian from the University of California Los Angeles, USA, presented the results of an analysis of self-reported loneliness and social isolation in a total of 1.746 patients diagnosed with idiopathic Parkinson's disease who participated in the CAM-Care-PD study. [1]
The main results were:
dr Subramanian said health systems need to be more proactive in helping vulnerable pwp. She offered a number of practical tips for clinicians. Probably the most important:
"Help patients connect with support groups!"
The exchange of the participants, but also their relatives, the mutual information and help - that is the way that the PingPongParkinson bases go. Another reason why PingPongParkinson deliberately decided to call his groups "bases", they should be real support points for the people.
The basis of the work in the bases is an active and proactive approach to dealing with the disease. Participation means a plus in quality of life, also with fun and sociability. The group thus eliminates the isolation of the individual and thereby strengthens self-confidence and solidarity.
The at least weekly meetings create a supportive cohesion that gives understanding and comfort and encourages new activities and changed behavior.
In addition to the direct health effects of table tennis, PingPongParkinson has the support potential of a real self-help group thanks to the automatic mutual exchange between the participants. With the further psychological advantage of not going “to help yourself”, but to table tennis.
How it all began
There are two people who can't get past PingPongParkinson's "history" - Nenad Bach and Will Shortz.
Nenad Bach was born in Zagreb, Croatia in 1954, graduated in civil engineering from the University of Rijeka and moved to New York in 1984. He was already making music while he was studying. He performed the song "Can We Go Higher?", written as a call for peace during the wars in Croatia and Bosnia-Herzegovina, in 1994 in Woodstock, United States and in 1995 in Modena, Italy, at the "Pavarotti & Friends" concert.
When Bach was diagnosed with Parkinson's, he stopped playing the guitar. Instead, at the invitation of a friend, he began playing table tennis with Will Shortz, owner of the Westchester Table Tennis Center (WTTC) and crossword editor of the New York Times.
He had never picked up a racquet before, but from that point on he played regularly. He noticed an improvement in his Parkinson's symptoms, which even went so far that he could play instruments again.
This encouraged him and in 2017 Nenad Bach founded PingPongParkinson USA, a 501 c3 non-profit organization with the aim of using table tennis as a form of physical therapy for Parkinson's disease. You can find it on the World Wide Web here more information. Based at the Westchester Table Tennis Center, 175 Tompkins Avenue, Pleasantville, approximately 35 miles north of New York City. The first ITTF Parkinson's Table Tennis World Championships, initiated by Bach, also took place there in October 2019.
Thorsten Boomhuis and Harry Wißler also successfully took part in this world championship. Immediately afterwards, it was clear to both of them that they wanted to follow the example of the Americans and set up a “Germany branch” of PingPong Parkinson. On 02.02.2020/XNUMX/XNUMX1 then became “PingPongParkinson Deutschland e. V." in
Nordhorn officially founded. It is the nationwide association of individuals and self-help groups who volunteer to take care of people with Parkinson's and their families using table tennis.
The focus of PPP's activities is to offer those affected and their families information and mutual exchange. Table tennis has proven to be ideal for this.
The concept of PingPongParkinson is based on the fact that it wants to offer table tennis for everyone with Parkinson's, regardless of their personal abilities, i.e. from beginners to world champions.
Nenad Bach's story in video
what you should know
PingPongParkinson VR
Ping Pong Parkinson is now available virtually. Anyone who has the appropriate technical requirements can play virtual table tennis with or against another PPP player at any time and place.
The simulation is extremely realistic and is particularly suitable for those who have not yet found a connection to a club, who want additional training units or newcomers to table tennis who would like to develop a few skills themselves first.
You can find out more about this at parkinson-journal.de/ppp-vr
Legal aspects 1: Severe disability
This is a guide that has been created to the best of our knowledge. However, it does not claim to be completely correct and complete. Any liability is excluded.
Legal aspects 1: Severe disability
According to the Federal Statistical Office, there are around 7,9 million severely disabled people in Germany, which is 9,5% of the population.[1]
The term "severe disability" is defined in Section 2, Paragraph 1, Clause 1 of the
Social Code Book IX legally defined:
“People with disabilities are people who have physical, mental, intellectual or sensory impairments that affect them Interaction with attitudinal and environmental barriers to equal participation in society with high probability for more than six months.
Section 2, paragraph 2 of Social Security Code IX defines when a severe disability is present:
"People are severely disabled within the meaning of Part 3 (SGB IX) if they have a degree of disability of at least 50 and their place of residence, their habitual residence or their employment at a workplace within the meaning of Section 156 is lawful within the scope of this code to have."
And § 2 para. 2 of the Social Security Code IX stipulates for equality:
“Severely disabled people are to be given equal status to people with disabilities with a degree of disability of less than 50 but at least 30, for whom the other requirements of paragraph 2 are met, if they cannot find a suitable job within the meaning of Section 156 as a result of their disability without equality obtain or not retain (equivalent disabled people).”
What does all this mean for people with Parkinson's?
