Bowen Therapy Can Improve Some Symptoms of Parkinson Disease
Bowen Therapy Can Improve Some Symptoms of Parkinson Disease
Bowen Therapy Can Improve Some Symptoms of Parkinson Disease
Parkinson Disease
Acknowledgement
I would like to thank all those who encouraged me along this journey. My family and
friends, who read and commented on my ideas, those who offered professional health
advice and the volunteers who so willingly participated in the process. Without all of them
this would not have been possible.
3
Contents
page
Summary…………………………………………………………………………… 4
Scientific Practices……………………………………………………………….. 12
Results ……………………………………………………………………………... 21
Conclusion …………………………………………………………………...…… 23
Glossary……………………………………………………………………………. 25
Bibliography……………………………………………………………………….. 26
Appendices………………………………………………………………………… 27
4
I have been using Bowen technique as a complimentary therapy since 1999. During this
time, 2 clients reported that Bowen Therapy was useful in alleviating some of their
symptoms of Parkinson’s Disease. I therefore decided for the purpose of my research
assignment for the Diploma in Bowen Therapy to follow up with a study proposing that
Bowen Therapy can improve some of the symptoms of Parkinson’s Disease.
1Shulman Lisa M, Acupuncture therapy for the symptoms of Parkinson’s disease, Movement
Disorders, Vol 17,Issue 4, 11 March2002, pp799-802,
5
Background to Bowen Therapy
Bowen Therapy was developed by an Australian, Tom Bowen, a self declared osteopath.
He advocated 3 W’s after a Bowen treatment. A person should drink water, walk (gentle
exercise and continue daily activities) and wait for the reaction. He also thought that a
treatment could consist of 3 or more sessions. He suggested the ideal time between
treatments was 7 days although it could be somewhere between 5 and 10 days for the first
2 sessions. The technique has been taught since 1986. Initially by Ossie and Elaine
Rentsch describing it as Bowtech, and later by others adding variations, describing it as
Facial Kinetics Russell Sturgess, NST ( Neuro Structural Technique) – Michael Nixon-
Levey and Smart Bowen – Brian Smart2 to name a few.
Bowen Therapy is now recognised by many Private Health Funds.
Bowen therapy is a gentle non-invasive remedial bodywork technique which gives muscle
relaxation. The technique uses a series of set precise moves over tendons, ligaments or
muscles and waiting times allowing for the body to respond. It can be done directly against
the skin or through loose clothing. Case studies indicate that Bowen Therapy works, but
as yet there has been no known research to establish why or how it works. It has been
suggested that Bowen could be thought of as the homoeopathy of bodywork as very little
work can have a great effect. Although it is not acupressure, it may at times use similar
positions on the body that acupressure and acupuncture uses.
Russell Sturgess, of Fascial Kinetics, in his introduction to his workshop on Scheussler
Tissue Salts for Bowen Therapists suggests that Bowen rehydrates the fascia or
connective tissue of the body working at a cellular level. He also suggests that ‘clients who
don’t drink sufficient water, smoke, or drink excessive alcohol will not respond as
favourably as someone who does the opposite to those actions.’3 Sturgess also advocates
tissue salts (minute homeopathically prepared doses of minerals naturally occurring in the
cells of our bodies) to complement Bowen Therapy.4
Bowtech suggests that ‘In contrast to other hands-on disciplines, where the practitioner
imposes correction on the client through the technique performed, the Bowen Technique
allows the body to heal itself with minimal intervention. Because of the subtlety of
Bowenwork and the body’s continuing response to it, other forms of manipulative therapy
performed up to four days before or five days after a Bowtech session may interfere with
its effectiveness.’5
Recently in my practice I have been complementing Bowen therapy with Scheussler
Tissue Salts. Initally it came to my attention with one of my Parkinson’s Disease(PD)
clients that administering Nat Mur cleared the light headedness which sometimes people
experience after a session. I have now used it on other non PD clients with similar results.
Nat Mur is the tissue salt which balances water in the body.
1, 2005, pvii
6
Background to Parkinson’s Disease
A description of Parkinson’s Disease as we know it today was first published by James
Parkinson in 1817 in his “Essay on Shaking Palsy”. It is also known as Parkinsonism,
Parkinson’s Syndrome, Paralysis Agitans & Shaking Palsy. Parkinson’s is a chronic
progressive degenerative disease of the central nervous system. Forty years later Jean
Martin Charcot added rigidity to the original clinical description and the syndrome was
named Parkinson’s Disease.
In medical literature the earliest reference to ‘shaking palsy’ was by Galen AD 138 - 2016
and ‘a description of Parkinson’s Disease in Sanskrit under the name of Kampavata is in
the ancient Indian medical text Basquarajiyam in 1400AD7.
