Parkinson’s On The Move
Publisher: Parkinson’s On The Move
Cost: Free
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.
Publisher: JCC Tampa Bay on the Cohn Campus
Cost: Free
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.
Publisher: JCC Greater Boston
Cost: Free
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.
Publisher: PD Warrior PTY LTD, Australia
Cost: Free
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.
Publisher Parkinson’s Foundation of the National Capital Area
Cost: Free
Publisher: Power For Parkinson’s
Cost: Free
When Should I Start Exercising
Right now! Everyone should exercise more, whether they have PD or not.
In PD, a special kind of neuron that produces the chemical transmitter dopamine gets damaged and lost. However, there is a lag between the time when neuron loss begins and when PD movement symptoms start to show. By the time most people are diagnosed, as much as 40 to 60 percent of their dopamine neurons are already gone. The reason people with PD dont experience symptoms until they reach this point is that the brain can compensate for the loss of dopamine neurons by adapting. In fact, the brain reshapes itself throughout life in response to experience. Scientists call this ability to change and compensate “experience-dependent neuroplasticity.”
Exercise Tips
To find exercise classes in your area call the Parkinsons Foundation Helpline at 1-800-4PD-INFO .
Page reviewed by Dr. Bhavana Patel, Movement Disorders Fellow at the University of Florida, a Parkinsons Foundation Center of Excellence.
*Please note that not all content is available in both languages. If you are interested in receiving Spanish communications, we recommend selecting both” to stay best informed on the Foundation’s work and the latest in PD news.
What Is The Best Type Of Exercise For Parkinson’s
As Parkinson’s affects everyone differently, there is no ideal solution or exercise for everyone. So the exercise framework suggests a blend of styles and intensity that will help people with Parkinson’s do what they can at different times over the course of their condition.
Some people should be participating in more vigorous exercise at the gym, or out cycling and running with friends. Others are best doing chair-based exercises at home.
Exercise might be done individually or in a class, and can be targeted to specific symptoms, like balance, or at improving general health and wellbeing, like walking.
So, to answer this question, we say that the best type of exercise should help people with Parkinson’s to feel and remain as fit and well as possible to manage everyday life.
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How Can I Benefit From Exercise
Symptom Management
Research has shown that exercise can improve gait, balance, tremor, flexibility, grip strength and motor coordination. Exercise such as treadmill training and biking have all been shown to benefit, along with Tai Chi and yoga. So far, studies have shown:
- Engaging in any level of physical activity is beneficial, rather than being sedentary this is associated with improved motor symptoms.
- For people with mild to moderate PD, targeted exercises can address specific symptoms for example: aerobic exercise improves fitness, walking exercises assist in gait, resistance training strengthens muscles. One study showed that twice-a-week tango dancing classes helped people with PD improve motor symptoms, balance and walking speed.
- Exercise may also improve cognition, depression and fatigue, but the research is still ongoing in these areas.
One study showed that people with PD who exercised regularly for 2.5 hours a week had a smaller decline in mobility and quality of life over two years. Research is ongoing to discover therapies that will change the course of the disease.
Neurologists within the Parkinsons Foundation Center of Excellence network recommend a regimented exercise program to their patients and also to people who are worried about getting PD due to family connection.
Can Exercise Help Patients Gain Ground On Parkinsons Disease
In medicines ongoing battle with disease, technology plays a major, ever-evolving role. Advances abound in the form of new drugs, medical devices and gene therapies. But a decidedly low-tech treatment strategy for at least one disease simply requires putting one foot in front of the other literally.
The target is Parkinsons disease, a progressive movement disorder that affects around 1 million people in the United States and 10 million worldwide. While there is no cure, there are drugs to treat the symptoms of Parkinsons, including tremors, rigidity, and impairment of fine motor movements. But a growing body of evidence suggests that a powerful counter to this movement disorder may be, well, movement.
A new nationwide trial that includes the University of Colorado is putting that idea to the test. Study in Parkinson Disease of Exercise is a randomized clinical trial investigating whether regular, moderate and high-intensity exercise can slow the progression of symptoms in patients in the early stages of Parkinsons disease who have not yet begun drug treatment.
