Parkinson’s On The Move
Thirty-one archived workouts for those with Parkinson’s. Videos are sortable by level of difficulty, area of the body to focus on, and preferred position . Other pages on this website offer free recipes and articles about nutrition and PD.
Also available is the Parkinson’s On The Move Exercise Library. This collection of 58 short videos each focus on stretching or strengthening a specific part of the body.
Suzanne Chen leads 43-minutes of stretch and strengthening exercises for those with Parkinson’s. Equipment to follow along include an elastic band, light weights , a 8-9 inch soft ball , and a stable chair with no arms.
Eight YouTube exercise videos for those with Parkinson’s, including four focused on neuromuscular integration, two total body conditioning and one seated strength. Most videos are about 30 to 45 minutes.
Similar to Rock Steady Boxing in the US, this Australian app is available from Google play or the App Store is designed for early stage Parkinson’s disease. It includes 10 PD Warrior core exercises for free with upgrades and additional bundles available via in app purchases to customize your workout. Each exercise is demonstrated by a physiotherapist.
Recordings of nearly 30 exercise classes that include a warm up, low/medium/high intensity exercises, boxing, dance, and cool down. There are also recordings of choir for PD classes and communications classes.
Creating An Exercise Plan With A Physical Therapist
Before beginning a new workout regimen, the American Parkinson Disease Association recommends consulting with a physical therapist who has experience treating your condition, such as a board-certified neurologic specialist .
A physical therapist can help you select the right routines and exercises to increase mobility, strength, and balance. They can also tailor a plan to your specific symptoms and lifestyle needs.
For example, to improve your performance on a routine skill, like walking, your physical therapist may have you work on whats called dual-task practice, during which they ask you to practice walking while bouncing a ball or counting backward. The idea is to get your mind used to focusing on two tasks simultaneously.
Similarly, if youre having problems getting up from a seated position, your therapist may have you target muscle strength in your legs and ask you to practice sitting and standing with seats at different heights, while counting or answering questions.
There are physical therapists who specialize in neurological conditions, including Parkinsons disease, Dr. Subramanian notes. Having access to someone who knows about the disease helps. In fact, research has shown that working with a physical therapist trained in the needs of people with Parkinsons disease can reduce the number of therapy visits needed and, therefore, patient costs. Given how expensive care for Parkinsons disease can be, thats important.
The Four Key Ingredients
Exercise programs typically comprise four key ingredients: aerobic and endurance training strength training balance training flexibility training. In addition, functional and task-specific training forms part of a more specialised application of exercise that aims to target functional mobility more specifically, still utilising the aforementioned core components to support the efficient performance of specific tasks, and may facilitate transfer of benefits from core exercise components to better overall functional ability.
Every individual is different. Its important to remember that although a combination of aerobic, resistance and balance exercises have the best overall effect, you may need to modify each element to suit your unique circumstance.
Aerobic Exercise:Aerobic exercise is described as continual movement to assist in the improvement of cardio-respiratory function. This includes walking, cycling, swimming and even dancing. Exercising to music specifically has seen some fantastic results in managing Parkinsons Disease symptoms.
Flexibility Exercise:Due to increasing rigidity or stiffness, individuals living with Parkinsons Disease may sometimes need additional stretching exercises. Stretching of the legs, arms and torso are all important to ensure you can function at your best. Research has shown that exercising in a group setting helps with motivation to continue participation.
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How Can It Help In Parkinson’s
Nordic walking can improve fitness in the same way that running does, but it is much kinder to the ankles, knees and hips as it has a much lower impact on the joints. This can be particularly attractive if you experience joint pain.
Perhaps the most important advantage of Nordic walking if you have Parkinsons is that is allows you to maintain and develop your ability to walk well by:
- enhancing balance and coordination
- reducing slowness of movement
- reducing freezingand gait problems
- improving mobility and creating more fluid movements
- correcting posture, particularly the stooped position associated with Parkinsons
- reinforcing the alternating movements of the arms and legs which can be lost in Parkinsons and so improving stability
- boosting independence and quality of life.
Various studies 1,2 have shown that people with Parkinsons who participate in Nordic walking programmes have improved functional independence and quality of life. It seems that mood also improves.
Once the basic steps have been learnt you can tailor your programme to suit how you feel at any particular time. Walking in a group also has social and psychological benefits.
Carers and family members who walk with you may find that they too feel fitter and have fewer aches and pains.
Benefits Of Exercise For Parkinsons Disease
One of the first things that any doctor will recommend in a Parkinsons Disease treatment program is exercise. This is because exercise has neuroprotective effects, which means that it improves the functioning of the neurons that control voluntary movement. Not only does exercise help to manage symptoms and slow disease progression, but it also has excellent psychological benefits and often promotes social interaction. Studies have repeatedly shown that patients who start exercise early on have much better overall outcomes.