Parkinson’s disease patients have lost 60% or more of their dopamine-producing cells by
the time their symptoms appear. Parkinson’s is not a fatal disease however as the number
of dopamine producing cells decline the symptoms become progressively more disabling.
There is no test or scan to positively identify Parkinson’s Disease. Diagnosis is based on a
progressive deterioration in function and clinical impression. No two people will experience
the condition in the same way, so management will vary. Treatment is usually focused on
maintaining a sense of quality of life for the person with PD. There is no widely accepted
known drug which can prevent the progression of the disease. Post mortem
pathophysiology shows a reduction in nigrostriatal dopamine neurons and a massive
reduction in striatal dopamine content. It can also be shown by autopsy of a person with
Parkinson’s Disease that there are microscopic brain structures called Lewy Bodies and
there is an accumulation of iron in the brain.
Most experts share the opinion that PD is caused by a combination of genetic and
environmental factors but no one knows what that combination is. About 10% of people
with PD have a family history of the disease. The origin of the disease has not been fully
investigated yet we know it occurs cross culturally, effecting 4 million people world wide.
Currently the most conservative estimate is that over 80,000 Australians are affected by
Parkinson’s Disease. 4,000 new diagnoses of Parkinson’s Disease are made each year. 8
It is estimated that there may be 2,000 people living with Parkinson’s Disease in
Tasmania.9
It affects both men and women but tends to be more common in men in a ratio of 3:2.
Although the perception may be that PD is an old persons’ disease, 5-10% of those with
the disease are under 40. 1-2 people per 1,000 in the population have Parkinson’s
Disease, increasing to 1 in 100 over the age of 60. Predominately Parkinson’s Disease
occurs in people in the middle to later years (50 – 75). It is the second most common
neurodegenerative disorder after Alzheimer’s Disease.10
A social study of people with Parkinson’s Disease by Susan Moore found that ‘there is a
significant stigma perceived to be associated with Parkinson’s Disease as well as
significant misconceptions about the course and outcome of the disease ’. 11 People living
with PD can be socially isolated as their movement disorder can be interpreted as being
drunk (associated with an unsteady gait) or communication difficulties may occur as their
6 Journal of the Royal Society of Medicine Vol 84 August 1991, Treatment of Parkinson’s disease in
“Ayurveda’ (ancient Indian System of medicine): discussion paper ; p 491
7 www.doi.wiley.com/10.1002/1531-8257
8 Parkinson’s Tasmania Newsletter, Beliefs and Knowledge about Parkinson’s Disease, Aug ‘06.Issue 4,
p4
9 Personal communication, Pauline Domeney, Secretary / Treasurer Parkinson’s Tasmania Inc
10 Beliefs and Knowledge about Parkinson’s Disease op cit
11 Moore Susan, Beliefs and Knowledge about Parkinson’s Disease, E-Journal of Applied Psychology:
There are a number of diseases which include Parkinson’s Disease in their symptoms and
these have been grouped together as Parkinson’s Plus Syndrome.
This includes
Progressive Supranuclear Palsy which is the most common syndrome. People develop
symptoms in their 60’s or 70’s - symptoms including bradykinesia, rigidity, dysarthria and
dementia as do people with PD. Those with Progressive Supranuclear Palsy develop
severe posture instability. Tremor is rare.12
Dementia with Lewy Bodies (DLB) is one of the more common forms of dementia and
shares characteristics with both Alzheimer’s and Parkinson’s Disease. Lewy bodies are
tiny deposits of protein found in nerve cells in the brain which diminish the ability of the
cells to function normally. DLB is characterized by
• fluctuating cognition,
• features of Parkinson’s Disease and
• recurrent visual hallucinations. 14
12 http://oascentral.emedicine.com/RealMedia/ads/click-
lx.ads/emedicine.com/Neuro/MoveNeurodegenerDis/Parkins, Section 4
13 Ibid section 3
14 Wilson, Dr Mark, What is Dementia with Lewy Bodies?, Information Sheet, Royal Hobart Hospital, 15
October, 2005
8
• involuntary movements
• poor balance
• slow movement
• problems walking including a slow, shuffling gait (Parkinson’s gait)
• problems getting up from chairs & in/out of vehicles
• (rigidity) especially in the face
• inability to swing arms
• odd posture including leaning forward and to one side
• festinating gait
• show little facial animation or delayed response in facial expression
• quiet, clipped speech, or problems saying the right words
• slurred speech
• incoherent speech
• problems swallowing
• unchecked drooling
• decreased blinking
• involuntary eye closure
• tiny handwriting
• ‘cogwheel’ jerking movements
• problems with freezing suddenly when trying to move
• diminished muscle strength
• difficulty with turning in bed
• trembling (tremor) at rest, (some experience an internal tremor) tremor may increase
with stress or fatigue
• ‘pill-rolling’ movements with fingers
• problems in grasping objects
• problems in dropping items
• problems in catching or lifting things
The documentary film, The Bridge At Midnight Trembles15, portrays the Australian actor
Richard Moir as he experiences living with Parkinson’s Disease, giving insight into both the
physical and emotional impact on his life. After seeing this I had a clearer idea not only of
how the symptoms impact on the life of someone who has PD, their family and their
friends, but also the impact of the drugs and surgery experienced by someone living with
PD.
