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Strength Training For Parkinson’s

Study: Weight Training Improves Parkinsons Disease Symptoms

Parkinsons Disease Exercises: Leg Strength

Ive been working hard to regain the strength in my right arm that Parkinsons took away from me. Im making progress. Weight training is a key ingredient in these efforts. It is important to stress that vigorous exercise is not all about cardio, in fact, weight training is a key component.

More specifically, Im referring to weight training as a progressive resistance exercise. This is a strength training method in which the load is gradually increased to allow muscles to adapt. The body adapts to exercise and needs to be constantly challenged in order to continue to grow and change. Essentially, this is the same basic concept we talk about with vigorous exercise, always pushing your limits.

As time progresses, youre increasing the weight, increasing the number of repetitions between rests, increasing the number of sets, and/or adding additional exercises to target complimentary muscles.

Without a doubt, PD makes this harder to achieve. But every small increase confirms that youre getting stronger. And over time, those small increases can add up to something significant.

A few years ago, Dr. Daniel Corcos, with the University of Illinois at Chicago, led a 2 year randomized controlled trial of Parkinsons which compared the effects of weight training vs. more general flexibility, strength and balance exercises. The conclusions were clear:

Back to the study

Happy Exercise!

Tips For Exercising Safely

Before starting an exercise program, consult with your neurologist and primary care doctor about any health concerns and ask for recommendations, the Parkinsons Foundation advises.

Ask your doctor to refer you to a physical therapist who knows about Parkinsons together, the two of you can identify any concerns and physical limitations you may have. Your exercise regimen should be targeted to address your symptoms and physical limitations.

You should stop any exercise or stretch that causes pain, and take steps to prevent falls while exercising, such as:

  • If indoors, remove area or throw rugs
  • Work out in well-lit areas
  • Dont use rolling chairs
  • Work out with friends or buddies, particularly when performing outdoor activities

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Re+active Pt Videos For Home Exercising

Cost: Free

re+active has posted to its YouTube channel a few exercise videos, including a seated re+move class , Parkinson’s exercise class , and pole walking .

Cost: Free

This is a series of 66 short videos. There are stretches, warm ups, workouts, fitness challenges, tai chi, and tips & tricks videos. The idea is by the time you’ve followed along with one video in each category, you’ve done a whole body workout.

Cost: Free

Three short videos include quick chair exercises, exercises for stronger legs and glutes, and exercises for better balance.

Cost: $14.95/month or $135/year after a free one week trial

A growing library of workouts for those with Parkinson’s, including: 5-minute workouts, Undefeated Boxing, Rise & Shine morning blast, exercise ball, Brain & Body Bar, and Parkinsons’ workout with towel and ball.

Cost: Free

This collection of pre-recorded exercise videos includes three 20-minute warm up/stretching videos, four 20-minute seated workouts, one 20-minute upper body boxing video, a 9 minute boxing basics video, two one-hour Rock Steady Boxing Winnipeg workouts, two advanced RSBW workouts, and two yoga Parkinson’s workouts.

Cost: Free

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Strategies To Improve Adherence

Patient adherence will be encouraged in the prerandomisation recruitment consultation. Each patient will be reminded of the session by a telephone call on the day of the meeting. Patient frequencies will be recorded using REDCap. In case of absence, the Intervention Monitoring Committee will contact the patient to clarify the reason for the absence and to reschedule the session. Leaving the session before completion and the reason will also be recorded. Adherence will be reported as a percentage of fully accomplished intervention sessions without protocol deviations given the total number of scheduled sessions .

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Qualitative Analysis Of 12 Included Studies

Exercise for Parkinson

shows the descriptive characteristics of included studies. Publication years varied from 1997 to 2014.

Results of meta-analyses

The effect of PRT on fast walking speed was assessed by pooling samples of three studies.,, The pooled sample consisted of 49 cases versus 55 controls. The pooled effect size was 0.06ms in favour of intervention, but below the minimal detectable change of 0.25ms as suggested previously. The I2 was 61%, indicating substantial heterogeneity.

The effect of PRT on comfortable walking speed was assessed by pooling samples of four studies.,,, The pooled sample consisted of 60 cases versus 66 controls. The pooled effect size was 0.03ms in favour of intervention, but below the minimal detectable change of 0.18ms as suggested previously. The I2 was 15%, indicating insignificant heterogeneity.