Some of the physical and emotional benefits of exercise include:
- Improved strength and flexibility
- Greater social interaction and community participation
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Tips For Getting Started
- First, be safe. Before starting an exercise program, we recommend you to see a physical therapist specializing in Parkinsons for full functional evaluation and recommendations..
- Use a pedometer and figure out how many steps you take on average each day, then build up from there. Many smartphones or smartwatches have a built-in pedometer feature or an application that can be downloaded.
- Exercise indoors and outdoors. Change your routine to stay interested and motivated.
- Again, most importantly pick an exercise you enjoy.
Seek out local PD exercise classes. Across the country, dance classes and boxing groups designed specifically for people with PD are growing in popularity. Contact the Parkinsons Foundations toll-free Helpline at 1-800-4PD-INFO or to find one near you.
Page reviewed by Dr. Bhavana Patel, Movement Disorders Fellow at the University of Florida, a Parkinsons Foundation Center of Excellence.
Parkinsons Disease: Exercises To Improve Mobility
As we discussed earlier, Parkinsons diseases affect your potential to move, but regular physical exercise can assist in keeping your muscles healthy and enhancing your mobility and flexibility. However, physical activities alone will not hinder the progression of the disease, but it will improve your balance and prevent joints stiffening.
The kind of exercise that is suitable for you will depend on your level of fitness, overall health, and symptoms. Ideally, activities that will stretch your limb through the full range of movements are encouraged. Here are some mobility exercises for Parkinsons patients suggestions that you can try: walking, gardening, yoga, and water aerobics.
Final ThoughtsIf you already have Parkinsons disease, regular exercise can help to manage symptoms and slow disease progression. Stretching, exercising, and moving will help to prevent loss of flexibility in your limbs and trunk, strengthening your joints and muscles, and improving your posture.
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What Types Of Exercise Can Help Manage Parkinsons Disease
There are several types of exercises you can do to manage Parkinsons disease. You can create a varied routine based on your specific concerns, fitness level, and overall health.
Aim to do at least a few minutes of movement each day. Include exercises that improve cardiovascular health, flexibility, and strength. If you change up your exercises every week. your body can learn new ways to move.
There are a few different types of exercise that may be especially helpful to those with Parkinsons, including:
- physical and occupational therapy
Tips On Exercise Intensity
Any good exercise will push you just above your limits. A simple way to measure intensity is by using a rating of perceived exertion, or RPE. There are two common scales used 0 to 10 and 6 to 20 but the way to use them is similar. The lowest number on the scale represents no exertion , and the highest number represents the maximum effort you can give.
Ideally, you should build up to a moderate to hard activity peak, around 5 to 8 on the 0 to 10 scale. A good way to check this level is to attempt to hold a conversation while exercising. Youre at a good spot if you feel slightly breathless and can only manage a few sentences.
Studies found that people with early PD who exercised at high intensity had nearly no decline in their motor scores after six months.
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The Basic Elements Of Exercising With Parkinsons
There are four core elements of exercise that are important for people with PD:
Including all four of these elements in your exercise regimen is ideal .
Aerobic activity or high-intensity exercise may be particularly important for Parkinsons and general health
High-intensity exercise has been formally studied in PD with impressive results. The Study in Parkinson Disease of Exercise Phase 2 enrolled 128 people with early PD, who were not yet on dopaminergic medication into three groups:
- a high-intensity treadmill exercise group, in which people exercised at 80-85% of their maximum heart rate
- a moderate-intensity treadmill exercise group, in which people exercised at 60-65% of their maximum heart rate
- a wait-list control group
After six months, the high-intensity group had essentially no change in their motor scores, whereas the control group had a three-point worsening of their motor scores.
Currently, the SPARX3 trial is enrolling participants and underway. This trial is similar to SPARX2, but with a goal of studying many more participants.
Cognitive challenges in exercise
Patients May Experience Stress And Anxiety Initially
Patients who have failed to respond to several medications may have low expectations. Some may be concerned about their ability to be safe in the pool while having a limited range of motion. Being seen in a swimming suit by others can be uncomfortable for many persons who have physical limitations caused by Parkinsons and other diseases.
There are several interventions that can assist people with these difficulties. Other patients testimonials and more data about water treatment might be beneficial. Explaining the treatment pool, Parkinsons disease therapy regimen, and what will happen inside and outside the pool can also be beneficial. In many circumstances, open communication, empathy, and humor may assist patients in overcoming hesitation, shyness, and concern.
How To Start Exercising If Youre Living With Parkinsons
Safety is key. The first thing you need to do is talk with your neurologist and primary care doctor to make sure that the exercise regimen that you embark upon is safe for you.
Next, ask for a referral for physical therapy. A physical therapist will be able to figure out what movement challenges you may have and design a program to help you improve. There are certain physical therapists with additional training in Parkinsons. Your physical therapist will work with you for your allotted sessions, and then can help you plan your ongoing exercise regimen that is tailored to you. You can contact the APDA National Rehabilitation Resource Center for Parkinsons Disease for help finding resources in your area.