15Moir, Richard & Storm, Esben, The Bridge at Midnight Trembles, DVD running time 52mins, released Feb
2006.
9
TRADITIONAL WAYS OF TREATING PARKINSONS DISEASE
Dopamine Agonists
These medications stimulate the dopamine receptors in the brain mimicking the action of
dopamine. Some of these drugs have side effects similar to drugs used in dopamine
replacement therapy and possibly interact with alcohol, anti-psychotics and blood pressure
lowering medications.
An example of this drug is Cabasar
Anticholinergics
This group was the first available treatment for Parkinson’s before levodopa.
They block the effect of the brain chemical acetylcholine, to rebalance its levels with
dopamine. They are rarely used nowadays. There is a possible interaction with anti-
histamines.
An example of this drug is Artane
Amantadine
This has both the dopamine Agonist properties and anticholinergic properties. It may be
used in controlling drug-induced involuntary movements.
An example of this drug is Symmetrel.
The drugs that people living with Parkinson’s have to take lifelong often have strong side
effects and the drugs lose their effectiveness with time.
10
Low dose naltrexone is a prescription drug available for people who have Parkinson’s
Disease. Not all medical practitioners would chose this approach.
“Naltrexone itself was approved by the FDA in 1984 in a 50mg dose for the purpose of
helping heroin or opium addicts, by blocking the effect of such drugs. By blocking opioid
receptors, naltrexone also blocks the reception of the opioid hormones that our brain and
adrenal glands produce: beta-endorphin and metenkephalin. Many body tissues have
receptors for these endorphins and enkephalins, including virtually every cell of the body's
immune system. The drug is taken between 9pm and 3am (usually at bedtime).In 1985,
Bernard Bihari, MD, a physician with a clinical practice in New York City, discovered the
effects of a much smaller dose of naltrexone (approximately 3mg once a day) on the
body's immune system.”
Bihari has since posted on the low dose naltrexone website references to the efficacy on
people who have Parkinson’s Disease in regard to stablising the condition and slowing the
progression of it. In Australia the drug is available at some compounding pharmacies. 16
Surgery for the treatment of Parkinson’s Disease was developed in the 1950’s.
Neurosurgery is increasingly common as a treatment for Parkinson’s. It is best suited to
those who have responded well to levodopa but have problems with involuntary
movements or have large fluctuations in their response to levodopa.
Thalamotomy
This has been the most common form of surgery. It involves lesioning very small specific
areas of the brain - the thalamus associated with symptoms of some forms of tremor.
Around 70% of people with Parkinson’s Disease have a tremor.
Pallidotomy
This involves lesioning of very small specific areas of the brain - the globus pallidus.
Pallidotomy is used to alleviate dyskinesias.
16 www.lowdosenaltrexone.org
11
COMPLEMENTARY AND OR ALTERNATIVE TREATMENT FOR PARKINSON’S
DISEASE
Vitamin E has also been examined in the DATATOP trial but the trial failed to establish
that Vitamin E either slows the progression or manages the symptoms of Parkinson’s.18
Researchers are also examining fermented papaya and blueberries in slowing nerve cell
death. Although optimistic about the research, scientists do not have enough conclusive
evidence to recommend these in the treatment of Parkinson’s Disease.19
Also Creatine and glutathione have shown promise in preliminary studies by The
National Institute of Neurological Disorders and Stroke but there is insufficient data to
recommend them for Parkinson’s Disease.20
Over the counter medications can also have side effects and possible interactions with
other drugs.
Physical Activity
People living with Parkinson’s Disease are encouraged to continue their daily activities as
far as possible. Occupational therapists, speech therapists and physiotherapists may be
able to assist with strategies to improve the quality of life. Exercise routines and sport
activities may need to be modified but do not necessarily need to be eliminated.