The provision in Section 2, Paragraph 1, Sentence 1 of Social Code Book IX means that not only obvious disabilities are subject to the definition, but also those with a non-visible disability, such as a serious chronic illness such as Parkinson's. People with Parkinson's are considered long-term patients or seriously chronically ill within the meaning of the law.
Determining whether a person with Parkinson's also has a severe disability depends on the extent of the disease.
To determine this, the person concerned submits a corresponding application to the pension office responsible for them. This decides in each individual case whether the criteria of a severe disability are met and issues a so-called assessment notice, which contains the determined degree of disability (GdB) and a mark, if applicable. The authority issues the notice even if the GdB is found to be less than 50.[2]
The GdB varies, in increments of ten, between 20 and 100 and quantifies the severity of the disability. It is therefore the measure of the physical, mental, psychological and social effects of a functional impairment due to damage to health.
When determining the extent of the disability, it is about the existing functional deficit, a duration of more than six months and the impact of the disability on participation in life in society.
The competent authority follows the so-called "supply medical principles". These contain reference values for the level of the degree of disability. The principles of medical care can be found in the "Medical Care Ordinance" at the Federal Ministry of Labor and Social Affairs.[3]
For Parkinson's syndrome is defined:
These standards are only a guide. Ultimately, an individual overall view of all impairments is crucial.
The degree of disability can be checked and, if necessary, reassessed if there are any changes in health. Since people with Parkinson's disease are usually found to be worse, it can only be recommended to have the GdB checked regularly! This review here is more opportunity than risk.
People with (determined) disabilities are entitled to certain disadvantage compensations.
These depend on the type and degree of disability.
If the integration office has given its consent to the termination, the employer can § 171 para. 3 Social Code Book IX only give notice of termination within 1 month after delivery of the consent.
Furthermore, the Participation Rechte of the works councils to § 102 Works Constitution Act andand the Disabled representative to § 178 Abs 2 Social Code Book IX to protect.
The tax office grants an additional allowance for income tax. The amount of the allowance depends on the GdB. It is currently:
GdB of 20 | 0,00 € | from 2021: €384,00 |
GdB of 30 | 310,00 € | from 2021: €620,00 |
GdB of 40 | 430,00 € | from 2021: €860,00 |
GdB of 50 | 570,00 € | from 2021: €1.140,00 |
GdB of 60 | 720,00 € | from 2021: €1.440,00 |
GdB of 70 | 890,00 € | from 2021: €1.780,00 |
GdB of 80 | 1.600,00 € | from 2021: €2.120,00 |
GdB of 90 | 1.230,00 € | from 2021: €2.460,00 |
GdB of 100 | 1.420,00 € | from 2021: €2.840,00 |
mark "blind" | 3.700,00 € | from 2021: €7.400,00 |
mark "helpless" | 3.700,00 € | from 2021: €7.400,00 |
The allowances are always annual amounts, which means that there is no monthly accrual. If the GdB only existed for part of the year or if it changes in the course of the year, the higher allowance applies to the whole year.
For people with a GdB under 50, the tax exemption applies until
2020 tax year only if they are legally entitled to a pension or other ongoing benefits as a result of the disability[4] OR if the disability has resulted in a permanent loss of physical mobility or through a typical Occupational disease originated.
Employees who have a GdB of at least 30 may be able to equal to severely disabled people become.
Upon application, the employment agency grants equality if the person due to their disability finds a suitable job i. s.d. § 156 Social Code Book IX cannot obtain or retain. Equal rights, like severely disabled people, have special protection against dismissal. However, you are not entitled to additional leave.
Equality, if granted, takes effect on the day the application is submitted. It can be limited. The employment agency does not inform the employer about equality.
[1] As of June 24, 2020
[2] Note: The degree of disability is not given as a percentage!
[3] www.bmas.de
[4] A pension from the statutory pension insurance does not count.
Legal aspects 2: Statutory health insurance
This is a guide that has been created to the best of our knowledge. However, it does not claim to be completely correct and complete. Any liability is excluded.
WHAT WE SHOULD KNOW ABOUT PARKINSON'S
Legal aspects 2: statutory health insurance and Parkinson's disease
Health insurance is compulsory in Germany, ie it is required by law. It insures against the risk of illness and its consequences and is offered by statutory (GKV) and private health insurance companies (PKV).
The following will only deal with the GKV.
News[1] there is in Germany 113 statutory health insurance companies with approximately. 71,4 million insured and family members.
Worth knowing in advance:
The WHO[2] published International Statistical Classification of Diseases and Related Health Problems (ICD) is the recognized one classification system for medical diagnoses.
The valid edition is ICD-10-WHO Version 2019.[3]
The primary parkinsonian syndrome is found in Chapter VI, notation G
Name: Diseases of Nervous system G20.2 primary parkinsonian syndrome
In Germany, everyone with statutory health insurance is entitled to extensive insurance benefits, the so-called mandatory statutory benefits, in the event of illness. This also includes the medical services required to treat Parkinson's disease, specifically:
Reimbursement of the costs for regular doctor visits, e.g. B. as a check-up, are statutory compulsory services of the GKV. In principle, the free choice of general practitioners and specialists applies, provided they work together with the statutory health insurance companies.