Groundwork previously laid
The study, which is underway at 29 sites in North America, builds on the findings of SPARX2. That trial concluded in 2016, with results published in 2018 in JAMA Neurology. SPARX2 was led at CU by Dr. Margaret Schenkman, then director of the Physical Therapy Program and a pioneering investigator in using physical therapy to treat Parkinsons disease.
The SPARX3 Team:
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Bump Up Your Fiber Intake
A high-fiber diet is a proven way to avoid constipation, a common problem for people with PD.
Parkinsons can slow down the intestines and cause constipation, Dr. Gostkowski says. Fiber helps keep things moving. There are plenty of high-fiber foods out there, so choose your favorites. Women should aim for 25 grams of fiber per day, and men should get 38 grams.
The Benefits Of Yogafor Parkinsons Disease
According to the Parkinsons Foundation, yoga can help with flexibility, breathing, and posture as well as relaxation and stress reduction. Best of all, its a self-paced activity, the foundation adds, which means you dont have to perform certain exercises if your physical limitations get in the way. Bonus: Your routine can be modified depending on your needs for example, doing seated yoga in a chair.
Yoga is really my go-to, Subramanian says. Mind-body exercises are really beneficial for mental health, which is important given the risk for anxiety and depression in Parkinsons disease.
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Which Types Of Exercise Are Best For Parkinsons
It is important to state upfront that there is no one best type of exercise for people with PD. It is most important to choose an exercise regimen that you enjoy, and will continue to do.
However, beyond doing exercise that you will stick with, there are some additional concepts to consider when designing an exercise program for someone with PD.
The One Best Exercise For Parkinsons Disease
What is the one exercise that is best? As an Exercise Scientist with a background in strength and conditioning I hear this A LOT. And what is typically meant by this question is, ‘what is the ONE exercise I can do in the shortest amount of time that will fix all that ails me and will make me look good?’ While we all want a magic exercise pill we know there is no such thing. And there is also no one exercise that will address the functional changes associated with having Parkinson’s disease. Decades of data consistently show that an all-inclusive exercise regimen that focuses on muscular strength, cardiovascular fitness, balance and flexibility is key for overall health and fitness, particularly for those with a progressive disease like Parkinson’s.
Importantly, it is not just aerobic activity and cardiovascular fitness that we need to be mindful of. As one ages, muscular strength and muscular flexibility decline resulting in decreased range of motion and less ability to perform common tasks like carrying groceries, walking long distances or up stairs. Due to this, the evidence based guidelines recommend doing muscle strengthening on the major muscle groups 2 or more times per week.
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Best Physical And Occupational Therapy Exercises
Physical therapy exercises target your areas of concern. They can help develop your strength, balance, and coordination. Youll also enhance your functional mobility by improving concentration, flexibility, and range of motion.
Occupational therapy exercises are intended to help you perform daily activities related to work, school, or home with greater ease.
Exercise And The Rate Of Pd Motor And Non
Exercise may also be disease-modifying in fully manifest PD as well as in prodromal and preclinical stages. Longitudinal cohort studies have demonstrated that exercise can be a predictor of slower progression of both motor and non-motor symptoms. In the population-based Parkinsons Environment and Gene study in central California, Paul et al. evaluated the association between physical activity and progression of both motor and non-motor symptoms in 244 subjects with early PD . They analyzed the subjects history of ever having participated in competitive sports and their overall physical activity level, in metabolic-equivalent hours per week , across 4 age periods of adulthood. Over 5.3 years of follow-up they observed that those with a history of competitive sports were less likely to suffer a 4-point decline on the Mini-Mental State Exam , or convert to stage 3 on the Hoehn and Yahr scale of motor disability . There was also a trend between higher MET-h/week and slower progression on MMSE and conversion to Hoehn and Yahr stage 3, with HR 0.71 , and 0.73 , respectively, .
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Focus Training On Specific Body Parts
If a specific part of your body is more affected by Parkinsons, avoid falling into the habit of using it less. You can boost the neural adaptation by forcing yourself to work that limb with strength training and specific task movements. For example, if your left arm is more affected, practice exercises to engage it. Try tapping your right arms fingers, wrist, and forearm with your left hand as quickly as you can. Pair these movements with a mental picture of you doing the activity in your mind. This will further enhance the rewiring that the exercise does, boosting your functioning of that limb.