The effect of PRT on Timed Up and Go test was assessed by pooling samples of three studies.,, The size of pooled sample was 26 cases versus 29 controls. The pooled effect size was statistically insignificant 0.71s in favour of intervention and below the minimal detectable change of 3.5s as suggested previously. The I2 was 0%, indicating insignificant heterogeneity.

The Eggers test for asymmetry of the funnel plot did not reveal a potential publication bias in any of the syntheses.

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What Kind Of Exercise Can I Do If I Have Trouble Standing Or Walking

Even with advanced Parkinsons symptoms, you can still reap the benefits of some activities. If you have trouble walking or balancing, hold a bar or rail to exercise and stretch. If standing or getting up is tough, exercise and stretch in a chair or bed. Physical exercise performed in a seated position, such as biking on a recumbent bike can allow you to exert yourself in a safe manner.

Facial exercises may help combat difficulties speaking or swallowing:

  • Chew your food longer and more vigorously.
  • Exaggerate your face and lip movements when you speak.
  • Make faces in the mirror.
  • Sing or read out loud.

Mental exercises give your brain a workout and can improve memory. For example:

  • Name as many animals as you can in 1 minute.
  • Play brain games and do puzzles.
  • Solve math problems in your head.

You can also add activity in small bits throughout your day:

  • Park further away from stores so you walk longer distances.
  • Stretch or do leg exercises while watching TV.
  • Swing your arms more when you walk, and take long strides.
  • Take the stairs instead of the elevator.

Secondary Outcomes: Physical Parameters

The studies reviewed have analyzed a variety of outcomes to assess the effects of training in people with PD, including both physical parameters and quality of life parameters, as reported in . For the secondary outcomes, we also considered the effects tested at the peak of the medication cycle.

Seven studies assessed balance using both self-reported scales and specific physical tests. Mini-Balance Evaluation System Test, Berg Balance Scale,,, Activities-Specific Balance Confidence Scale ,,, FAB Scale, Choice Stepping Reaction Time, Single Leg Stand Time,, Maximum Balance Range, Limit of Stability Test,, Center of Mass Displacement,, and the Latency of Compensatory Postural Response to External Perturbation Test were administered. Regardless of intervention type, most of the articles reviewed reported an improvement in balance in agreement with the literature data.,, However, a statistically significant improvement highlighted by the ABC test was reported in the study of Combs et al in the group that carried out traditional exercises compared to the box training group. Shen and Mak also reported a statistically significant improvement in terms of balance/limit of stability in repetitive step group training with respect to the strength training group, although there was no statistically significant improvement between groups., It is worth noting that Volpe et al pointed out a statistically significant improvement in the hydrotherapy group with respect to physiotherapy.

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Walking Economy Walking Work Efficiency And Maximal Oxygen Consumption

Following a 6-min warm-up at low-to-moderate intensity, a 5-min submaximal walking economy test was conducted on a motorized treadmill . The inclination was held constant at 5%, and the speed was adjusted according to the patients body mass to obtain a workload of 40 W . Heart rate and pulmonary gas exchange were measured continuously, and walking economy was defined as the average oxygen uptake during the last minute of the test . Walking work efficiency was calculated as /energy expenditure , where energy expenditure and external work were converted to kilocalories to allow work efficiency to be expressed as percent change . At termination of the 5-min work economy test, the patients were also asked to rate perceived exertion on a Borg scale , and a blood sample was drawn from the fingertip for analysis of hemolyzed blood lactate concentration .

What Are The Findings

Parkinson’s Disease Exercises: Whole Body Strength
  • Strength training performed against a resistance different from body weight is well tolerated in subjects with mild to moderate PD.

  • Strength training improves both physical parameters and quality of life parameters of PD patients.

  • To support the beneficial effects of strength training, clinical trials that include specific muscle strength evaluation are required.

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Sensitivity Analysis And Publication Bias

We used the fast gait velocity analysis, which included in the most literature, as an example to conduct sensitivity analysis and publication bias. Sensitivity analyses suggested that no single study could affect the total effect size by omitting the articles one-by-one. The shape of the funnel plot was generally symmetric in the overall publication, the data points were equally distributed around the funnel and no obvious small sample effects. These showed that no indication of significant publication bias was, respectively, found which is consistent with the Begg’s test and Egger’s test in the overall population.

Figure 10. Funnel plot for the assessment of publication bias.