Inpatient treatment in the hospital is also a compulsory service of the statutory health insurance, but the patient has to pay a share of the costs.
This applies when the costs of drug treatment are covered by statutory health insurance Benefits in kind principle. Insured persons must therefore, with the exception of co-payments, for treatment including the prescribed
Medicinal, medicinal and aids generally not pay if the regulation is made within the framework of the statutory catalog of services.
According to the Social code V, insured persons are entitled to adequate, needs-based medical treatment that corresponds to the generally recognized state of the art in medical science. What exactly this includes is not determined by the law, but by the Federal Joint Committee (G-BA), the supreme decision-making body of the joint self-government. The G-BA also decides what is known as the Drugs Directive.
(see the separate elaboration "Co-payments in statutory health insurance")
By means of so-called discount agreements, health insurance companies can negotiate better conditions with drug manufacturers. They usually pass on some of the savings they make to the insured, for example by waiving the co-payment. The pharmacists are accordingly obliged to give preference to medicines within the framework of this discount agreement and to exchange a medicine prescribed by a doctor for a preparation from a manufacturer with whom the health insurance company has a discount agreement. To do this, however, the active ingredient and potency must be identical and the dosage form and package size must be comparable.
The doctor can exclude this exchange of drugs if he deems it necessary. To do this, he must tick the box "aut idem" Mark with a cross.
Remedies or healing measures are also part of the statutory mandatory benefits.
Depending on the symptoms and the stage of the disease occupational therapy, physical therapy or speech therapy as Remedies in question, all of which are often an integral part of the treatment of chronic degenerative diseases such as Parkinson's.
The provision of medicinal products for members of the statutory health insurance funds is regulated in the medicinal product guidelines of the Federal Joint Committee. The so-called remedy catalog provides information about which remedy can usually be prescribed for which diagnosis / diagnostic group and in what quantity. Before prescribing medicines, the doctor must convince himself of the patient's condition, including appropriate diagnostics, and document it. This also applies to subsequent regulations.
The principle of economy must be observed. It is therefore important to consider before the regulation whether e.g. B. by aids, drugs or self-responsible measures of the patient, the therapy goals can be achieved qualitatively equivalent and more cost-effectively. If this is not the case, remedies can be prescribed.
The catalog of remedies contains the following definitions for the REGULAR CASE of Parkinson's:
priority
Remedies |
Optionals
Remedies |
supplementary
Remedies |
prescription amount | ||
Physical therapy | General
physiotherapy Specific Physiotherapy for Treatment of diseases of the central nervous system using the neurophysiological techniques Bobath, Vojta or PNF (Proprioceptive neuromuscular facilitation) |
None | Cold therapy
heat therapy |
First prescription:
<= 10 units Subsequent prescription: <= 10 units total prescription quantity of the normal case <= 30 units at least once a week |
|
occupational therapy | sensorimotorperceptive
Treatment Motor-functional Treatment Brain performance training / neuropsychologically oriented treatment
|
Psychological treatment | Thermal
Applications |
First prescription:
<= 10 units Subsequent prescription: <= 10 units Total prescription quantity of the normal case <= 40 units |
|
At least weekly | 1x | ||||
priority
Remedies |
Optionals
Remedies |
supplementary
Remedies |
prescription amount | ||
speech therapy | The
Difficulties swallowing: Vocal, Speech and Speech therapy 30, 45 or 60 Minutes with the patient, depending on the specific disorder and community-led approach |
None | None | First prescription:
<= 10 units Subsequent prescription: <= 10 units total prescription quantity of the normal case <= 60 units at least once a week |
The Therapeutic Products Directive enables prescriptions to be made outside the norm. If therapy goals can only be achieved through additional prescriptions in individual cases, longer-term prescriptions are possible.
In people with Parkinson's with the most severe impairment (stage 5 according to Hoehn and Yahr), there is a so-called "long-term need for medicinal products" according to the diagnosis list (Annex 2 HeilM-RL[4]) went out. Here, the permanently necessary remedies can be prescribed as "prescriptions outside the normal case" without the normal case having been run through beforehand.
In people with Parkinson's with moderate to severe impairments (stages 3 or 4 according to Hoehn and Yahr), there is a so-called "special need for prescription" according to the agreement on practice specifics for medicinal products[5] went out. Here, however, after the normal case has been run through, the permanently necessary remedies can also be prescribed as “prescriptions outside the normal case”.
For individuals with Parkinson's disease below Hoehn and Yahr Stage 3, the insured person must submit an application for approval if they believe that their level of functional/structural impairment is comparable in severity and duration to the higher stages.
Below are a few highlights from the catalog of medicinal products that are expressly non-prescribable according to Appendix 2 of the Therapeutic Products Directive:
catalog of medicinal products are prescribable
The GKV covers the costs for journeys if they are absolutely necessary from a medical point of view in connection with a service provided by the health insurance company in the case of:
Insured persons must have their health insurance company approve trips to outpatient treatment beforehand. Approval by the health insurance company is deemed to have been granted to all insured persons who have a severely handicapped ID card with the mark o exceptional walking disability o blindness o helplessness
or have the need for care of care grades 3, 4 or 5. For people with care level 3, additional medical certificates are required.
