Parkinson's and Exercise
Parkinson’s is a neurodegenerative disease that affects an area of the brain that produces dopamine. Dopamine has both motor and non-motor effects on the body. Common motor symptoms of Parkinson’s include: resting tremors, slow movement, rigid muscles, and balance/coordination difficulties. Non-motor symptoms include constipation, apathy, depression, and sleep disorders.
Pharmacological options only address the symptoms, but do not stop the progression of the disease. Exercise is beneficial for everyone, but when it comes to Parkinson’s, exercise can not only help improve both motor and non-motor symptoms, it can also create a neuroprotective effect: protecting the nervous system from damage and slowing down the course of the disease.
Research is still being explored when it comes to the most effective exercise for people with Parkinson’s, but let’s take a look at the evidence to help guide you in developing an exercise program, which could help you find relief from some of your symptoms and help slow the progression of your symptoms. Any exercise program should be created in collaboration with your physician or health care professional based on your abilities and goals.
Cycling has shown benefits in decreasing tremors, improving walking, and improving organization and planning. Depending on a person’s ability, using a stationary bike might be a better option for safety and positioning. Bikes that have a built in motor assist actually show greater benefits than a static bike.
Walking is a great aerobic exercise and has many cardiovascular and mood enhancing benefits. People with mild to moderate Parkinson’s have seen improvements in walking and balance after 6 weeks of treadmill training 40 minutes a day 3 times a week. Aerobic training on a treadmill has also been shown to decrease the fear of falling.
Forced aerobic exercise is done with a partner who pushes you to a certain intensity of workout (90-100% of maximal heart rate). This has been researched in cycling and has shown improvements in stiffness, slow movement, and tremors. Functional MRIs have shown an increased activity in the cortical and subcortical areas of the brain with forced aerobic exercise.
Studies in strength training have been shown to increase muscle mass and bone density, which are favorable outcomes for people with Parkinson’s and can lead to improved function and independence. Lower limb strength training has been associated with an improvement in walking in people with moderate Parkinson’s.
Tai Chi and Yoga
People with Parkinson’s who practiced Tai Chi for 6 months were found to improve balance and decrease falls, as well as demonstrated improvements in movement. Yoga has been found to have a similar effect with the added benefits of decreasing depression and improving quality of life. There are many options for yoga for all abilities, and many poses can be done in sitting.
Looking at research and trying to find “the right exercise” can be overwhelming. One of the most important things when starting an exercise program is making it sustainable. You’re more likely to be consistent with activities that are meaningful and life giving. Sometimes reframing the “why” of exercise can make all the difference.
Some people might feel motivated to do exercise just by thinking exercise is something they “have to do” to slow the progression of the disease, but it might not be the most effective motivator. When we do things because “we should” or “we have to” it doesn’t feel like a choice, and your brain responds by feeling stressed. It might be more helpful to connect more to your body. “I move because it makes my body feel better”. This also helps guide you from overdoing it.
When it comes to Parkinson’s, people can often feel disconnected from their bodies, as it is behaving in such a way that feels out of their control. Making a decision about what kind of exercise that is best for you as an individual actually helps change the way you feel about an activity and it becomes more sustainable.
People with Parkinson’s are especially prone to depression and isolation. It’s easy to spiral further into depression, but neurologically, it works the same way to spiral upward out of depression. One step at a time may seem small, but it helps us take the next step.
Oliveira, d. C., Filho, A. S. S., Murillo-Rodriguez, E., Rocha, N. B., Carta, M. G., & Machado, S. (2018). Physical exercise for parkinson's disease: Clinical and experimental evidence. Clinical Practice and Epidemiology in Mental Health : CP & EMH, 14, 89-98. doi:http://dx.doi.org/10.2174/1745017901814010089
Parkinson’s Disease: a Comprehensive Guide for the Health Care Professional https://pdfs.semanticscholar.org/2580/c8bbcce630bb6fbd7fdc772c1cb592ea3363.pdf?_ga=2.11834356.1156502820.1562712883-1415965256.1562712883
The Science of Parkinson’s Exercise https://medium.com/parkinsons-uk/the-science-of-parkinsons-exercise-part-2-2d680afa1a01
Neuroprotective Benefits of Exercise https://www.parkinson.org/Understanding-Parkinsons/Treatment/Exercise/Neuroprotective-Benefits-of-Exercise
Four Extremely Useful Tips for Creating Your Own Upward Spiral https://lindagraham-mft.net/four-extremely-useful-tips-creating-upward-spiral/
Mayo Clinic https://www.mayoclinic.org/diseases-conditions/parkinsons-disease/symptoms-causes/syc-20376055
American Parkinson Disease Association https://www.apdaparkinson.org/what-is-parkinsons/symptoms/
All content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your doctor or 911 immediately. Reliance on any information provided by the Neofect website is solely at your own risk.
- Clarice Torrey, OTR/LClarice is an occupational therapist, product designer, and health writer based out of San Francisco, CA. Clarice works for RAD Camp as a Community and Product Manager.