Anecdotal evidence suggests that some people with PD have benefited from Homeopathy
– in relieving cramps, Massage in reducing stress and stiffness, Herbal Medicines in
sleep problems and agitation, Hypnotherapy in sleep problems and depression.22
It was reported in the medical journal, Movement Disorders, that researchers found when
using a range of PD and behavioural scales, quality of sleep showed improvement by the
use of Acupuncture. Also 85% of patients reported subjective improvement of individual
symptoms over a 10 – 16 week period of time when they received 2 acupuncture
treatment sessions per week23
17 National Institute of Neurological Disorders and Strokes Press Release Monday October 14, 2002.
18 ibid
19 ibid
20 ibid
21 www.guide4living.com/parkinsons/alternative-treatment.htm
22 ibid
23 Shulman Lisa M, Acupuncture therapy for the symptoms of Parkinson’s disease, Movement
SCIENTIFIC PRACTICES
‘Modern health care is implemented on the basis of evidence based practice.
McKenna et al (2000) argues that evidence can be as much opinion based as research
based27
There are many forms of research undertaken in the medical world today. Some research
is based on gathering evidence from written and oral sources and forming an opinion
based on the materials available. Other research uses techniques which compares
Subjects who receive intervention with those who do not, or investigates differences within
groups of Subjects who all receive intervention.
Broadly speaking research on Parkinson’s Disease explores 2 directions. One seeks the
causes of the disease from a genetic29, environmental30 or combination of the two points of
view.31 The other seeks possibilities for improving the quality of life of the person living with
Parkinson’s Disease32. My research falls into the category of improving the quality of life of
a person living with PD. In Anna Dicker’s terms my research would fit somewhere between
level II and level III as it was a random selection but did not use a control and experimental
group.
METHOD OF RESEARCH
No funding was received for this project and no money was exchanged between
volunteers and the person doing the research. The study was not set up as an alternative
but rather a complementary therapy to the existing treatment the volunteers were already
using. Nobody was asked to withdraw from any prescribed antiparkinsonian medication. In
this aspect it is similar to the research using Transcranial Electric Polarization33.
Initially a flyer34 calling for volunteers from people living with Parkinson’s Disease was
placed in areas within the Huon Valley. This encompassed a variety of shops, libraries,
health service providers, community groups and the local council. in Hobart I contacted a
physician who has patients with Parkinson’s Disease and I contacted the Parkinson’s
Tasmania group. An article was also published in the Huon Valley Newspaper.35
Those who volunteered were asked to complete a questionnaire36 to identify their
symptoms and provide a brief client history. If they were unable to complete the form
themselves a carer or an observer was used to assist in the process. All volunteers were
to be anonymous.
For the purpose of this research I used a random group of volunteers who had been
diagnosed with Parkinson’s Disease by a medical practitioner. The volunteers were offered
4 sessions of Bowen Therapy. 10 volunteers came to consulting rooms but there were 3
volunteers who were treated in a nursing home. The volunteers were not necessarily
treated concurrently but at times of mutual convenience over a time frame which began in
July 2006 and ended in February 2007. All treatments were given by the same therapist.
The specific treatment was tailored to the individual needs of the volunteers as no two
volunteers had exactly the same symptoms.
A limited repertoire37 of moves was used in the Bowen sessions. The sessions were
planned at intervals of week 1, week 2, week 4, and week 6. Volunteers were asked after
each session to complete a table monitoring their symptoms using the terms ‘deteriorated,
28 ibid
29 www.medicalnewstoday.com/printerfriendlynews.php?newsid=45442, Rare Disease’s Gene May
Illuminate Major Disorders, 19 June 2006.
30 P A , Allergy linked to Parkinson’s risk, Mercury, Hobart, Wednesday, Aug 9, 2006, p 19
31 www.findarticles.com/p/articles/mi_mOFDN/is_6_5/ai_68727247/print. Dr Parris Kidd discusses PD
‘including probable etiological factors in the disease: genetic susceptibility, toxic exposure, an inadequate
antioxidant defence system and lack of antioxidant nutrients.
32 www.medicalnewstoday.com/printerfriendlynews.php?newsid=43208, Multidisciplinary Treatment
Program Improves Long-Term Outcomes of Individuals With Parkinson’s Disease, 14 May 2006
33 www.medicalnewstoday.com/printerfriendlynews.php?newsid=40260
34 See Appendix A Flier
35 See Appendix B Research on Parkinson’s Disease
36 See Appendix C Initial Questionnaire
37 See Appendix D Therapists Observations & Treatment
14
remained unchanged, moderate improvement, great improvement’. They were also invited
to make comments about the treatment.38 If necessary they could use a carer or observer
to assist.
Following the fourth treatment an oral questionnaire was given. 39
My hypothesis was that Bowen Therapy can improve some of the symptoms of
Parkinson’s Disease.