Patients who are permanently restricted in their mobility but do not have a severely disabled person's pass have the option of equal treatment after the individual case has been checked by the health insurance company.
Outpatient treatment for about 4 weeks can be approved every 3 years if it is necessary to prevent an impending disability, to eliminate or improve a disability or to prevent it from getting worse. The medical and treatment costs are fully covered; Subsidies can be granted for board and lodging.
If an outpatient treatment is not sufficient, an inpatient treatment can be approved.
In this case, the fund also covers the costs of accommodation and meals.
Psychotherapy is reimbursed by all licensed therapists within the framework of the cost-effectiveness requirement.
Alternative treatment methods are generally not reimbursed in the GKV.
However, some health insurance companies voluntarily pay for special therapies. The reimbursement must be requested from the health insurance company.
However, there is a ban on services for alternative practitioner treatments.
In the other EU countries, there is basic insurance protection, so that services can be claimed without the prior consent of the health insurance company. But:
It is therefore highly recommended to take out health insurance for travel abroad!
(see the separate elaboration "Financial benefits in the event of incapacity for work")
[1] Stand: 26. August 2020
[2] World Health Organization
[3] ICD-11 comes into force on January 1, 2022
[4] Annex 2 to the Medicines Directive: List of diagnoses for the long-term need for medicines according to § 32 Para. 1a SGB V
[5] Agreed between the National Association of Statutory Health Insurance Funds and the National Association of Statutory Health Insurance Physicians (§ 84 Para. 8 SGB
Gait disturbance due to Parkinson's disease
WHAT WE SHOULD KNOW ABOUT PARKINSON'S
Gait disorders caused by Parkinson's
What image does the term "severely disabled" generate? A person in a wheelchair. What about Parkinson's? An old gentleman, bent over with tapping steps, who trembles even in summer.
Contrary to my goddaughter's definition: "People are old over 30, very old over 40", I don't feel old, walk halfway upright and don't tremble. I'm also not in a wheelchair and I'm trying to keep it that way.
However, when I am without effective medication and/or under emotional stress, I am "severely disabled". Imagine you are standing at the bakery counter in the supermarket foyer on Saturday morning, or 10
meters away, in a line with horizontal stripes every 1,5m. All the
City dwellers who spend their relaxed weekends on Saturdays after a close
Initiate a schedule and show great understanding if a movement of the snake in front of you leads to a gap in the dimensions of the Gobi desert, i.e. more than 1 meter, not being filled by you immediately.
Why? Because you're frozen to the ground in this very desert. At the latest when the person behind you drives the shopping trolley into your heels and indicates to you that you should listen to his insults and not shout so much and then push your car out of the row into the middle, where you appear to be on display even without a pedestal, everyone feels with you... …..whether your alcoholism, dementia or other frailty.
Luckily, they cheer you up with constructive solutions: Less drink, stay at home, or simply disappear. This emotional experience stays with you until you find a way to leave the place after the longest 30 minutes of your day. This can only be topped by combining it with one
Urge incontinence at a time when you still thought of TENA as a Greek goddess. Nice weekend.
Sure, that's an extreme scenario, but far from unrealistic.
This requires a pronounced gait disturbance, which occurs in the ON area (under sufficient medication), since more levodopa does not bring any change. This is referred to as levodopa resistance.
The freezing of the passage (FOG – freezing of Gait) was defined as
“short-term, episodic absence or significant reduction in
Forward movement of the feet despite the intention to walk". Individuals with Parkinson's/pwp suddenly feel as if their feet are stuck to the ground when attempting to move forward. This usually takes a few seconds, but can occasionally exceed several minutes or longer.
The understanding of the mechanisms of FOG is incomplete and the treatment is considered a very difficult task by clinicians. Hypotheses for the explanation according to Nieuwboer are:
Compared to other pwp, those with FOG show significant gait disturbances, such as decreased step reinforcement, impaired gait coordination, and increased step time variability. This model assumes that when these motor deficits accumulate to the point of motor collapse, FOG occurs.
The relationship of motor, cognitive and limbic processes is both competitive and complementary. Since dopamine neurons are usually exhausted in pwp, the simultaneous processing of cognitive and/or limbic information during the motor task leads to an overload of the information processing capacity within the basal ganglia. The interference between neural processes would explain the phenomenon that increasing cognitive load while solving a dual task breaks down locomotion.
This model emphasizes the conflict resolution deficit. Under normal
Conditions will prevent people from taking hasty action and delaying the choice of response until the conflict is resolved. In contrast, pwp with FOG fail to process the reaction conflict. They force a faster reaction decision but with less agreement, triggering FOG.
This model viewed FOG as a decoupling between the preplanned motor program and the motor response.
These models and hypotheses explained FOG from different perspectives. Even though they are incomplete and can only partially describe FOG, it is worth noting that these models are helpful for a better understanding and characterization of FOG and provide clues for further research. More importantly, based on these models, therapies for the treatment of FOG can be developed and applied.
