What Exercises Are Good For Parkinson’s Disease

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How Fitness Controls Symptoms And Which Activities Doctors Recommend You Try

by Cheryl Platzman Weinstock, AARP, April 23, 2021| 0

En español | You know that exercise is good for your heart and that it strengthens your bones. But it’s also one of the more important cornerstones of managing Parkinson’s disease , the second most prevalent progressive degenerative disease of the nervous system that affects movement.

Intensive research in the past several years has found that for Parkinson’s patients, exercise can increase coordination and balance, reduce falls and improve mood. Codrin Lungu, program director in the Division of Clinical Research at the National Institute of Neurological Disorders and Stroke, a part of the National Institutes of Health , says that preliminary evidence also shows that exercise slows the progression of the disease.

To understand how that might be so, research is building on earlier studies showing that exercise in older adults increases brain volume and improves neurological connections in areas that would otherwise undergo age-related decline. Research also has shown that intensive exercise appears to increase dopamine receptors that coordinate signals from the brain to muscles. Scientists believe a lack of dopamine causes PD.

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Strength Training Helps Build Muscle Mass

Strength training can involve lifting weights, using machines at the gym, using your own body weight for resistance, or even using common household items like a milk jug filled with sand, the Parkinsons Foundation notes. Your strength training should focus on the following muscle groups:

• Core muscles
• Arm muscles
• Hands and wrists

In general, strength training should be done two to three times per week, but scheduled so that youre not targeting the same muscles on consecutive days, as your muscles need to rest and recover, the foundation advises.

As with stretching exercises, strength training can be performed while standing, sitting, or while on the ground.

The Wisconsin Parkinson Association recommends several exercises to help strengthen your grip and improve your reach. Tasks such as handwriting and reaching for items on higher shelves can be a challenge for people with Parkinsons disease, and hand exercises can help minimize these issues.

In general, resistance training helps build and maintain muscle mass, Subramanian says. The stronger you are, the more independent youll be.

What Exercises Are Best For People With Parkinsons

Researchers are looking at different types of exercise, including tai chi, tango dancing, gym and resistance training. Often, exercise studies do not compare different types of exercise side-by-side, so there is no definitive answer to which type of exercise is best.

However, at Parkinsons UK we know how important it is to have guidance on the best exercise for Parkinsons. So weve been working with leading physiotherapists and built on their extensive clinical experience to develop recommendations about what exercise is most suitable for people with Parkinsons.

There are different exercise styles depending on how your symptoms affect you. And everyone with Parkinsons should be looking for exercise that help them to do:

• aerobic activity to get the heart pumping
• exercises that concentrate on strengthening the major muscle groups
• regular stretches that move limbs through thefull range of motion
• exercises that focus on, and improve, balance, and
• combined movements that make you think hard as you co-ordinate your four limbs together, or that work your ability to do two or more things at once can play an important part of your exercise routine.

In this post we look at what research evidence there is for popular types of exercise that are recommended and enjoyed by people with Parkinsons.

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The Cranial Nerves And Parkinson’s Disease

I do not believe these points can be co-incidental.

Indeed, the connections between eye health and general wellness are phenomenally strong, and so being mindful of how we use our eyes is a very important part of the jigsaw to progressive symptom reduction. Here, I will cover some of the things I’ve learned and what I’ve found actually helps me. Primary sources are Dr Eric Cobb of Zhealth Education, Cheryl Townsley – Wisdom Coach, Dr Joaquin Farias – developer of the Farias Technique for movement disorders, and Dr Stephen Porges -;developer of the Polyvagal Theory.

Aerobic Exercise Benefits Patients With Parkinsons Disease

ROCHESTER, Minn. Youve likely heard this before: Exercise is good for you. It helps your heart, bones, back and more.

But heres one thing you might not have heard: Ongoing aerobic exercise may slow the progression of Parkinsons disease, a progressive disorder of the nervous system.

Aerobic exercise means vigorous exercise, which makes you hot, sweaty and tired says ;J. Eric Ahlskog, Ph.D., M.D., a neurologist at Mayo Clinic. This could include activity such as walking briskly or using an elliptical machine.