STUDY SUBJECTS
All people who volunteered had a medical diagnosis of their condition as being
Parkinson’s Disease or one of the Parkinson’s Plus Syndromes This was a study of
eight people, 4 female and 4 male, drawn from an initial pool of 13 people living with
Parkinson’s Disease in southern Tasmania.
All people who volunteered were initially accepted and received at least 2 treatments.
In my research the Subjects were identified thus: S1, S2, S3, S4, S5, S6, S7, S8, and
volunteers who were withdrawn from the study were identified as V1, V2, V3, V4, V5.
Subjects 1 – 8 received 4 sessions and the volunteers 1 – 5 received 2 sessions.
Of the 13 people who volunteered, 2 had been diagnosed with Dementia with Lewy Bodies
, 2 did not present with a tremor, 2 had a known history of Parkinson’s Disease in the
family, 1 person had been living with Parkinson’s Disease for 33 years. The male to female
ratio was 8 to 5.
Of those 13 people 5 were not included in the study for the following reasons.
2 people withdrew because of matters unrelated to the treatment given.
2 people withdrew because of negative reactions to the treatment. Another person was
withdrawn from the data as I learned that physiotherapy was being given after the
treatment and also that this volunteer had other medical conditions which may have
impacted on the results.
All Subjects in the study received 4 sessions of Bowen Therapy.
1 reported having been treated in the past by a naturopath for Parkinson’s Disease.
Nobody in the study had experienced Bowen Therapy previously.
The age range of the Subjects in the study was between 56 and 86 years.
The age of diagnosis of Parkinson’s Disease ranged between 34 and 85 years. The
Subjects had been living with PD for somewhere between 1 year and 22 years.
1 person in the study had a family history of Parkinson’s Disease. All others had no known
history of Parkinson’s Disease in their family.
2 people in the study had strong opinions on what had caused or triggered the onset of
their PD. One said it was triggered following chickenpox and the other attributed it to his
experience of working with chemicals used in road making.
Only 1 Subject in the study indicated that standing was an issue for them and the same
Subject was the only 1 who identified tremor in jaw. This was the oldest Subject. Only 1
Subject indicated that depression was an issue and was one of the 2 diagnosed with
Dementia with Lewy Bodies.
4 identified
• Difficulty in swallowing
• Walking with a limp or shuffle
• Problems turning over in bed
3 identified
• Stiffness
• Problem getting out of a chair
2 identified
• Muscle pain
• Problems getting out of vehicles
Comments
S4:Felt relaxed for the first 3 or 4 hours after session
S5:[therapist] S5 needed to take medication at 3pm. Took it at 3.30pm. Noted that next
week’s appointment needed to be earlier. Felt quite light headed for 2 hours then had a
headache. Headache disappeared overnight and had extra energy after 36hours. When I
say balance deteriorated it happened in 5cm darkness.
S6: Subject experienced dizziness on rising so nat mur was given. Post treatments
comments by Subject: better urine output and control. Better sleep. No left leg pain. No
night leg pain.
S7: Soreness and stiffness in arms.
S8:[therapist] S8 went to sleep during part of the session
Comments:
S2: Observer reported that after session tremor is less intense and doesn’t last as long.
(She sees him most days.)
S4: If I talk or think about tremor it starts.
S5: Had a slight neck ache also slight improvement in limbs. More stamina. The
deterioration due to medication. (upgraded sinemet ½ tablet every other dose.
S6: (from therapist) S6 experienced clammy sweat during treatment. (from S6 after
session) Generally unwell
S7: During session mentioned he didn’t drink much water. He was light headed after
treatment so was given a glass of water then the tissue salt nat mur. After session S7
commented on soreness and stiffness
S8: [therapist] S8 fell asleep once during session. Nat mur given.
Comments:
S5:just the feeling well being. Still had to take medication for headache. There is an
improvement in my balance as I find I am putting both feet more firmly on the earth. [oral
comments] didn’t need to go to the toilet as frequently as before. She could control it
better. Since having PD I have been more effected by strong smells.
S6: General aches and pains. Feet warm for the first time in ages
S7: Soreness and stiffness
S8:Prior to treatment S8 said he had a bad week. He was still prepared to have a session.
[therapist] S8 fell asleep twice during the session.