In addition to important and established treatment approaches, newer therapeutic strategies also seem to be effective and are being further tested with FOG.
Parkinson's complex therapy are on site and spare time for you. Furthermore, a certain basic knowledge of one's own illness helps to get the attention of the experts or to get it if it doesn't want to come by itself.
Just as we are in an area where chemical
Processes in the brain and feelings can no longer be separated with precision, the placebo effect plays a prominent role.
Process in which the therapist uses the finest liquid streams in the
Body – they extend from the skull (cranium) to the sacrum (os
sacrum). A session usually lasts an hour and addresses the organism in a gentle way. After the application you feel more relaxed, more energetic, more alive. Since the regular
I have neither neck tension nor dizziness.
Hospitalization or anesthesia is not required.
dTMS is a treatment option when standard drug therapy is not an option or has not worked sufficiently. A big advantage of treatment with dTMS are the very rare side effects. I will make my experiences in the next few months.
There are several pharmacological treatments available that
Effective in reducing the number and duration of freezing episodes. Currently, dopamine replacement therapy with levodopa remains the first choice for FOG treatment in Parkinson's disease.
An open-label, uncontrolled study evaluated the transdermal patch rotigotine as monotherapy in untreated pwp over a 6-month period and found that the patch improved all aspects of gait, including walking straight, gait initiation and gait, compared to baseline
Rotation. Unfortunately, this effect did not occur for me. studies with
Dopamine agonists added to levodopa also found beneficial effects on gait speed with adjunctive therapy with apomorphine and pramipexole compared to levodopa alone.
I can personally confirm this new assessment.
Number of falls reduced. Although dementia occurs in the final stages of Parkinson's disease, the disease is primarily a motor disorder. I started two intensive treatment approaches, both of which were ineffective after the initial placebo effect.
Opicapon, but I find it difficult to judge the effectiveness.
movement disorders one therapeutic value own. Various cannabinoids can reduce dyskinesia and some forms of tremor and dystonia caused by levodopa in Parkinson's disease. In addition, they can Decrease in tics in the Tourette-syndrome and contribute to hypokinetic parkinsonian syndromes: My personal attempts with highly concentrated, freely available CBD oil were, however, without effect. Other pwp report good results, eg a reduction in stress levels and thus better sleep and less escalation of motor problems.
/ THC, the main ingredient of Cannabis. For Parkinson's disease, dronabinol is only available as a so-called "off-label" treatment, medically indicated and with special approval. I stopped the treatment because it was ineffective. Coincidentally, at the same time there was a survey of PwP worldwide by the well-known American Michael J. Fox Foundation, which also showed a rather weak average effect. Since we are in an area with a very relevant placebo effect when it comes to freezing, there is also an opportunity to support good faith with equally good marketing.
I have tried many of these therapeutic approaches myself, together with my very dedicated neurologist. I would like to say explicitly that these approaches all had their justification and also showed good success with other FOG-stricken pwp.
Mobile on all skins – assistance dog for pwp part 1 – what is that?
This is a guide that has been created to the best of our knowledge. However, it does not claim to be completely correct and complete. Any liability is excluded.
WHAT WE SHOULD KNOW ABOUT PARKINSON'S
Mobile on all skins – assistance dog for pwp part 1 – what is that?
"An assistance dog for Parkinson's - what should it do for you?"
"Isn't that expensive, does the health insurance company pay for it?"
Questions that reach me immediately when I walk my dog with "Assistance dog for people with Parkinson's - AZUBI" on the identification blanket.
LEIA is still an adolescent Labradoodle with many ideas of her own, which she implements with great energy. It is therefore still a long way from being a reliable helper in my freezing phases. But one
We could both pass the assistance dog test without any problems: LEIA as the dog and I as her assistant.
In Germany, the “assistance dog” often causes frowns, even among dog people. In the USA and even in some neighboring European countries, assistance dogs have long been thought beyond guide dogs for the blind. An assistance dog is legally defined there and has the necessary access privileges to support the partner anywhere, such as to grocery stores or hospitals.
A loving fur nose recently found its way to me through a search by an experienced assistance dog trainer in order to support me as a team partner with my gait disorders in the future. The team of pwp (person with Parkinson's disease) and assistance dog (in training) briefly introduced. Ladies first:
LEIA, 9 months, born on a farm in
Gelsenkirchen, almost with a view of Schalke, daughter of a
Labrador lady from the working line and the king poodle Bergmann. Currently 54 cm shoulder height and 22 kg and abysmal dark eyes, wrapped in the pitch-black coat of a poodle lady who played with my goddaughter's straightening iron.
Karsten, 50+, was born not far from the table tennis stronghold of Borussia Düsseldorf. Diagnosed with Idiopathic Parkinson's Syndrome for 10+ years. Despite excellent medical care, with regard to "freezing of gait" out of therapy and therefore turned to the dogs.
A hint, if I may be allowed here: A dog is cute, especially when
puppy and it is impressive what such an animal can and wants to achieve.
But what a dog means in everyday life, to look after it, to train it and to do justice to the animal, should be aware of before making a decision.
