Parkinsons Home Exercise Program
You dont need to join a gym or purchase expensive fitness equipment to stay active with Parkinsons disease. On the contrary, there are many great exercises that you can do from the comfort of your home, regardless of which stage of the disease you are in. Take a look at some great examples in the sections below.
What Are The Best Exercises For Parkinsons
An example of one of the best exercises for Parkinsons disease is the toe up, which gets the patient to raise his or her toes when taking a step. Stretches for the neck, arms and legs are also important, although some may be difficult for the patient to perform. Other exercises for Parkinsons include practicing being in small spaces, using small steps when turning and practicing any daily activity that is difficult.
The toe up exercise is one of the most important for people who suffer from Parkinsons disease. To perform the exercise, the person walks slowly while ensuring that the foot lands on the heel and rolls forward to the toe. Also, when performed slowly, the exercise can be used as a stretch for the lower leg muscles, which can help with leg cramps.
Practicing taking steps in the correct way is also important for someone with Parkinsons. In general, the person should use short steps only when turning, and long steps for regular walking. This can take some practice, but can reduce the chance of the patient falling over.
Parkinsons Disease Exercise Program
The goal of the Parkinsons Disease Exercise Program at the Fitness Center at University Hospitals Avon Health Center is to empower people with Parkinsons disease by improving their physical and emotional fitness in a fun and safe environment that encourages healthy choices and camaraderie. The program is a collaboration between University Hospitals Neurological Institute and the Fitness Center at University Hospitals Avon Health Center.
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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.
Seeking Help For Cognitive Changes
Cognitive change is a sensitive issue. In fact, the doctor is often as hesitant to address this subject as the person with PD is to ask about it. Sometimes, the doctor will delay discussing cognitive impairment out of concern for the person who is still coping with the shock of a new PD diagnosis or struggling with motor symptoms.
For this reason, the person with PD often needs to be the one to initiate the conversation. Tell your doctor if you or your loved one is experiencing problems that upset the family or cause interruptions at work.
Cognitive issues are never too mild to address with your care team. A doctor can provide ways to help, often referring you to a psychiatrist, neuropsychologist, speech or occupational therapist for further evaluation and assistance. The neuropsychological evaluation can be particularly useful, especially in the early stages of a cognitive problem. Having this baseline test can help the doctor determine whether future changes are related to medications, the progression of the PD itself or to other factors such as depression.
When reporting symptoms of mild cognitive impairment, the doctor will first want to rule out causes other than PD, such as vitamin B-12 deficiency, depression, fatigue or sleep disturbances. It should be noted that PD does not cause sudden changes in mental functioning. If a sudden change occurs, the cause is likely to be something else, such as a medication side-effect.
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Fun Games For Boosting Brain Health In Seniors With Parkinsons
In addition to tremors, slowness, stiffness, and balance issues, its also common for seniors with Parkinsons to experience cognitive problems, which could include difficulty with solving problems, processing information, doing specific tasks, or paying attention. Playing the following five brain games may help aging adults with Parkinsons manage the cognitive issues theyre experiencing.
Treating Parkinson’s Disease With Exercise
The University of Maryland Parkinson’s Disease and Movement Disorders Center is recognized as a leader in studies of exercise in Parkinson’s disease.
Our current study investigates the effects of physical training and cognitive training on both gait and cognition as well as dual task performance .
“This study builds on our experience from a previous study of exercise for gait and mobility in Parkinson’s disease. Since both motor function and cognitive function are important for mobility and performance of daily activities, this new study will investigate the individual and combined effects of treadmill training and cognitive training,” explains Lisa Shulman, M.D., co-investigator and professor of neurology at the University of Maryland School of Medicine.
The researchers, who received funding through a VA Merit Award, have enrolled more than 90 people with PD who are divided randomly into three groups:
Participants in each group receive physical and cognitive assessments at the beginning of the study. They come into the exercise lab three times a week for three months for their training and then the physical and cognitive assessments are repeated. Three months later, the participants are tested again to assess long-term effects of the training.
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These conflicting results may be linked with the different types of exercises, but also suggest that the benefits of exercise may be function-specific linked with attention, processing speed, executive function, memory, or working memory.
Researchers at the Institute of Movement and Neurosciences, German Sport University, Cologne, Germany and colleagues at the School of Health and Sport Sciences, University of the Sunshine Coast, Queensland, Australia, performed a comprehensive literature review of randomized clinical trials that evaluated the effects of various types of exercise coordination, resistance, and aerobic on specific cognitive function in people with Parkinsons.
