Parkinson’s and exercise: What do I do?

Parkinson’s Disease has always been a professional interest of mine but the interest became more personal when my Dad was diagnosed several years ago.

When it comes to our bodies there isn’t much that isn’t helped by some level of regular exercise. Got an ailment, diagnosis, ache, or pain? There’s an exercise for that. However more and more research is coming out in supporting the role of exercise in slowing the progression of Parkinson’s disease. Exercise and skilled physical therapy can also improve balance, gait, and strength deficits that already exist. However, you are best served to start exercising early and often. Heck how about we exercise before we get a Parkinson’s diagnosis! That would be ideal right? But if you or someone you love has recently been diagnosed with Parkinson’s Disease, you better get moving….literally.

This NIH study looked at 3 different types of exercises, low-intensity treadmill exercise, high-intensity treadmill exercise, and a combination of stretching and resistance training. They concluded” Sixtyseven patients were randomized to either lower-intensity treadmill exercise, higher-intensity treadmill exercise, or a combination of stretching and resistance training. For their primary outcome of gait speed, all training types increased distance walked in 6 minutes at 4 months, but lower-intensity treadmill exercise led to the greatest increases. For their secondary outcome of cardiovascular fitness, both treadmill groups demonstrated improvement. In contrast, the stretching-resistance group improved muscle strength and motor scores on the Unified Parkinson Disease Rating Scale. The authors conclude that all 3 types of exercise have benefits, and patients may benefit most from a combination of lower-intensity training and stretching and resistance.”

They also reviewed a collection of other studies on the benefits of exercise and Parkinson’s, and they put the results into a nice easy to read table. Basically, if you look at almost all the studies exercise is good and the key is that it helps slow the progression, so it’s important to start early.

All this information can be overwhelming. What do I do? What if I didn’t start early? Do I walk, do I do yoga, do I go to the gym, a fitness class? First, check with your doctor to be sure it’s safe for you to exercise.  If you are moderately or severely affected all is not lost, exercise can still benefit you. I would recommend that you first seek out an experienced Physical Therapist in your area to assess your areas of need and get you started on an exercise program. If you are newly diagnosed, do something, anything, that you enjoy so you will keep up with it. Having worked with people with Parkinson’s these are the things I think a good exercise program should include.

Conditioning

Fatigue is a very common symptom of Parkinson’s disease. Some sort of cardiovascular conditioning program like walking, biking, aerobics class can help improve your endurance, ward off fatigue, and improve sleep.

Strengthening

Getting and staying strong as we age is important for all of us but especially important for those with neurological conditions. Increasing strength can reduce the risk to fall, maintain independence and lead to overall improved quality of life. I especially like exercises that include trunk rotation and move through several planes of motion not just one, and whole-body functional exercises.

Flexibility

Parkinson’s makes muscles and joints very stiff. Every individual with Parkinson’s should stretch regularly to maintain joint mobility and range of motion. I have always liked to pay special attention to neck and trunk range of motion, and extension. Parkinson’s pulls you into flexion, so paying attention to stretching the legs and spine into extension is important.

Balance

Postural instability is a common symptom of Parkinson’s disease and balance exercises should be a significant part of any exercise program for Parkinson’s. Preventing falls before they happen helps maintain independence. Not to mention that having a fall is a major blow to a person’s confidence making them afraid to get up and move which leads to decline and increased risk to fall, it’s a vicious cycle.

It’s hard to know where to start. You can always ask your neurologist if they know of any Parkinson’s specific programs in your area or for a referral to Physical Therapy. Youtube and the internet have many videos of Parkinson’s specific exercises. If there aren’t any Parkinson’s specific classes in your area, look for classes specifically for seniors, they tend to address, strength, conditioning, and balance. And you can always find a knowledgeable personal trainer to help you develop and stick with a personalized program tailored specifically to you.

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