Depending on the severity, Freezing of Gait (FOG) is a challenge even for a positive thinker like me. On some days my performance can drop by more than 90% for the whole day. Freezing is not only not being able to walk, it is also difficult to stand. Activities that you normally take for granted suddenly become indomitable. I often don't know what's worse: the helplessness I feel, the people who don't stop helping me even though it's hard enough without them, or those who look at you sadly or angrily because I supposedly looked too deep into the glass again.
My first self-help, at the suggestion of my wife, was to use an m-scooter. This was later replaced by an e-scooter, at a time when these did not yet have a bad reputation. A very important value of this device was that I went from a drunk to a slightly whimsical person, and that pitying or disparaging looks turned into a smile. This different assessment of my fellow human beings in freezing situations decides about the hours afterwards. Will I get out again, or do I really slip into the feeling of helplessness. That this is not only of great importance for FOG, but everywhere where disability is not visible or behavior is not consistent with the external impression, I later realized when I was looking for solutions for my freezing. I came across two little girls with walking problems. On the Irish "Late Late Show" they were asked by the moderator what makes their assistance dog important to them. They named, in their words, exactly this transformation of their environment
When I searched YouTube for current Parkinson's trends, I happened to see a report on the laying out of the late US President George W. Bush Sr. There was a dog lying in front of the coffin. A so-called "service dog" who supported the ex-president with the consequences of his Parkinson's disease and had now survived his partner.
A dog that can help me walk and is happy to do so, that's it! A dog can also be used much more universally than an eScooter, has 4Motion and not just rear-wheel drive, and is much more popular. That's how I got the dog.
Many partnerships between assistance dogs and pwp show that the dog is the key to independent participation in community life.
Especially in the case of pwp who suffer from a severe form of the "freezing of gait" symptom in the advanced stage of their disease, an assistance dog, enabled through appropriate training, can make progress in an acute freezing situation possible.
Assistance dogs can also help with a range of symptoms of Parkinson's disease, from physical challenges such as unbalance with a risk of falling, to social and
emotional problems.
assistance dog, both physically and mentally?
need an assistance dog and can only keep one dog?
Dogs need service dogs exercise, so one is encouraged
Service dog requires owners to get some exercise every day.
trigger depression. Interacting with a puppy can change these feelings. A dog can make people smile and make them feel better and others feel more comfortable around you.
My first summary, before training as an assistance dog: Labradoodles are cute, especially as puppies. Behind a languorous look that makes you forget everything, you combine all the good qualities of Poodles and Labradors. The poodle's high level of intelligence enables it to learn all sorts of stupid things very quickly and to see through the master's tricks before it even thinks of them. A first "Is he cute!", Follows the landing approach of 20+ kg cute young dog on the, only slowed down by the leash
Admirer, one: "But if he has energy - that certainly makes a lot
Work…I have to keep going.”
"She's still young." / "It will grow out of it." / "With the right one
Training," / "It's puberty." / "She just wants to play."
I believe all this to report and benefit from a fully trained assistance dog in a year's time, like the pwp from Dublin in the example below.
"It'll be fine!"
A father of two with Parkinson's disease says his life has been transformed by having a dog that helps him with mobility and stability.
The Dublin Neurological Institute (DNI) pilot at Mater Hospital is a first for Ireland at least. While dogs have previously been trained as companions for pwp, this is the first specifically for the
mobility, stability and gait support.
Result: “This is the best treatment to improve my quality of life of all the treatments I have received for Parkinson's in the last 17 years.” He added: “When I used to go, people always thought I was drunk or on drugs. Now they just smile. We both walk more than six kilometers every day.”
Parkinson's is a long-term neurological disease that occurs in Ireland around
8.000 people are suffering. It affects the way the brain coordinates body movements, including walking, speaking and writing. While there are a number of treatment options available to manage the disease, there is currently no cure. Consultant neurologist Professor Tim Lynch from the DNI wanted to try something different to help the sufferer. “While HE has coped well with his Parkinson's disease over the years, he has
Problems with his feet getting stuck on the ground and freezing. So we had the idea that an assistance dog would be a support to avoid falling. Secondly, it could give a nudge to the leg that is frozen and act as a starting signal for the foot.” The consultant neurology professor from the DNI, who is leading the pilot, contacted the Cork-based charity Dogs for the Disabled. This trains dogs to support a variety of people with disabilities.
The charity's CEO said: “It's the first time we've worked with a Parkinson's patient. We selected and trained a dog based on an assessment of the PwP's needs, wants and personality type.
“It is a strong dog, a great worker, with real drive and determination. He's really developed well and it's just amazing to see how happy they are together." This is the first dog in Ireland to be specifically trained to support mobility, stability and gait.
Technical researchers have performed a gait analysis by
Have sensors attached to both. “Through these scientific measurements and using psychological tools, we are trying to prove whether there is a difference in gait.
“As far as we know, this is the first long-term study of a Parkinson's patient with a dog trained specifically for him. It would be very exciting if we could scientifically prove that this is beneficial for them,” said the supervising doctor from the DNI. The data collected during the project will eventually be published so that more stability dogs can be trained. “My dog is like a part of me at this stage. I don't go anywhere without him. He takes care of me and I take care of him,” he said.