Symptoms S1 S2 S3 S4 S5 S6 S7 S8
Tremor in hand G U M G U 3/5
Tremor in leg M U M U 2/4
Tremor in Jaw G 1/1
Tremor in head M M G 3/3
Problems with U U M M U U 2/6
writing
20
Problems dressing U U U U U U
Problems eating M M U 2/3
Problems with U M 1 /2
facial muscles
Difficulty in U M U U 1/4
swallowing
Difficulty in M 1/1
standing
Deteriorating U U M U M 2/5
speech quality
Depression U
Stiffness U U M 1/3
Muscle pain M U 1 /2
Muscle cramps U U G U U 1/5
Stooped posture U U M 1/3
Walking with a limp M U U U 1/4
or shuffle
Difficulty in getting M U U 1/3
going
Problems with U U M M U U 2/6
balance
Unsteadiness U U M M U U 2/6
Problems turning U U M U 1/3
over in bed
Problems getting M U M U U 2/5
out of bed
Problems getting U M U 1/3
out of a chair
Problems getting in U U
or out of vehicles
Falling M M M U U 3/5
Quality of sleep M M M M G U 5/6
Improvement 5/12 1/1 3/12 1/10 14/15 14/16 2/14 7/9
Comments
S4:I get cold trembles inside as well as the ones in my arms and legs. Only after I got PD
S5:legs not so trembly in the early mornings (could be medication). Energy increased. Not
having as many trips to the toilet.
S6: Headaches and pains in hands
S7: Soreness and tiredness, stiffness. Too gentle with treatment.
S8: [therapist] was change from prone to supine without getting off table. Went to sleep
several times during session
When the symptom log was not provided or inconsistent the material was collected from
the final oral questionnaire.
RESULTS
After the first session 5 out of 8 reported there was an improvement in some of their
symptoms of PD.
Half of those presenting with quality of sleep as a symptom reported there was an
improvement.
3 people reported that their symptoms remained unchanged.
After the second session of Bowen therapy all 8 people reported that there was an
improvement in some of their symptoms.
After the third session 7 out of the 8 volunteers reported an improvement in their
symptoms.
1 person reported their symptoms remained unchanged.
After the fourth session 7 out of the 8 volunteers reported an improvement in their
symptoms.
1 person reported their symptoms remained unchanged.
All Subjects reported at some time over the 4 sessions that they had an
improvement in some of their symptoms.
6 people reported that some of their symptoms showed a moderate improvement.
2 people reported that some of their symptoms showed a great improvement.
The following symptoms showed improvement by 50℅ or more of the people in the study
after the fourth session
• Tremor in the hand
• Tremor in the leg
• Tremor in the jaw
• Tremor in the head
• Problems with eating
• Standing
• Falling
• Quality of sleep
22
The only symptom where over 50℅ of people reported that there was an improvement
after each session was Quality of sleep at 83%.
Over the 4 sessions there was an increase in the number of Subjects reporting an
improvement in tremor.
DISCUSSION
When I began my research I did not include quality of sleep as one of the symptoms of
PD to be considered. I was encouraged by medical practitioners to include it and for that I
am most grateful as this was the symptom that consistently showed improvement after
each Bowen treatment in over 50% of Subjects. It is interesting to reflect that Lisa M
Shulman’s study using acupuncture to relieve the symptoms of PD also found that the only
symptom showing improvement was quality of sleep.40
I had no preconceived idea that Subjects would use different indicators to measure quality
of sleep, so it was interesting to see the outcome. One of the people in the study used a
reduction in nightmares and sweating as the measure of improvement. He attributed the
onset of both the nightmares and sweating to the time he began to use one of the
antiparkinsonian drugs. Others measured the frequency they woke during the night and/ or
the need to go to the toilet during the night as measures of quality of sleep. Further studies
investigating the effect of Bowen Therapy on PD symptoms, would benefit by specifying a
variety of measures, including the measure of bladder control/frequency of urination on the
symptom of quality of sleep.
There was an increase in the number of Subjects reporting an improvement in tremor over
the 4 sessions. For easier interpretation of results, given the size of the study, all forms of
tremor were grouped as tremor. Only one Subject reported measuring the improvement by
the decrease in intensity and the frequency of tremor. This Subject only monitored 1
symptom and was also one of the 2 Subjects reporting a great improvement in tremor. It
was difficult for the Subject and or the person who made the observation to monitor more
as the subject was confined to bed in a nursing home, with limited mobility. The observer
visited the subject most days. It may be worth including guidelines for measuring tremor by
intensity and frequency for Subjects in future studies. Many people with PD also adjust
their own medication daily under the guidelines of their medical practitioner so this may
also need to be added to the reality of measuring. This is another factor that might need to
be considered when measuring the effect of Bowen Therapy on tremor.
It would be difficult to extrapolate anything where there was only 1 Subject identifying a
particular symptom. Therefore in this study, ‘difficulty in standing’, although returning a
positive result, has not been commented on in the results: similarly the unchanged status
of the 1 Subject who identified depression.
