Exercise

Exercise is an important part of healthy living for everyone. For people with Parkinson’s research has shown that exercise is particularly important to help maintain balance, strengthen your muscles, and increase your mobility.

In this video Rachel Dolhun MD from The Michael J. Fox Foundation  discusses the benefits of physical activity, provides tips on starting and maintaining a workout regimen, and covers the latest research on exercise’s effect on PD

What’s the Best Exercise for Parkinson’s? 

It’s not a popular answer, but it’s the truth: The best exercise is one that is safe, enjoyable and that pushes you. Research supports a variety of exercises for Parkinson’s — treadmill walking, boxing, dancing and many others — but one is not necessarily better than another. Some people prefer swimming to biking; others like group fitness classes rather than exercising alone. Still others like to mix up their routine with a variety of workouts. Find what you enjoy and what motivates and challenges you. Then do it regularly, at least three times per week.

How Do I Find What Exercise Works for Me?

Experts recommend beginning exercise as soon as possible after diagnosis, but it’s never too late to get started. A physiotherapist can help guide you to the best exercise program for your needs, as well as help you improve your mobility. 

boxing for parkinsons
Adrian Unger started Punchin’ Parko’s Exercise Program (PPEP) after his diagnosis and said “It’s a way to fight back against Parkinson’s disease.

 

Who Should Exercise? 

Everyone with Parkinson’s should exercise. It’s important for general health and well-being and can ease motor and non-motor symptoms such as constipation and sleep problems. Regardless of your age, fitness level or stage of Parkinson’s, there is something you can do to get and stay active.

What Is the Best Time of Day to Exercise? 

The best time of day to exercise varies based on sleep and work schedules, personality (some love working out before the sun comes up while others prefer nighttime routines) and medication effect. Find a time when your medication typically works best to control symptoms so you have the best mobility and can exercise to your full potential.

 

Are There Specific Exercises for Motor Symptoms?

Certain exercises may be helpful for specific motor symptoms of Parkinson’s:

  • For balance, consider tai chi and yoga.
  • To improve coordination and agility, look into dancing or boxing. 
  • For significant balance problems or limited mobility, seated aerobic exercises can give a challenging workout that raise the heart rate. 
  • To target freezing of gait (sudden, temporary inability to move) or falls, find a Parkinson’s-specific physical therapy program that emphasizes bigger movements with walking and activities and can help with fall prevention strategies. Talk to your neurologist about finding a therapist who specialises in Parkinson’s.
  • For dystonia — muscle cramping that often affects the calves, feet or toes — try lower impact exercises (water aerobics or walking, for example) that don’t bring on symptoms. Stretching overactive muscles and strengthening the opposing muscles also may help. 

 

Do Certain Exercises Target Non-motor Symptoms? 

You can tailor most exercises to work on memory and thinking. For example, while exercising, you can do math problems or name as many items as you can think of in a category (such as animals or automobiles) in one minute. Your physical therapist can provide other suggestions.

Most exercises also can help fatigue, a common Parkinson’s symptom. It sounds counterintuitive to exercise when you feel tired, but this is one of the best treatments for fatigue. You may feel a little worse before you feel better (most people with or without Parkinson’s feel tired when starting an exercise program). Rate your fatigue before and after working out and keep a log to see how much you can do and how fatigue improves over time.

The PD Warrior program is specifically targeted towards people with Parkinson’s. You can find out more in this video below

Play Video

 

Can Exercise Prevent Parkinson’s? 

No therapy, including exercise, has yet been proven to prevent Parkinson’s. But studies of large populations have shown that people who exercise are less likely to develop Parkinson’s. (This means that exercise is associated with less risk of Parkinson’s, but is not necessarily the cause of the decreased risk.)

Does Exercise Slow Disease Progression? 

Pre-clinical work demonstrates that exercise has protective effects on brain cells. It boosts trophic factors, which are like “fertilizer” for brain cells and increases the number and activity of mitochondria, the cells’ energy sources. It also helps you use the dopamine your brain already has, more efficiently. (Dopamine is the brain chemical responsible for normal movement that decreases in Parkinson’s.) Clinical studies also suggest that symptoms may progress more slowly in people who exercise.

Can Exercise Replace Parkinson’s Medication? 

Exercise is just as important as the medication you take for Parkinson’s but it’s not a replacement. Some people are able to decrease their medications because they can manage symptoms with exercise, but others need more medication in order to exercise. (Marathon runners, for example, may need more medication to run for longer distances.) To get the most benefit, work with your doctor to make sure you’re on the best combination of medications to control your symptoms so you can exercise regularly. 

How do I get started

It depends on your overall fitness level, but a good first step is to talk to your doctor and have a thorough checkup before starting any activity. For many people it’s important to start slowly, and one good way to start is with a physical therapist. This way you can get an “exercise prescription” and work with an expert to determine what you can (and can’t) do safely. Especially if you haven’t been regularly exercising, it may be best to begin under the supervision of a professional who has access to professional equipment.

The best way to achieve benefits is to exercise on a consistent basis. People with Parkinson’s enrolled in exercise programs with duration’s longer than six months, regardless of exercise intensity, have shown significant gains in functional balance and mobility as compared to programs of only two-week or ten-week durations.

People new to exercise programs are generally best off working with an individual or group training leader; for people whose mobility is significantly affected by PD, a physical therapist may be the best choice for helping to start a program.

 

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