Originally by Philip Bromwell
Mobile on all skins - assistance dog for pwp part 2 - training
This is a guide that has been created to the best of our knowledge. However, it does not claim to be completely correct and complete. Any liability is excluded.
WHAT WE SHOULD KNOW ABOUT PARKINSON'S
Mobile on all skins - assistance dog for pwp part 2 - training
At the beginning there is the search for a suitable puppy. Not every dog is suitable for training as an assistance dog. Factors such as the dog's confident nature and individual talents play a major role here. Ultimately, the dog can turn his hobby into a job. the
Ideally, an assistance dog school will search for the dog.
For example, Leia is a Labradoodle, a cross between an intelligent standard poodle with little shedding and a will-to-please Labrador who just loves to serve his partner. In addition, with a shoulder height of approx. 55 - 65 cm and a weight of approx. 25 - 30 kg, she will be strong enough to support me or help me up.
When on duty, an assistance dog should present itself as follows:
Have people or other dogs retrieved without confrontation
For the assistance dog handler this means:
assistance dog should react with understanding and friendliness. This person may have a pronounced fear of dogs, has even been bitten before, or they suffer from a dog allergy. Perhaps you are facing a service dog team for the first time and have no idea how important the dog is to its owner.
An assistance dog also has the express right to take care of its puppies and dogs
to enjoy young dog time. After the first year of life, in which essentially basic general behavior is trained, the special training begins. The dog is slowly introduced to its later tasks.
In the so-called self-training, the training goals are defined together with the dog school and trained in weekly training sessions. This prevents errors from creeping into the training. When the dog moves in with its partner early on, the bond between the team is built up and strengthened in a targeted manner right from the start. Another aspect of self-education is that the dog does not have to change homes. He grows into his later task right from the start. For the pwp, the training means intensive work and a lot of discipline on the one hand. On the other hand, it is a lot of fun to experience the progress of the training directly. The cost of training is about 30% of the cost of one
foreign training. The risk for character and health
Suitability and the correct way of working of the dog are the responsibility of the owner. Above all, it should be noted that especially when training puppies, the health suitability can usually only be tested at an age of about 12 months. Should the dog then prove to be unsuitable, the owner is left with the previous expenses and costs. Furthermore, it is then necessary to consider whether the dog
family dog can stay with its owner and a second dog starts training, or whether another home has to be found for the first dog, since the owner can only keep and care for one dog.
External training describes the complete training of the dog by a trainer. During his 2-year training, the dog has no contact with his future partner. After completing the training, there is an extensive induction phase with the pwp, for whom the
dog is intended. The young team then completes the team test after the induction period. A longer waiting time of at least 2-3 years must be planned for this training variant. It takes time for the dog to be found and trained. Due to the high expenditure of time, the medical care and care of the dog on the part of the training facility, the costs for this form of training are significantly higher than the costs of self-training.
Unfortunately, the costs of training an assistance dog are not covered by health insurance (exception: guide dogs for the blind). So you have to see for yourself whether you can pay for it out of your own pocket or whether you can get donations or financial aid.
position education alimony
Buy Puppy | 1.150 € | |
Veterinary costs before delivery | 320 € | |
Early education with the coach | 1.600 € | 320 € |
Basic equipment | 500 € | |
Dog food, chews, games… | 1.500 € | |
Liability insurance | 90 € | |
surgical insurance | 400 € | |
Vet expenses holder | 800 € | |
Dog tax | 220 € | |
Basic training assistance dog | 4.900 € | |
group school | 1.600 € | |
Assessment of fitness for service | 250 € | |
Specialist training as an assistance dog | 5.500 € | |
final exam | 500 € | |
Training period (1,5 years) | 14.100 € | 5.550 € |
Dog food, chews, games… | 1.400 € | |
Liability insurance | 60 € | |
surgical insurance | 300 € | |
species costs | 500 € | |
Dog tax | 140 € | |
retraining | 1.100 € | |
Term of Service (per year) | 1.100 € | 2.400 € |
Education + maintenance for 10 years: €49.400
Sniff people, bags, goods in the store, shelves, counters, lanterns, fences, grass, bushes, trees or the ground. In his free time, he can sniff as much as he likes to compensate.
Assistance dog often eats on the floor. Whether a piece
Sausage rolls on the footpath or someone at the table next to you in the restaurant drops something, he must ignore this.
Use the elevator and behave appropriately while in the elevator. This includes checking and only getting on and off on command, not bothering other passengers and not sniffing at passengers.
give yourself While washing his hands, he should remain seated or remain seated until his partner picks up the leash again. To ignore: If the assistance dog encounters other dogs or people on duty, it must not pull them towards them, but must walk past them on a loose leash and ignore them. On command, if the partner so desires, individual dogs or people may be greeted.