Where Can I Find Support If I Have Parkinsons Disease And Want To Exercise

You can find exercise support in your community. For example, many gyms and community centers offer seated exercise classes for people who struggle with balance. Ask your healthcare provider for ideas if you have Parkinsons disease and want to exercise.

A note from Cleveland Clinic

Exercise is an important part of managing Parkinsons disease. Talk to your healthcare provider about your exercise program and choose activities you enjoy so you stay motivated to get up and move every day.

Last reviewed by a Cleveland Clinic medical professional on 04/08/2021.

References

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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.

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.

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.

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.

Cost: Free

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.

Cost: Free

Cost: Free

Cost: $25.95

What Types Of Exercise Can Help Manage Parkinsons Disease

Strength Training for People With Parkinson

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

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Compliance And Adverse Events

The average attendance rate for the training group was 90%. In all, participants took part in 1380 training sessions, resulting in a total of 13 adverse events and an incidence rate of 0.9%. None of these events caused injury or pain that interfered with the participants ability to proceed with the balance training or other activities.

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Strengths And Limits Of This Review

The strengths of this review are the selective eligibility criteria and high methodological quality of the articles included. However, we could not answer the question of whether strength training improves motor symptoms and quality of life of PD patients, as we were not able to perform a meta-analysis because data included studies with different designs and different primary and secondary outcomes.

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Neuroprotective Benefits Of Exercise

Neuroprotection is when your brain works to prevent the death of neurons, or brain cells. For people with PD, exercise is not only vital to maintaining balance, mobility and daily living activities, but it has the potential to have a neuroprotective effect.

The Parkinsons Foundation studied exercise as part of our Parkinsons Outcomes Project study. Our Center of Excellence network believes that 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.

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Exercise And Physical Therapy

Parkinson’s Disease Exercises: Boxing with Strength

Research has shown that regular exercise benefits people with Parkinsons disease.

Exercise:

  • 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?

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Weight Training Improves Parkinsons Symptoms

Twice-Weekly Resistance Training Sessions Can Improve Tremors, Slowness, and Rigidity

Feb 16, 2012 Weight training twice a week may reduce the stiffness, slowness, and tremors often seen in people with Parkinsonâs disease, a new study shows.

A progressive neurologic disease, Parkinsonâs affects up to 1 million people in the U.S. Symptoms include tremors and difficulty with movement and walking. The study shows that weight training for two years trumps stretching and balance exercises for these so-called motor symptoms.

The findings are to be presented at the annual meeting of the American Academy of Neurology in New Orleans.

In the study, 48 people with Parkinsonâs disease participated in a weight-training program or another program aimed at improving flexibility, balance, and strength. Participants exercised for one hour twice a week for two years. They were aged 59, on average, and had had Parkinsonâs for about seven years.

Everyone saw benefits after six months, but these benefits lasted two years among those in the weight-training group.

It is always a good idea to talk to your doctor before beginning a new exercise regimen.

âAnyone can do it, from the newly diagnosed to people with advanced Parkinsonâs in wheelchairs. It is never too late to start,â Corcos says.

People in wheelchairs may be able to exercise their ankles using resistance bands, for example.

Static Standing Balance Exercises For Parkinsons

You can start by doing a static standing balance exercise. To start, stand with both feet flat on the floor, with your head and belly button level. Lift your left leg off the floor and hold it there for 30 seconds. Then slowly place it back on the ground and repeat with the opposite leg. You can also add other objects to the exercise, such as a chair or table. Try starting out with 5 repetitions on each side and gradually increasing the number of repetitions.

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Data Synthesis And Analysis

We used a random effects meta-analysis to quantify the pooled effect size of included studies as a more natural choice than fixed effects in the context of multiple clinical trials conducted in diverse settings. In addition, test for heterogeneity supported this choice. The test for heterogeneity was conducted using the I2 statistic describing the percentage of variation across studies originating more from heterogeneity than from chance. We calculated the non-standardised means of difference in change of means for each study and for the pooled study sample. When the SD of difference of changes of groups means was not reported, the coefficient of correlation between prevariance and postvariance was set at 0.6. The potential publication bias was evaluated by Egger’s test for asymmetry of the funnel plot , where the trim-and-fill method was used to impute studies into a funnel plot to correct asymmetry. All calculations for the meta-analysis were performed using MIX 2.0. V.2.0.1.4. BiostatXL, 2011, available from , Comprehensive Meta Analysis CMA, V.2.2.064, available from , and Microsoft Excel 2013.

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