That doesnt mean stretching or balance exercises are not helpful, Dr. Ahlskog notes. Those types of exercises help with Parkinsons symptoms, such as rigid muscles, slowed movement or impaired posture and balance.

But to help fight the progression of Parkinsons disease, including dementia one of the most feared long-term outcomes of the disease Dr. Ahlskog points to scientific studies that show aerobic exercise enhances factors that potentially have a protective effect on the brain. For instance, aerobic exercise liberates trophic factors small proteins in the brain that behave like fertilizer does when applied to your lawn. Exercise helps maintain brain connections and counters brain shrinkage from Parkinsons disease as well as from brain aging, says Dr. Ahlskog, author of The New Parkinsons Disease Treatment Book, which further explores the benefits; of aerobic exercise.

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Parkinson Society British Columbia Exercise Recordings

Publisher: Parkinson Society British Columbia

Cost: Free

Purchase Info:

Cost: Free

Features thirteen men and women with PD of different ages demonstrating;both standard and advanced workout routines with twice-weekly variations.;Intro reviews benefits of exercise and keys to success. Exercises were;developed by physical therapist expert.

Cost: Free

Archived classes from March 2020 to the present include yoga, shadow boxing, multi-tasking/cognition, strength and coordination cardio, bigger and stronger.

Publisher: Parkinson’s Association of Southwest Florida

Cost: Free

Four of the videos posted to the PASF YouTube channel are exercise videos.; Each is 25 minutes long.; Focus of the videos include strength and mobility, balance skills, seated and mat exercises.

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
• Stay hydrated
• Avoid overexertion

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What Kinds Of Exercises Are Helpful For People With Pd

• Any exercise is beneficial. Our;tip sheet;and;podcast episode;are specifically helpful for people with PD.
• Any form of physical exercise you do without injuring yourself will provide benefit. Before beginning any new exercise, consult with your physician and, if available, a physical therapist that understands PD.
• Formal exercise programs balance several different aspects of fitness including strength, balance, coordination, flexibility, and endurance.
• Each of these areas provide a benefit to people with PD. Achieving a balance that works and engages you in a program you can start, maintain and expand upon is the goal.

Many programs target the rapid gains that can be achieved through a focus on improvements in functional capacity and mobility. These programs vary according to different aspects of physical training. Examples of exercise programs for people with PD include:

• Intensive sports training
• Treadmill training with body weight support
• Resistance training
• Alternative forms of exercise
• Home-based exercise

Working Out with a Partner

The Potential Neuroprotective Effect Of Exercise

Arguably the most important benefit of exercise if you have Parkinsons disease is its neuroprotective effects. The Parkinsons Foundation defines neuroprotection as defenses against the damage, degeneration, and/or death of neurons, or the cells in your nervous system.

This is important, given that Parkinsons interferes with the neurons in your brain that control body movement.

In fact, the Parkinsons Foundation says that interventions that provide neuroprotective benefits, including exercise, can change the course of Parkinsons disease in other words, slow the progression of symptoms.

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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.;

How Hard Should I Exercise If I Have Parkinson’s Disease

A rating of perceived exertion is a good way to measure intensity. On a scale from 0 to 10, 0 would be how you feel while sitting or lying down, while 10 would be the maximum effort you can give. Building up to an effort between 5 to 8 means you are exercising at a high intensity. A good gauge is, if you can have a conversation with someone while exercising, you should probably increase your intensity.

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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.

Keep On Moving Exercises To Do At Home

Publisher: Keep It On

Four short videos designed to be challenging and engaging, including physical amplitude, arms and legs working and thinking together, brain exercise, daily-life moves / dance-like exercise.; Repeat them as often as you need to improve your individual outcomes.;;

Coming soon – breath and voice exercise.

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How Hard Should I Exercise If I Have Parkinsons Disease

A rating of perceived exertion is a good way to measure intensity. On a scale from 0 to 10, 0 would be how you feel while sitting or lying down, while 10 would be the maximum effort you can give. Building up to an effort between 5 to 8 means you are exercising at a high intensity. A good gauge is, if you can have a conversation with someone while exercising, you should probably increase your intensity.