On call
Guide vocal signs to retrieve within partner's reach
Wear
Bringing goods in a bag from the seller to the wheelchair user
Carrying mail or newspapers into the house
Putting rubbish, direct mail in wastebasket or dustbin
Pull
nose poke
pressing a doorbell
Operate the light switch
Operating a foot switch for lamps
mobility aids
emergency situation
Bark for help on command
Find and fetch supervisors on command
Place front paws on the wheelchair user's lap to maintain an upright position so that the partner can get the mobile phone or a backpack, for example
medical duties
On all skins mobile - assistance dog for pwp part 3 - legal
This is a guide that has been created to the best of our knowledge. However, it does not claim to be completely correct and complete. Any liability is excluded.
On all skins mobile - assistance dog for pwp part 3 - legal
The European Parliament changed (March 06.03.2009th, XNUMX) the guidelines for the application of the principle of equal treatment, so that guide dogs and assistance dogs are treated equally.
"(12b) Effective non-discriminatory access can be ensured in a number of ways, including through the concept of 'design for all' and by facilitating the use of assistive devices for people with disabilities, including mobility and access aids, such as recognized guide or assistance dogs.”
The guidelines of the European Parliament also found their way into German politics in 2017 and so the Bundesrat on February 10th
2017 (at its 953rd session) determined that by amending § 33
SBG V the possibility should be created to include assistance dogs in the list of aids (according to § 139 SGB V).
In addition, legal requirements are to be created so that assistance dogs can be entered in the severely disabled ID card. And the need for nationwide uniform quality standards for assistance dogs was also identified.
III. And what about other EU countries?
As a direct neighboring country, Austria has in § 39 of the
The Federal Disability Act (BBG) regulates what is meant by assistance dogs, but also what requirements must be met in order for a dog to be called an assistance dog.
To specify the law and criteria and requirements
The Federal Ministry of Labor has to clarify assistance dog teams,
Social, health and consumer protection guidelines for assistance dogs, which came into force on January 1st, 2015.
However, this system also has its flaws, mainly due to the rigid ones
Examination criteria clearly not related to the individual needs of the
concerned. In addition, this law does not clarify the question of financing Austrian assistance dogs.
Since 2013, §11 of the Animal Welfare Act has stipulated that institutions that train dogs with or for third parties must be officially approved and require proof of expertise. Any institution
(Training center, dog school, trainer), who has the required trainer license/expertise according to §11 of the Animal Welfare Act, can and may train assistance dogs, examine them and issue accompanying documents for the dog.
Uniform legal regulations/minimum standards for the
However, there is currently no training/testing of assistance dogs in Germany. However, according to the Federal Government, these are in the works, which is why it is all the more important to look for a reputable and competent trainer who can train a prospective assistance dog team so well that they can also pass an “official” examination that will be introduced later in accordance with the then valid legal Specifications can pass without problems.
In addition to the accompanying document/proof of training, other helpful documents for taking an assistance dog with you can also be a severely disabled person’s pass and a medical certificate confirming the need for the assistance dog.
Can an assistance dog go everywhere (supermarket, cinema, doctor, etc.)?
Theoretically yes, according to various paragraphs from the social code books
(SGB), the General Equal Treatment Act (AGG), the
Disability Equality Act (BGG) and the UN
Convention on the Rights of Persons with Disabilities (UN-BRK) and according to the
The Federal Government Commissioner for the interests of people with disabilities must be provided with barrier-free social services (this also includes help from animal assistance). This means that assistance dogs can accompany their human anywhere.
Practice shows, however, that this is difficult even with a guide dog and even more so for other assistance dogs.
The leash obligation, for example, is not based on federal but on
decided at state level. For this reason everyone should
Assistance dog handlers take a look at the state dog law applicable in their own state.
Example LHundG NRW: § 17 exceptions from the scope
With the exception of Section 2 Paragraph 1, this law does not apply to service dogs
Authorities, rescue service or civil protection dogs and guide dogs for the blind. For Disability Assistance Dogs, herding dogs and useful hunting dogs are not subject to the statutory leash requirements when used.
Training weekend in Munich from December 10th to 11.12.2022th, XNUMX
The following players have signed up so far:
Maria Kolbinger, Sven Trautner, Juergen Zender, Rodrigo Antunes, Ruth Eisinger, Catherine, Ruediger Ott, Reinhard Kaltenegger Ulli Heydt, Ernst Hillenkamp, Armin Galsterer, Franco di Lena, Katharina Schmidbaur and 3 more people. The course is fully booked.
Latecomers can theoretically decide up to one day before the start of training, provided there are still places available. The registration then takes place directly via the website of the provider. There you can also see whether there are still spaces available.
Active training takes place for 2 hours in the morning and 2 hours in the afternoon. In between, the tables are available for free play.
Further information from the organizer:
We have been organizing our weekend courses in Munich for over 20 years. Milbertshofen is a district in the north of Munich and is easy to reach by public transport.
Appointments | 2 days = 8 hours | 1 day = 4 hours |
12.11.22-13.11.22 | 80,00 € | 50,00 € |
10.12.22-11.12.22 | 80,00 € | 50,00 € |
We offer:
The breakdown of the focus by days:
In the course of a course, all hitting techniques are basically demonstrated and practiced systematically. Since everything is not possible in just one day, we divide the priorities as follows:
Course 2 days