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.
Dance For Pd Instructional Dvds/streaming
Cost: vol. 1 DVD $29.99, vol. 2 DVD $59.98, vol. 3 $29.99 DVD, vol. 4 $24.99 stream or download , vol. 1, 2 or 3 streaming $23.99 each, full media bundle $120 .
Each volume is a complete class with movements that draw from ballet, modern dance, tap, jazz and improvisation to create accessible, stimulating dances for all.
Volumes 1 and 3 feature seated and standing dances, and a teacher is always on screen to demonstrate both seated and standing versions. Volume 2 is designed to be done seated. Volume 4 is the first all standing class, but can be equally enjoyed from a chair.
Cost: Free
In early 2019, trained and licensed Dance for PD affiliate, Pamela Lappen, posted a series of twelve 30-minute videos on YouTube using the Dance for PD exercise model. Between March and September 2020, she posted five more exercise videos .
Cost: $39.95 for book/DVD set
This exercise program includes categories such as wake up call, walking and balance, cardiovascular, strength, facial and vocal, and night-time stretching. Suitable for any disease stage, with many levels of difficulty. Designed by certified trainer and orthopedic surgeon with PD.
Cost: $39.95 for book/DVD set
Fifteen chapters are organized by activity of daily living, including getting off the floor, getting out of a car, getting out of bed, freezing, moving about in big crowds, and getting dressed.
Cost: Free
Cost: Free
Cost: $50/month
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.
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How Can Exercise Help
Drug therapy has changed the trajectory of the disease progression for many with Parkinsons, and theres exciting research that supports the role of exercise in slowing and even reversing some symptoms. It appears that exercise stimulates the brain to better compensate for the reduction in dopamine production through a process called neuroplasticity. This process essentially rewires the brain, creating new pathways that enable the body to move more normally.
Peter Schmidt, Ph.D., senior VP and chief research and clinical officer of the Parkinsons Foundation, says that those with Parkinsons disease can gain significant benefits from including two and a half hours of moderate to intense exercise every week. That amount seems to be the sweet spot for slowing the progression of the disease and improving motor function.
Taking part in almost any exercise is great for those with Parkinsons, but Dr. Schmidt stresses that including new activities that are new helps challenge neural circuits and stimulates the brain to learn, which can have the biggest impact on slowing the progression of the disease.
Heres a list of activities that will keep you moving well with Parkinsons disease.
Aaptiv has thousands of different workouts, ranging from strength, outdoor running, to meditation and yoga.
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.
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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.
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.
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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
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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Early Exercise Can Decrease Depression In Patients With Parkinson Disease
Exercise is known to offset many physical side effects of Parkinson disease. A recent pilot study suggests that early exercise also can reduce depression symptoms among individuals with PD.
A study of 31 patients randomly assigned to two groups found that patients in the early start group scored “significantly better” on the Beck Depression Inventory, according to Parkinsonism & Related Disorders .
Physical therapists are movement experts who develop treatment programs to help people with Parkinson’s Disease stay as active and independent as possible. They improve quality of life through hands-on care, patient education, and prescribed movement. You can contact a physical therapist directly for an evaluation. To find a physical therapist in your area, visit Find a PT.
Important Things To Focus On In Your Parkinsons Exercise
Patients with Parkinsons disease usually find it difficult to be independent in daily activities of living. However, self-exercise is one of the best ways they can improve and train their body to reach a good level of independence in their daily life. Here are 10 wonderful exercises for individuals with Parkinsons disease that target range of activities.
1. Maintaining your balance
To maintain balance, patients of Parkinsons disease can practice swinging both arms while walking. This will lessen fatigue and loosen the arms and shoulders. Furthermore, walking while changing the speed of your gait from fast to slow from one destination to another is a good technique for improving your balance. Using a chair as a support, you can also do leg lifts to the front and side, making sure that your back stays straight and your spine remains in a neutral position.
2. Walking
The best exercise to improve your walking in Parkinsons disease is toes up! The rule is to stride forward, striking the heel and rolling the foot as you transfer weight forward to the toe. This is a good way to avoid commonly occurring calf cramps or freezing, making the lower leg active. In addition, always practice walking briskly, with both arms helping to elevate the strides. To aid balance, legs should always be further apart while walking.
3. Sitting and standing
4. Posture and tight muscles
5. Fine motor skill: Working the hands and fingers for everyday tasks
6. Facial exercises
7. Voice exercises
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Exercise And The Risk Of Developing Pd
Most prospective cohort studies have found an inverse relationship or trend between physical activity and the subsequent development of PD , with a pooled hazard ratio of 0.66 for developing PD when comparing the highest level of physical activity with the lowest level . The first published study linking prior physical activity to PD was by Sasco et al. who carried out a case-control study in 50,002 male students attending the University of Pennsylvania and Harvard College between the years 1916 and 1950. Their study observed lower odds of developing PD if the student played varsity sports or underwent regular exercise in college with OR of 0.64 and 0.83, respectively. They also observed that in adulthood, those subjects who engaged in moderate exercise or heavy sports had lower odds of developing PD, although neither of these associations achieved statistical significance .
Other epidemiological studies that support the inverse relationship between physical activity and developing PD include studies from the NIH-AARP Diet and Health Study cohort , the Cancer Prevention Study II Nutrition Cohort the Finnish Mobile Clinic Health Examination Survey , a populated-based case-control study in California , and the Survey of Health, Aging and Retirement in Europe .
Apda In Your Community
APDAExercise & Parkinson’sWhat types of exercise are best for people with Parkinsons disease?
In last weeks blog, we addressed the reasons why it is vital for people with Parkinsons disease to exercise, including improving particular motor and non-motor symptoms such as impaired balance, gait disorders, depression, and cognition.
Today, we will tackle another important question what types of exercise are most beneficial to help people with Parkinsons disease improve their quality of life? Well also address several specific types of exercise designed for people with PD and some tips on how to get started with an exercise program.
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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.
Add Medication For A Winning Combo
Diet and exercise are important for managing PD, but dont forget about medications. Take them regularly and exactly as your doctor prescribes.
If you tend to forget your medication, set an alarm to remind you. You can also use a pillbox thats labeled with days and times of day. Take your meds on a set schedule, dont skip doses and dont double dose, says Dr. Gostkowski. When youre diligent about taking your medications and following a healthy lifestyle, youll feel your best.
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More Questions To Contemplate
Christiansen emphasized that exercise is not a replacement for medications that effectively manage Parkinsons disease, notably carbidopa-levodopa and dopamine agonists, which are a group of drugs that fire parts of the brain that are normally charged by dopamine. However, he added, exercise could help people safely avoid the side effects of these medications, at least temporarily.
It would be impactful if we could possibly delay the onset of symptoms, and/or decrease the dose of medications, Christiansen said.
He added that SPARX3 will also examine a host of potential secondary outcomes of regular exercise, including improvements in quality of life, cognition, walking, fitness, and quality of movement. Researchers will also scrutinize blood biomarkers that are indicators of inflammation and changes in the nervous system.
In fact, the SPARX3 trial launch only begins to answer many questions about the promising but emerging benefits of exercise for Parkinsons disease patients, Christiansen said.
Were hopeful that both groups will show the benefits of exercise, but we dont know if it will be one or the other or equal, he said. He noted, for example, that its not a good thing if patients spend so much energy on their exercise regimen that they have little left over for activities in the community.
We dont know if more intense exercise is better, he concluded.
For more information on the SPARX3 trial, contact study coordinator Katherine Balfany at or 303.724.9101.
Parkinson Society British Columbia Exercise Recordings
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.
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.
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