Integrating deliberate shaking into daily living: a paradoxical exercise for Parkinsonian tremor.

Abstract

Medication often falls short in controlling tremors in Parkinson's disease. While physical activities suggest potential benefits, current exercise regimes have limitations. This paper explores the concept of deliberate shaking as an intervention to aid exercise uptake and potentially leverage synergies between medication and physical activity. It examines the rationale for and mechanisms of deliberate shaking before exploring its further examination and implementation for tremor rehabilitation. This conceptual article draws on relevant literature using the SANRA guide to explore the potential of deliberate shaking to relieve tremors in Parkinson's disease. Deliberate shaking is a controlled exercise where an individual consciously initiates and partially surrenders to rhythmic movements while maintaining the ability to stop at will. Integrated into daily activities, this practice may target and stimulate specific muscle groups. It may alleviate tremor through various mechanisms: neurobiological, physiological, and cognitive and psychological. Before implementation, empirical research is needed to assess its feasibility, safety, and effectiveness. Implementation requires assessing eligibility for a shaking prescription, setting personalized goals, providing guidance as needed, and ensuring appropriate safety measures are in place. Deliberate shaking is a potential adjunct treatment for Parkinsonian tremor. However, it requires further testing.