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 Rachelle’s 25 minute Dance Beyond Parkinson’s 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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Basic Science Supporting Exercise As A Disease Modifier In Pd
In animal models of PD, exercise has shown to be neuroprotective against the neurotoxins, 6-OHDA and MPTP. Several protective mechanisms have been implicated, including neurotrophic growth factors release, anti-oxidation, and anti-inflammation . Tillerson et al. demonstrated in both 6-OHDA and MPTP rodent models that fixed-speed treadmill exercise twice a day for 10 days post-lesioning resulted in recovery of behavioral deficits and attenuated the loss of striatal dopamine, DOPAC, homovanillic acid, dopamine transporter, tyrosine hydroxylase, and vesicular monoamine transporter compared to those rodents who were not exposed to exercise. A prior study by Tillerson et al. also showed that forcing unilaterally 6-OHDA-lesioned mice to use their contralateral, impaired forelimb for the first 7 days post-intrastriatal 6-OHDA infusion could also attenuate both the resulting neurochemical as well as behavioral deficits. They postulated that this neuroprotection was due to the release of neurotrophic growth factors, and then provided evidence for glia cell-derived neurotrophic factor as a candidate mediator .
What Type Of Exercise Should I Do If I Have Parkinson’s Disease
Exercise is a planned, structured, repetitive activity that is intended to improve physical fitness. There is no right exercise for people with Parkinsons. Everyones regimen will differ, depending on overall health, symptoms and previous level of activity. Any exercise helps, and a variety of exercise types may provide well-rounded benefits.
Aerobic exercise
Aerobic exercise involves activities that challenge your cardiorespiratory system such as walking, biking, running, and activities in the pool. Participating in aerobic exercise at least three days a week for 30-40 minutes may slow Parkinsons decline.
Strength training
Strength training involves using your body weight or other tools to build muscle mass and strength. Strength training two days per week, starting with low repetition and weight, may be beneficial in Parkinsons disease. A focus on extensor muscles, or muscles in the back of the body, can help with posture.
Flexibility training
Stretching two or more days per week can be beneficial to maintain range of motion and posture. Holding each stretch of major muscle groups for 30 to 60 seconds can improve muscle length.
Balance and agility training
This type of training often combines aerobic exercise, strength training, and flexibility training. Examples include:
- Dancing.
- Tai chi, yoga or Pilates.
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When Should Someone With Parkinsons Start Exercising
After youve been diagnosed with Parkinsons, try to start an exercise regimen as soon as possible, says the Parkinsons Foundation. The foundation calls this the pre-habilitation stage, and warns against waiting until you start to have pain or problems with your movements to begin an exercise regimen.
Still, its never too late to start. People who have advanced Parkinsons and exercise have better health-related quality of life than people who dont exercise, so its important to stay active and even try new routines as your condition progresses.
There are so many benefits to exercise with Parkinsons disease, Subramanian says. In addition to all the positive effects on symptoms and progression, there are other benefits as well, including social ones, if you work out as part of a group. Exercising will also likely help you to sleep better, which is important for overall health.
Really, she continues, the more physical activity the better, as long as youre safe. And if youre worried about staying motivated, a general rule is that any exercise that you love is something youre going to keep doing.
Dont hesitate to try different things, too, which will challenge your brain and your body. Youll see the positives right away, she says.
Neuroprotective Benefits Of Exercise
Exercise is an important part of healthy living for everyone, however, for people with Parkinsons disease exercise is not only healthy, but a vital component to maintaining balance, mobility and daily living activities, along with a potential neuroprotective effect. The Parkinsons Foundation Quality Improvement Initative studied exercise as part a Parkinson’s Outcomes Project study.
Every Center of Excellence agrees that they believe exercise is important to good outcomes in PD, and data supports that. Exercising enhances the sense of wellbeing, even across different disease stages and severities. There is a growing consensus among researchers about the short and long-term benefits of exercise for people with PD.
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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.