40 www.guide4living.com/parkinsons/alternative-treatment
23
S6 who reported a great improvement in 4 symptoms was the oldest in the group, had
been given the most recent diagnosis of PD and was the person who drank the most water
(2 litres) daily. S6 found it necessary to drink that amount of water because one of the side
effects of the antiparkinsonian drug prescribed resulted in a dry mouth.
It is interesting to note that the Subjects who drank 3 glasses of water or more daily had
the greatest improvement in terms of the number of symptoms which improved.
Conversely the 2 people who withdrew from the study because of the discomfort they
experienced following sessions, reported that they did not drink any water41. These results
seem to confirm what Russell Sturgess has said about those who can benefit most from
Bowen and seems to support the theory of Russell Sturgess and John Coleman that
Bowen may be rehydrating the fascia. They believe that the fascia rehydrates by drawing
the water from somewhere in the body. If there is insufficient water then discomfort may
occur. It is also interesting to note that after the administration of water then Nat Mur,( the
water balancing chemical in the body), light headedness was relieved. Further
investigation on the effects of Bowen therapy and water consumption could be worthwhile.
S7 who has Dementia with Lewy Bodies, consistently gave the same ratings after each
session42. All symptoms were rated as moderate improvement or unchanged. One of the
characteristics of DLB is fluctuating cognition. It may be useful to consider refining a study
to include only those who have Parkinson’s Disease rather than encompassing those with
this Parkinson’s Plus Syndrome, since the cognition fluctuations of DBL Subjects are likely
to make their responses unreliable, with the potential to skew the results.
Even though Subjects reported improvement in their symptoms they did not necessarily
wish to have Bowen again. It is only conjecture on my part for the reasons for this
response; or it may simply mean that Bowen is not a suitable treatment for everyone. In
the light of experience, if I were to repeat this study, I would attempt to ascertain what
Subjects expected from Bowen Therapy prior to treatment so the outcomes could be
effectively measured against expectations.
Subjects of the study were responsible for the monitoring their own symptoms. Perhaps
some form of objective monitoring could be made. There was no regularisation in the
symptoms monitored or in the severity of the symptoms. This also could be considered in
future studies. All Subjects had a different set of symptoms and therefore the treatment
varied. Perhaps a greater sample would enable a clearer comparison of symptoms to be
made as this study used a small sample from a geographically limited area.
Conclusion
In conclusion, this study resulted in some useful insights, in particular the influence of
Bowen Therapy on Subjects’ quality of sleep, and the correlation between the daily water
intake and the improvement of PD symptoms. In addition, given that people living with PD
experience more tremor when they are fatigued or stressed, the findings of both Anna
Dicker’s study43 (that Bowen reduces stress) and this study (that Bowen improved tremor)
suggest that Bowen may be particularly useful in alleviating the tremor symptom, whatever
its cause.
Wellbeing of Staff, The Australian Journal of Holistic Nursing, Vol 12 Number 5, Southern Cross University
October 2005.
24
It is not possible to make an unbiased assessment, or draw broad conclusions from this
study. However it does provide sufficient initial evidence of symptom improvement to
conclude that Bowen Therapy is useful in alleviating some symptoms of PD and to suggest
that a larger, detailed and more controlled study, possibly limited to the symptoms of
tremor and quality of sleep would be worthwhile.
Glossary
Globus pallidus “the smaller and more medial part of the lentiform nucleus of
the brain, separated from the putamen by the lateral medullary lamina and
divided into external and internal portions closely connected to the stratum,
thalamus and mecencephalon” Mosby’s Dictionary
Kick in period denotes the period of time taken for the drug therapy to take
effect.
On / off periods denotes the time when the drug therapy was having an
effect or not.
Substantia nigra a dark band of gray matter lying between the tegmentum of
the midbrain and the crus cerebri. Mosby
Bibliography
Books
Other references
www.alternativemedicine.com
www.australianprescriber.com, Drugs for Parkinson’s Disease
www.brainaustralia.org.au Brain Disorders Parkinson’s Disease 20June
2003
www.disability.vic.gov.au
en.wikipedia.org/wiki/Dopamine
www.gsk.com.au/gskinternet/publishing.nsf Healthy Home Newsletter
March 2006 edition
www.3.interscience.wiley.com Acupuncture for the symptoms of
Parkinson’s Disease
www3.interscience.wiley.com Evaluation of acupuncture in the treatment
of Parkinson’s disease: A double-blind pilot study
www.lowdosenaltrexone.org
www.movementdisorders.org
www.michaeljfox.org
www.mwc.com Teaching people with Parkinson’s Disease About Their
Medication
www.ninds.nih.gov/disorders/parkinsons;disease/parkinsons;disease;backgro
under.htm National Institute of Neurological Disorders and Stroke
www.nlm.nih.gov/medlineplus Study Shows Impact of Parkinson’s Gene
http://oascentral.emedicine.com
www.parkinsonaction.org
www.parkinsonsnsw.org.au About Parkinson’s Disease Symptoms and
Complications Treatment and Therapies
www.parkinsons-vic.org.au, Parkinson’s Profile
www.pdf.org Surgical Treatments Medications and Treatments
(Parkinson’s Disease Foundation)
28
Appendices
29
Appendix A
Do you have Parkinson’s Disease
or
know someone in southern Tasmania
or
Appendix B
Text given to Huon Valley Newspaper for publication.
