PING PONG THERAPY
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Foreword by Cvetka Pavlina Likar
From the foreword:
Foreword by Vinko Kurent
From the foreword:
I only felt the need to enhance my treatment with physical exercise six years after my diagnosis in 2011. I sought an effective group exercise that would allow patients to complement their medication therapy, socialize, have fun, slow the progression of the disease, and improve their quality of life, as well as that of their loved ones. I was captivated by the “Ping Pong Parkinson” (PPP) idea, developed in the U.S. based on table tennis. I was inspired by the experience of American musician Nenad Bach, who regained hand functionality for guitar playing after three years of regular table tennis practice, while also sharing his experience with patients worldwide. Experts who monitored his improvement believe the therapeutic effect of table tennis results from the intense body and eye movements of the patient, along with constant brain engagement, which promotes neuroplasticity, creating new neurons and connections to calculate and send feedback commands to the body.
A friend recommended Gregor Komac, a physical fitness trainer for older adults, a former national table tennis representative, and an active competitor and coach. I invited him for a meeting, described the challenges of Parkinson’s patients, introduced him to the significance and effects of table tennis exercise, and shared my own and others’ experiences. After our first meeting, Gregor and I connected well. Once he reviewed the PPP program, he accepted the position as a coach for Parkinson’s patients.
With quality training, individual competitive progress also began to show. By 2021, we were “ready” for competitive appearances. After the first national championship, with former President of Slovenia Borut Pahor as honorary sponsor, the President of the Slovenian Olympic Committee, Bogdan Gabrovec, awarded us competition equipment for a 7-member team (6 patients and a coach) as a reward for our participation in the 2nd World Championship in 2021 in Berlin.
Physical Preparation
The physical abilities of a table tennis player play a crucial role and vary from person to person, making it important to consider this when planning training. The exercise program should be carefully designed to evenly strengthen all parts of the body to avoid poor posture, which could negatively impact the game.
Each Parkinson’s patient must be physically well-prepared for quality training, especially for tournaments, which require good physical fitness alongside strong technique to achieve progress and top results.
Types of motor skills in table tennis
For successful play, a table tennis player needs coordination, endurance, flexibility, strength, speed, accuracy, and balance. Elite players are characterized by exceptional speed, strength, quick reaction times, and coordination. Special exercises are designed for Parkinson’s patients, with balance, flexibility, and coordination being the most important factors.
The Importance of Breathing
During any physical activity, breathing changes occur. The body requires more energy and thus demands more fuel—oxygen. However, even in sports, we aim to breathe correctly. No matter how important the activity is or how much we focus on proper execution, we must not hold our breath or breathe shallowly and too quickly. At first, you need to consciously focus on breathing until it becomes automatic. It might mean paying less attention to exercises initially, but proper breathing is more important than perfecting a move or a stroke. The basic rule is to exhale when contracting the body (e.g., bending or squatting) and inhale when expanding (e.g., rising from a squat).
Before training, the body needs a thorough warm-up. The goal of warming up is to increase blood flow, especially to the muscles that will be most engaged, reducing the risk of injury. From a breathing perspective, proper breathing creates more carbon dioxide, which will increase oxygen uptake in the cells, widen airways and blood vessels, and contribute to better flow and easier breathing during training.
In certain situations, more power is required for a single movement (like a stroke), which necessitates contracting more muscles, accompanied by a strong exhalation through the mouth. In many sports, this loud exhale sounds like a shout. The next moment, you need to focus on restoring calm nasal breathing.
Whenever you feel the slightest lack of focus, dizziness, or shortness of breath, you should stop the activity and start breathing properly as soon as possible. The intensity and duration of training should be adjusted so that you can breathe through your nose.
Dietary and Other Factors in Parkinson's Disease
Parkinson’s disease (PD) is the second most common neurodegenerative disease, with its prevalence increasing as the population ages. Science has yet to fully understand all the causes of PD or clearly define some of the main ones. The loss of dopamine is a known cause of PD, but what causes this dopamine loss? It is believed that numerous factors contribute to the onset and development of the disease, including oxidative stress, mitochondrial dysfunction, protein metabolism, and neuroinflammation. Most of these factors are related to lifestyle, particularly diet.
Epidemiological studies show a clear link between an increased risk of PD and a Western diet, as well as a positive connection between slowing the disease’s progression and a proper diet and lifestyle. Only with proper nutrition can we obtain the compounds that fight oxidative stress and inflammation, as various phytochemicals alter the mechanisms contributing to the onset and progression of PD.
The disease is characterized by uncontrolled movement while at rest (tremor), which further reduces muscle strength, increases instability, worsens osteoporosis, affects sleep disorders, cognitive abilities, depression, and even constipation. The underlying disease significantly reduces quality of life, and if other conditions are added, the situation becomes even more difficult. Every step and action to slow PD is, therefore, crucial.
Current treatment strategies focus on symptomatic improvement, as there are no drugs to slow the disease’s progression.
The most important thing is to focus on the factors we can control. The good news is that we can do a lot to slow the progression of PD. Parkinson’s patients are not helpless victims, doomed to wait for worse times. There is no reason to give up. They can greatly improve their current quality of life and the times ahead.
So how can we prevent or at least slow the progression of PD?
First: Eliminate all foods and other factors that negatively affect autoimmune and chronic diseases, including alcohol, smoking, sugary drinks, etc. Eliminate or minimize all animal-derived foods and processed foods like sausages, salami, cheese, and other meat and dairy products.
Second: Eat a whole, diverse plant-based diet as close to its original form as possible, grown organically (without pesticides). The diet should focus on starchy foods, with limited intake of fats and processed sugars. Pay particular attention to consuming enough nutrients rich in polyphenols, as well as vitamins D3 and B12.
Third: Make lifestyle changes by increasing care for physical and mental activity, practicing good interpersonal relationships, reducing stress, strengthening connections with nature, and increasing life satisfaction. Regular physical activity is best achieved through table tennis, yoga, meditation, infrared sauna sessions, ensuring adequate sleep, and regular bowel movements.
These measures benefit not only the healthy and young but can also significantly slow the progression of nearly any disease in older and sick individuals.
An example of exercises for balance, strength, and coordination
You have two table tennis balls, one in each hand. Toss both balls so they cross paths in the air, and then catch them. Repeat at least 10 times.
