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How a German hospital used ayurveda as supportive therapy to help Parkinson’s patients walk better

Does ayurveda hold the answers for those suffering from Parkinson’s Disease as a complementary therapy? A 67-year-old patient at a German hospital followed an ayurvedic treatment and diet regime for five years, at the facility and at home. The result: She did not need high doses of dopamine, which is needed in such cases to activate neurotransmitters that guide our mobility. She walked steady and had better control of her limbs.

Professor Dr Horst Przuntek, founder of the Evangelical Hospital, Hattingen, Germany, decided to include ayurveda for his patients as early as 2009 when he understood the link between gut health and Parkinson’s Disease. Travelling all across India, he came in touch with several ayurveda practitioners and was taken in by their emphasis on our gastro-intestinal system as the root cause of every single disease in the body. “Now modern medicine is also understanding the gut microbiome and its importance,” says Dr Sandeep Nair, Research Associate, Department of Neurology and Complementary Medicine, Evangelical Hospital, which has a 60-bedded separate department for the neurological disorder.

PATIENTS SHOWED CONSISTENT IMPROVEMENT

“In 2019, we found that 7,650 Parkinson’s patients had benefitted from ayurveda as a complementary treatment alongside allopathy,” he adds. Such has been the efficacy of the combined therapy that the hospital now gets patients from Europe and the Middle East as well.

Dr Nair and Dr Sandra Szymanski, chief neurologist and head of the specialised Department for Neurology and Complementary Medicine at the Evangelical Hospital, were in Goa for the World Ayurveda Congress and Ayush Expo. They showcased the success of Ayurveda as a complementary medicine for patients of Parkinson’s, multiple sclerosis and other neurological diseases. The team has arrested progressive disease conditions with yoga, physiotherapy, occupational therapy, speech language therapy and psychology.

“Currently we have 15-20 patients in our department who are getting Ayurveda treatments in the form of individual and group treatments like yoga and meditation, physiotherapy, ergotherapy, speech therapy, psychological diagnostics and support, various forms of massage, therapeutic affusions, Ayurvedic panchakarma therapy and Marma therapy,” says Dr Szymanski.

WHAT OBSERVATIONAL STUDIES SAY

While randomised trials are awaited, there have been observational studies. “One of the studies, in which Dr Przuntek was also involved, said that a link between the microbiome and the clinical course seems likely. Dietary intervention and bowel cleansing are sufficient methods to impact the gut microbiome in patients with Parkinson’s disease. Therefore, a positive impact on the clinical course is feasible,” says Dr Nair.

According to a study conducted by Dr Przuntek, which was published in the MDPI journal, “In a case-control study, we assessed the gut microbiome of 54 Parkinson’s patients and 32 healthy controls. Additionally, in this proof-of-concept study, we assessed whether dietary intervention alone or additional physical colon-cleaning would lead to changes of the gut microbiome in Parkinson’s patients. Sixteen patients underwent a well-controlled, balanced, ovo-lacto vegetarian diet intervention, including short fatty acids, for 14 days. Ten of those patients received additional treatment with daily faecal enema over eight days. Stool samples were collected before and after 14 days of intervention. In comparison to healthy subjects, we could confirm previously reported Parkinson’s-associated microbiome changes.”

Another study, conducted by Dr Nair and Dr Sunil Kumar, looked at olfactory dysfunction, a frequent non-motor symptom of Parkinson’s disease that involves deficits in odour detection, discrimination, and identification, as it is mentioned in Ayurvedic texts.

“Patients received the prescribed allopathy and Ayurveda treatment for their ailments along with an Ayurveda diet, massage and purification therapies. They were given sniffing sticks supplied by Burghart Messtechnik. A paired T-test was conducted to compare scores obtained in the smell test before and after treatment. It showed that patients, who were treated first with Vasthi and then Ksheerabala oil Nasya, showed significant improvement in scores, which meant that they could smell better. The results of patients, treated with only Vasthi, also showed significant improvement in smell test scores,” they said.

HOW AYURVEDIC PROTOCOLS ARE INCLUDED

Dr Szymanski says that the patients usually receive a vegetarian Ayurvedic diet. In addition, there is a general nutritional advice on the principles of Ayurvedic nutrition and an individualised advisory, which also includes lifestyle modification. Ayurvedic formulations are used internally and/or externally depending on the individual indication. “It has become clear that the principles and treatment methods of Ayurveda, together with conventional methods in primary Parkinson’s disease, bring sustained stability. Patients become stable in their gait and other movements, symptoms do not worsen and they maintain an improved lifestyle,” says she.

The doctors say it is evident that the disease progression can be controlled in neuro-degenerative disorders, mainly in patients with Parkinson’s syndrome, but this was not so obvious before the incorporation of Ayurveda as a complementary system. “A gradual reduction of the Levodopa dose is possible for patients who consistently integrate the prescribed Ayurveda diet, daily routine and treatment instructions in their everyday lives over a period of at least three to five years (depending on the individual constitution and pathology),” says Dr Szymanski.

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Levodopa is the precursor to dopamine and is used as a dopamine replacement agent for the treatment of Parkinson’s disease. It is most effectively used to control bradykinetic symptoms apparent in patients.

Dr Nair adds that a sustained improvement in the motor symptoms of Parkinson’s patients depends on their adherence to the Ayurvedic diet and treatment recommendations. Dysarthria and hypophonia can be treated more efficiently than with speech therapy alone. Common non-motor symptoms, namely hyposmia/anosmia and gastrointestinal disorders such as chronic constipation, are treatable with Ayurveda, in contrast to the limited treatment options in conventional medicine.

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Dr Nair claims that his department at Evangelical is the only medical department in the world where both allopathy and ayurveda doctors go together to inspect a patient in the ward. “Despite the large number of nutritional and treatment instructions, patients do not feel pressured but appreciate the opportunity to actively deal with their illness. Ayurvedic medicine is accepted by our hospital management, our Parkinson’s patients and their various self-help groups. We have managed to create social acceptance in the community,” he adds.

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