Physical exercise is generally associated with increased cognitive function in older adults, but the effects in individuals suffering from PD are not known,Stuckenschneider said.
Eleven studies comprising 508 patients were included . Patients disease severity ranged from mild to severe .
The studys main outcome was overall cognitive function, which was subcategorized in specific domains, including attention, executive function , speed of processing , and memory. The Unified Parkinsons Disease Rating Scale , commonly used to assess both motor and non-motor symptoms, was included as a secondary outcome.
Global cognitive function also showed a tendency to improve after aerobic, resistance, and combined resistance and coordination exercises, but not after coordination exercises.
Brian Grant Foundation Exercise Videos
Publisher: Brian Grant Foundation
Cost: Free
Cost: Free for 9 videos $29/month or $290/year for online streaming
The nine free classes include boxing fundamentals, HIIT , chair fit, tai chi, core, yoga, stretching/mobility. The free classes are 13 to 30 minutes. Classes are led by a physical therapist with Parkinsons specific certifications.
Paid classes incorporate PWR! Moves, cognitive dual task training, balance training, intensity training, and flexibility. For subscribers, new 20-25 minute videos are released weekly.
Publisher: Rachelle Smith-Stallman, Albany, NY
Cost: Free
Dance exercise class videos on YouTube. Each is fewer than 10 minutes long. Nearly 30 videos as of October 28, 2020.
Rachelle was featured at the Davis Phinney Foundation Victory Summit Albany in October, 2020. Watch an interview with Rachelle here, and Rachelles 25 minute Dance Beyond Parkinsons Summit presentation here.
Publisher: Bowen McCauley Dance, Washington, DC
Cost: Free
Six seated dance exercise class videos on YouTube. Each is about one hour long. All are with the same instructor.
Publisher: Mark Morris Dance Group, New York
Cost: Free for 16 videos $50 for 100+ videos
Sixteen archived exercise classes are available for free viewing. Classes are designed to increase coordination, balance, flexibility, and strength through music and movement from a broad range of dance styles. 100+ archived classes and additional benefits are available for a $50 membership.
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Q: What Should Prompt Someone To Ask For A Referral For Cognitive Rehab
A: The following are examples of situations in which cognitive rehab may be right for you:
- You or your care partner have noticed changes in your thinking or memory or have any concerns or questions about your cognition.
- You experience difficulty, slowness, or reduced efficiency in daily situations or activities that require planning, organization, multitasking, making decisions, solving problems, thinking quickly, etc. .
- You or your care partner have noticed that you are starting to withdraw from more cognitively demanding activities or are doing less than you used to.
Even if you have no current cognitive concerns, consultation with an occupational therapist can be helpful to plan or learn strategies to potentially delay functional decline. As with any therapy for PD, it is never too early to think about cognitive rehab!
How To Get Started Linking Parkinsons Disease And Exercise
Because Parkinsons disease clients have special needs, trainers need special training, too. Just ask Bobby Kelly, finalist for the IDEA 2021 IDEA Personal Trainer of the Year. When he first met Parkinsons patient Buddy Linder, Kelly was hesitant to take him on as a client. He was not in great shapein a wheelchair and already losing his ability to speak, Kelly remembers. I initially told his wife, no.
But programs at the local Muhammad Ali Parkinson Center, part of the Barrow Neurological Institute in Phoenix, were full, and the Linders needed help. Kelly thought about it and developed a game planfor himself and for Linder.
Step one, says Kelly, is do your research. That meant contacting the Center and learning everything he could. The Centers stance on exercise is clear: We strongly encourage people with Parkinsons disease to include exercise in their treatment plan, and they recommend training in boxing, dance, yoga and tai chi.
Wait. Boxing? Oh, yes.
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Q: What Is Cognitive Rehabilitation What Problems Does It Address
A: Cognitive rehabilitation refers to interventions that aim to improve or maintain a persons participation in daily life activities and roles by improving cognitive function. There are different approaches to cognitive rehab:
- Restorativetraining : aims to improve or strengthen specific cognitive skills like attention or memory through repetitive practice of tasks that challenge those skills. An example of this approach is computerized brain training games.
- Strategy-basedapproaches : address everyday function more directly by training the use of strategies to work through or around cognitive challenges and accomplish daily activities. Such strategies can range from external devices like memory notebooks and medication alarms, to internal strategies like self-cueing and pacing, to more general planning, time management or organizational strategies for navigating daily activities and routines.
In addition to my clinical interests, my research focuses on these types of strategies and their efficacy in PD. There is variation within and overlap among different approaches to cognitive rehab, and clinicians may employ multiple approaches depending on the persons cognitive and functional strengths, limitations, and goals.
