Phase One – Weeks 1 and 2
Evaluate the current PwPs in the four districts of Uganda where we will work. They include Jinja, Budaka, Iganga, and Kibuku. Current patients number about 160.
Since few have been diagnosed by a physician, each will receive a complete neurological examination. Those that meet the criteria for a diagnosis of PD will receive an additional quantitative evaluation using the Unified Parkinson's Disease Rating Scale (UPDRS).
Those who do not meet the criteria will still be included in the program, but their records will be kept separately. Those who are unable to walk unassisted will be provided with a palliative care regimen.
An additional problem will be addressed at this evaluation. Currently there is no testing for vitamin B-12 deficiency. Even if testing were available, the cost would be prohibitive. People with B-12 deficiency often have symptoms similar to PD. A simple screening test that could identify them relates to the impairment in sensing vibrations of a tuning fork held on an ankle bone. Those who cannot perceive 256 Hz vibrations will be started on daily sublingual vitamin B-12 tablets.
Phase Two – Weeks 2 and 3
This phase will focus on education and coaching. Education will include not just teaching PwPs, but also educating the paraprofessionals and volunteers. Group meetings will be held to foster trust, community, and education about PD.
Two specific physical activities will be taught. Mindful Swift Walking and Yoga. The walking instruction will be in small groups. And local paraprofessionals will be instructed in the methods of coaching. PwPs will be encouraged to mindfully swift walk a minimum of 3 days a week. A yoga instructor will be evaluated for her teaching methods and that person will be transported to each district. Ideally instruction should be twice weekly in each district.
We will cooperate with a company called CliniCrowd that is gathering data about the effectiveness of a naturally occurring nutriment called mannitol. Previous studies have gathered data suggesting that mannitol may be effective in the treatment of PD. All confirmed PwPs we work with in Uganda will be offered mannitol at the rate of one to two teaspoons twice a day for at least a year.
The CliniCrowd Platform is a protected crowd-based platform that collects, analyzes and generates the communities veriﬁed experiences with researched Nutriments.
Click here to visit their website
Phase Three – Weeks 3 and 4
Visit each district and confirm that education, group meetings, Mindful Swift Walking and Yoga are scheduled and will meet regularly.
During this time, all PwPs’ information will be entered into a database for continued evaluations three times a year.
Ongoing efforts to interact with officials at the Ministry of Health and Makerere Medical School in Kampala will continue to take place. Every possibility of interacting with them will be pursued.
A budget for in-country ongoing support will be created.