Effects Of Physical Exercise On The Treatment Of Parkinsons Disease

Other therapeutic strategies have been evaluated clinically and scientifically in recent years in the search for an action to reduce clinical problems of PD, such as, non-pharmacological interventions like physiotherapy and physical exercise . Rehabilitation through physical therapy has a variety of goals and methods that generally promote benefits in parkinsonian mobility, posture, and balance. However, some limitations have been observed in a consensual way by some researchers in two topics: in relation to the benefits that seem to be more immediate , and the variety and low methodological quality of the studies . Other nonpharmacological approaches to rehabilitation in Parkinsons disease are the practice of different modalities of physical exercises such as walking, running, strength training, whole body vibration and functional exercises, which are related to the reduction in the risk of falls, decreased motor symptoms, motor performance improvements, balance and gait improvements, positive repercussions in quality of life and executive functions .

Kurtais et al. investigated the effects of six weeks of supervised treadmill walking, three times a week for 40 minutes in patients with mild to moderate PD, and observed significant improvements in lower limb functional parameters such as walking, balance, and agility, and in related parameters, the adaptations promoted by aerobic exercise as increase of peak VO2 and caloric expenditure in METs .

Aerobic exercise

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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.

Exercises For Parkinson’s Disease: Managing Symptoms

Determined, consistent, and tenacious are just a few words I like to use to describe my Parkinson’s Disease “fighters.” I call them “fighters” because instead of lying down and giving up, they have chosen to take charge of their future. They commit to FIGHT BACK against Parkinson’s Disease, and that is a “fight” I want to join!

You must observe how the “fighter” moves, processes information, and responds to challenges. As personal trainers, we utilize that information and create fitness programs to address the motor symptoms those living with Parkinson’s Disease struggle with every day. And the best place to start is with “Foundational Movements” that will broaden a fighter’s Activities of Daily Living . People living with PD require a unique fitness program to address the impact of PD on their ADLs.

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Eyes And Thought Patterns

Next time you are lost in your own thoughts, as you come out of the reverie, see if you can be cognitive of what your eyes were doing while you were “in your own head”. What were your “unseeing” eyes actually focused on and was the focal point near or far? Which direction, with respect to your nose,;were they looking? I believe most of us will find that the answers to these questions are different depending on whether we are daydreaming pleasant thoughts or locked into anxious ones?

Boxingcan Give You A Mental And Physical Workout

Yes, boxing can be a fun and beneficial type of exercise for Parkinsons disease, according to the Parkinsons Foundation. However, your boxing routine should be noncontact and performed in a safe and proper setting.

Boxing is a workout that combines aerobic activity, strength training, balance movements, and agility exercise all in one. Plus, it also provides a mental workout, challenging both the body and the brain, the foundation adds.

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Here Are 3 Essential Components For Developing Your Weekly Parkinsons Exercise Routine

Pathophysiology Of Parkinsons Disease

The progressive death of dopaminergic neurons in the Substantia Nigra pars compacta located in the midbrain, more precisely in the Basal Ganglia , promotes a significant decrease in the levels of the neurotransmitter dopamine, and as a consequence the functional impairment of the neural circuits . The chronic reduction in dopamine levels gives rise to the manifestation of the motor symptoms that characterize this disease. However, the pathophysiology of PD is not limited to the dopaminergic system, that is, neuronal degeneration of other areas of the brain such as the brainstem and cortex competes and even precedes neuronal death in BG. Thus, other neurotransmitter systems are compromised, thus making PD a multisystemic pathology manifested by a series of motor and non-motor symptoms .

Examples of experimental tests showing a high and a low data dispersion.

The cardinal motor signs of PD are: resting tremor, plastic-type muscular rigidity, bradykinesia , and postural instability. This set of symptoms associated or not, forges characteristic clinical signs in patients with the disease such as gait and balance disorders, mask facies and dysarthria. In addition to these symptoms, a set of sensory autonomic and cognitive-behavioral symptoms may manifest during the course of the disease .

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