How To Exercise With Parkinsons
Whether you’re a first-time exerciser or a lifelong athlete, the key to working out with Parkinsons is to safely and regularly move your body in a variety of ways. Your fitness regimen should include these four main categories of exercise:
- Aerobic activity
- Balance, agility, and multi-task exercises
People with Parkinsons should strive to perform aerobic activity at least three times weekly and to complete exercises from the other categories two to three times each week.
In total, the Parkinsons Foundation suggests performing 150 minutes of moderate tovigorous exercise weekly.
To help you achieve this goal, try these helpful tips:
- Invest in a treadmill, elliptical, or exercise bike. This will make it convenient to perform aerobic exercise from your home, regardless of the weather.
- Obtain a set of light hand weights from a local exercise shop or thrift store. These can be used for a wide variety of strength training exercises.
- Follow along with one of the many online exercise classes on YouTube that are tailored to people with Parkinsons disease. The Parkinsons Foundation and the Davis Phinney Foundation offer many great online exercise videos.
- Connect with a workout buddy by finding a local Parkinsons support group associated with the American Parkinson Disease Association
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Data Extraction And Quality Assessment
Two investigators independently extracted the relevant data and information from the eligible studies. Basic information about the study characteristics , population, interventions and comparisons , and measurement outcomes was extracted. Another two reviewers evaluated the quality of the included studies based on the standard criteria of the Cochrane Risk of Bias Tool . Any disagreements that existed were resolved through discussion. If necessary, a senior investigator was consulted to achieve a consensus.
Keep On Moving With A New Online Parkinsons Exercise Program
Ready to kick off the new year with a new at-home exercise routine? Youre in luck! Keep ON Moving, a series of home workout videos created for people living with Parkinsons, will help you feel energized, engaged, balanced, and prepared to live well today, throughout 2021, and beyond.
Developed through a partnership between BIAL and the European Parkinsons Disease Association , the exercises are based on the dual-training method and combine voice, movement, and cognitive tasks. Each video is short and can be done in combination with other videos and repeated as often as you would like.
keep on moving workouts available now
- Physical Amplitude Workout. Keep your heart rate up while challenging your ability to divide your attention, engage your memory, and negotiate the visual-vocal connection
- Arms and Legs Working and Thinking Together. This routine focuses on large movements, rhythm, response times, selective attention, and memory
- Brain Exercise. Boost your cognition with exercises in motor planning, dual tasking, memory, and focused attention
- Daily-life Moves Dance-like Exercise. Brighten your day through dance routines that strengthen your memory, dual tasking abilities, motor planning, and focused attention
- Breath and Voice Exercise. Practice voice loudness and articulation while learning new breathing techniques that can help you live well in many aspects of life
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Major Sources Of Risk Of Bias For Clinical Studies
Most of the studies had a selection bias from not adequately standardizing control subjects. More specifically, the subjects physical fitness levels and their concomitant medications before and during the study period were not documented and may have impacted their ability to exercise and the ability to compare their potential benefits on cognition. Additionally, information bias resulted from variability with the timing and intensity of the exercise intervention between subjects. Individuals may have received different amounts and types of exercise which could have affected the impact of exercise on cognition.
Of the five randomized controlled clinical trials, four studies included control groups that received the same social interaction as the exercise intervention group. One study included a control group receiving usual care, which did not control for the potential benefits to the subjects mood and cognition from increased social interaction through participation in the exercise intervention. Overall, both the pre-clinical and clinical studies showed a trend of selective reporting for only significant outcomes. A risk of bias across studies includes a publication bias, as studies with insignificant or negative findings are less likely to be published. The risk of bias for each clinical study is summarized in Table .
Study Selection And Synthesis
There were 14 records included in this analysis . Thirteen records were found through searching databases and one record was found through searching the references of articles identified for inclusion in the analysis. The records comprised six pre-clinical animal studies and eight clinical studies in humans. Of the six pre-clinical studies, all were randomized controlled studies. Two studies examined the effects of exercise on unspecified aspects of cognition , and four studies examined the effects of exercise specifically on learning and memory . Of the eight clinical studies, four studies examined the effects of exercise on unspecified aspects of cognition , and four studies examined the effects of exercise specifically on tasks of executive function . The clinical studies included five randomized controlled trials, one controlled trial and two pre-post trials. A quantitative comparison or meta-analysis could not be performed for either the pre-clinical or clinical studies because there were only a small number of reports identified, and when compiled together they had heterogeneous patient populations, exercise interventions and outcome measures.
Figure 1
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