Additionally, physical therapy can help counteract the tendency for people with PD to reduce the size of their movements. The Lee Silverman Voice Technique has designed a program called LSVT-BIG which trains participants to make big movements. You can search for an LSVT-trained professional near you.
Anyone starting out on an exercise program could benefit from APDAs Be Active & Beyond exercise guide which includes clear photos with simple instructions that are easy to follow, with exercises that address all levels of fitness.
Agility Flexibility And Balance Exercises
Agility and balance exercises typically integrate the first three types in creative ways. Good examples are:
Yoga, Pilates, or Tai Chi
These three forms of exercise all promote balance and body awareness.
Yoga is a great way to stretch and strengthen your muscles. Many different yoga classes are available, so find one tailored to your fitness level.
Pilates is a unique form of exercise that emphasizes controlled movements and proper alignment. The focus is on quality over quantity, so each movement is performed with control and intention. Breathing is also an important part of Pilates- you will often hear instructors cueing students to breathe into their backs or engage their core.
Tai chi is a form of martial arts that can help improve balance and coordination. It is also a low-impact exercise, ideal for people with Parkinsons. In addition, its been touted as meditation in motion, making it great for easing worry and anxiety.
Water aerobics are typically performed in a pool. It has added benefits for balance training and can ease those who fear falling. The water provides resistance that can help to improve muscle strength and flexibility, and the low-impact movements are easy on the joints.
In addition, the waters hydrostatic pressure can help reduce inflammation and pain. And because water aerobics is typically done in a group setting, its also a great way to socialize and make new friends.
No-contact Boxing or Karate
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How Do You Know If You Or Your Loved One Has A Problem With Swallowing
Swallowing difficulties can start very subtly and initially not be obvious to either the person with PD or their loved ones. There are signs to look out for before swallowing difficulty becomes overt . Some of the signs you should pay attention to include:
- Slow rate of eating people with difficulty swallowing may slow down their eating in order to avoid coughing or choking
- Fatigue during eating or decreased enjoyment of food
- A sensation that food is sticking in the throat
- Coughing or excessive throat clearing during eating
- Difficulty in swallowing pills
- Unexplained weight loss people with difficulty swallowing may reduce their consumption in an attempt to eat without coughing or choking
- Change in dietary habits people with difficult swallowing may alter their diet in order to avoid foods that cause difficulty. This may not be a choice made consciously
- Diagnosis of a pneumonia this could be caused by aspiration, or entry of a foreign substance into the airway
If you think there might be a swallowing issue, it is important to speak with your doctor about it. There are steps you can take to properly assess the situation and improve your swallowing function. This can in turn reduce your risk of choking, make eating more enjoyable, and lessen the chances of unwanted weight loss and/or other discomforts.
How Do I Get Started
Once you have checked with your doctor that Nordic walking is safe and suitable for you, you will need to buy a pair of walking poles. There are various makes to try, so ask others who walk for recommendations and check with specialist companies for advice on choosing suitable poles.
As Nordic walking poles spend a considerable amount of time behind you, they have a strap which goes around your wrist so that the poles can be released behind you and then quickly held again when in front of you. When choosing poles make sure the grip is comfortable and the strap large enough for you to easily slip your hand in and out. The swing-weight is also an important factor, so dont get anything too heavy or too light you should be able to maintain the natural arm swing without too much vibration. Poles are generally quite slim and have an adjustable length. They usually have two different types of end spikes for gripping grass, mud or ice, or a paw to cover the spike when walking on tarmac or asphalt.
The only other equipment you need is loose, comfortable clothing and a comfortable pair of shoes with good support under the heel and across the front of the foot. Sports shoes or boots designed for low level walking are usually well suited. You must be able to push off at the toes, so shoes should bend at the front and not on the arch of the foot.
Exercise And Physical Therapy
Research has shown that regular exercise benefits people with Parkinsons disease.
- reduces stiffness
- improves mobility, posture, balance and gait
Aerobic exercise increases oxygen delivery and neurotransmitters to keep our heart, lungs, and nervous system healthy. General exercise may also reduce depression. Learning-based memory exercises can also help keep our memory sharp .
What types of exercise are best for people with Parkinsons disease?
There is increasing evidence that aerobic and learning-based exercises could be neuroprotective in aging individuals and those with neurodegenerative disease. Facilitating exercise programs that challenge our heart and lungs as well as promote good biomechanics, good posture, trunk rotation and normal rhythmic, symmetric movements are the best. Dancing to music may be particularly good for decreasing stiffness.
Types of exercisesthat do this:
- Walking outside or in a mall
Types of exercises that promote cardiopulmonary fitness:
- Hiking using walking sticks
- Swimming with different strokes with the eyes open and closed not only challenge motor learning but also increase heart rate and provide good cardiopulmonary conditioning.
- New bodyweight-supported treadmills can also be helpful to protect from falling, and to facilitate easier coordinated movements for fast walking with a long stride or jogging.
Types of exercise that do NOT challenge motor planning:
Is there any value in strength training?