It is not contagious and not a mental illness but it is a degenerative disease of the
brain that affects a person’s ability to control body movements. Many people
display a tremor that may be in their arms, legs or head. Others have difficulty
walking and may have a shuffle or limp. Some have difficulty eating, while in
others their speech deteriorates. Many experience muscle pain and cramps.
People living with Parkinson’s Disease may have many of the above symptoms.
Every person living with Parkinson’s is different.
At the moment there is no blood test or scan that determines whether or not a
person has Parkinson’s Disease. It is diagnosed by a medical practitioner. As yet
the cause of the disease has not been established and as yet there is no known
cure.
Drug therapy is the main form of treatment and some people combine it with
physical therapies, diet and self-help programs.
If you have been diagnosed with Parkinson’s Disease or know of someone who
has, and wish to volunteer to participate in the research, please contact Margaret
on 0417 050 449 or after hours on 6297 1644.
32
Appendix C
Initial Questionnaire
Are you or have you been treated for Parkinson’s by any of the following
General Practitioner Physician Neurologist Neurosurgeon
Physiotherapist Occupational therapist Speech Therapist
Nutritionist..Complementary Health Therapist – please name therapy
Margaret Horn
Bowen Therapist
PO Box 138
Franklin
TAS 7113
Dear
Thank you for contacting me. I would like to inform you of what you are letting yourself in
for. Just to fill you in on Bowen Therapy I have included my brochure which I have
available for all my clients. I am an accredited Bowen therapist with the Bowen Association
of Australia and have been practising since 1999.
If you wish to participate in the research you will be invited to experience a treatment made
up 4 Bowen Therapy sessions. Each session may be up to one hour in duration and will
follow the time pattern below.
WK1 WK2 WK3 WK4 WK5 WK6
After each treatment you will be asked to reflect on your response. It may be useful to
make diary notes yourself and or seek observations from those who have close contact
with you.
Prior to the first session I would like you to complete a questionnaire on how you
experience Parkinson’s Disease and return it to me. When I receive your questionnaire I
shall contact you to make your first appointment.
I have also enclosed a separate sheet for your contact details.
After the 4th session I will contact you and ask you to complete another brief questionnaire.
Repertoire of moves
Lower Back
Upper Back
Middle Back
Hit the Lat
Neck
TMJ
Hamstrings
Knee Reflex
Burning Heel
Ankle
Hammer Toes
Pelvis
Non-Response
Cranial
Clammy sweat
Thirst
Need to urinate
Dizziness on rising
Disorientation
Sleepiness
Lethargy
Surge of energy
Hunger
Emotional response
Comments
35
Appendix E
After your Bowen session please list any reactions within 48hours.___________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
Deteriorated
unchanged
Remains
Improvement
Moderate
Improvement
Great
Symptom
_______________________________________________________________
______________________________________________________________
Your next appointment will be at _________ on ________________________
36
Appendix F
Oral Questions to be given approximately a fortnight after completion of 4 th session.
What medication do you take and at what times and how much is taken?
What was the first sign or symptom that you had Parkinson’s Disease?
Looking back in hindsight how long do you think it was before Parkinson’s Disease
was diagnosed?
Have you or any of your relatives had Multiple Sclerosis (MS), fibromyalgia, restless
leg syndrome, Motor Neuron Disease, Polio, Dementia, or Peripheral Neuropathy
(Include grandparents, parents, aunts or uncles, siblings or cousins)
During your life what occupations have you had? Dates or age if possible
What occupations/ hobbies/ pastimes have your relatives with PD( not already
mentioned) had?
37
Have you had any stressful physical experiences in your life and at what ages did
they occur?
Have you had any stressful emotional experiences in your life and at what ages did
they occur?
Do you have any other significant medical conditions for which you are being
treated or have been treated for in the past?
What do you drink of the following each day and how much of it?
Coffee or tea
Fruit juice
Water
Deteriorated
unchanged
Remains
Improvement
Moderate
Improvement
Great
Symptom
As per Subject
Any comments you can make about other reactions to the treatment.
Any comments you would like to make about other reactions to the treatment.