I was trying out a couple of new classes at the gym last week for a bit of variety. The first was Zumba which I’ve never done before. I think I’ll probably go again. First thing I noticed was all the chatter beforehand. I’ve been plodding away at my routine in the gym but it’s not as sociable as a class.

I really like the music too - I used to love dancing and it is just a good excuse to have a dance in the middle of the day. I’ll have to watch a few on youtube to get the hang of the steps. It’s always a struggle trying to get my eyes open at the right time to see what her feet are doing. I tried hiding at the back but of course every now and then everyone turns round and suddenly you are at the front.

I was wary of doing the turns as I didn’t want to keel over. By the end I was freezing a bit and staying closer to the wall. And if I tried to turn then my neck is so stiff I can’t look over my shoulder to see what they are doing. It was certainly a lot gentler than the yoga class I tried last year.

Then I signed up for another one which looked like it was dance based. However once in the room people were getting mats out. Turns out she plays music to cover the sound of your creaking muscles while your abdominals are put through their paces. Fortunately all my hard work in the gym has paid off (three times a week) and apart from being hopelessly slow and uncoordinated, I managed and it’s probably just what I need to shift some spare tyre.

She did a few yoga type stretches too and I remembered I had the same difficulty trying to figure out how to copy some of the arm & leg manoeuvres over 15 year ago when I first started yoga.

About 5 years ago a neurologist tried to get me to copy a sequence of hand movements – the Luria 3 – step. I found it extraordinarily difficult.

I asked for an assessment of my memory and cognition and a specialist memory clinic acknowledged ”both memory and executive difficulties”

Impairment of motor planning in patients with Parkinson’s disease: evidence from ideomotor apraxia testing G GOLDENBERG, A WIMMER, E AUFF, G SCHNABERTH Journal of Neurology, Neurosurgery, and Psychiatry 1986;49:1266-1272

It is suggested that defective encoding and central processing of visuospatial information impairs memory for movement which is necessary for correct imitation of movements. Enhanced vulnerability to interference between successively presented items may cause further deterioration of performance in the copying of movement sequences.

Luria’s three-step test: what is it and what does it tell us? M. F. Weiner, L S. Hynan, H. Rossetti, and J. Falkowski P Int Psychogeriatr. 2011 Dec; 23(.10): 1602–1606.

In our clinic, the procedures of the three-step Luria test require that patients imitate three hand motions performed by the examiner. With fingers fully extended and the patient following, the examiner places his right hand with a cutting motion on his right knee or on a table, then in a fist with the knuckles down, and then palm down with fingers extended. Examiner and patient then repeat this three more times. The hand motions could be reinforced by counting from 1 to 3 along with each segment, or by saying “cut, fist, and slap.” Patients are then asked to repeat the movements unguided by the examiner.

Management of Neurobehavioral Symptoms in Parkinson’s Disease Jorge L. Juncos and Ray L. Watts 2003

Mild to moderate cognitive dysfunction affects may nondemented patients with PD. Although this dysfunction has been termed bradyphrenia, the cognitive equivalent of bradykinesia, it is now clear that the dysfunction extends beyond a mere slowing of cognition to include aspects of working memory, attention, mental flexibility, visuospatial function, word fluency, and executive functions.

The latter include anticipation, planning, initiation, and the monitoring of goal-directed behaviors. The biochemical basis for these deficits is thought to be, at least in part, due to denervation of the dopaminergic and noradrenergic inputs to the frontal lobes.

Profile of Cognitive Impairment in Parkinson Disease G. S. Watson and J.B. Leverenz Brain Pathol. 2010 May; 20(3): 640–645.