In this article, we examine why exercise benefits people with Parkinson's disease (PD), and how it affects the brain. We also take a look at some examples and tips for exercising with the condition.
Why is exercise good for people with PD?
Exercise may help to improve balance, coordination, grip strength, and tremors in those with PD.
The Parkinson's Foundation say there is growing evidence of the short and long-term benefits of exercise for people with PD.
A study, known as the Parkinson's Outcomes Project, by the same organization, found that people with PD who did exercise for at least 2.5 hours a week experienced a slower decline in their mobility and quality of life than others.
One of the main benefits of exercise for people with PD is symptom management. This includes improvement of:
- grip strength
- motor coordination
Impact of exercise on the brain
Dopamine is a neurotransmitter that controls the brain's reward and pleasure centers, as well as regulating movement and emotional responses. In PD, there is a dopamine deficiency.
While exercise has not been shown to increase the amount of dopamine in the brain, research does show that it helps it to be used more efficiently.
Types of exercise
Trying different forms of exercise is important, as it may help to challenge PD symptoms more effectively.
The exercises that someone with PD should undertake will depend on how limiting their symptoms are. In all cases, the exercise should focus on three areas:
- flexibility and stretching
- aerobic, also known as cardio
- resistance or using the muscles against opposing force
There are many different types of exercise that involve all three of these areas. These exercises include:
- tai chi
The exercise type known as "random practice" has been shown to benefit people with PD particularly. This is an aerobic exercise that challenges the individual to change speed, activity, or direction.
It is also essential for someone with PD to vary activities. This is because people with the condition may have trouble changing activity and doing two activities at the same time. As a result, random practice and variation will help to challenge those symptoms.
Things to consider
There is no specific exercise program that someone with PD should undertake. The best exercises to do will take into consideration an individual's symptoms.
The support charity Parkinson's UK recommend that people with mild symptoms should focus on vigorous exercise, such as working out in a gym.
People with moderate symptoms should focus on exercises that target those symptoms. Individuals with more complex symptoms should simply focus on using exercises to help them complete daily activities that are problematic.
It is worth noting that cycling, in particular, requires both balance and reaction time. These two qualities are both impaired by PD. As a result, using a traditional bicycle could be a safety risk. Alternatives include three-wheeled bikes and tandems.
The University of California also say that weight training is not the best choice for people with PD, although strengthening exercises do have value.
Strengthening exercises that are alternatives to weight training include:
- pushing up to rise onto the toes
- modified squats
- repeatedly getting up from and sitting in a chair
- wearing weights on the ankles and wrists at home or on a walk
- push-ups or wall push-ups
Swimming is a good exercise for coordination, but it does not require balance. As such, it may not be the best exercise for people with PD.
The ideal time for someone with PD to exercise is when their mobility is best, which is often around an hour after they have taken their medication. This can vary, however, so every individual will have to work out when their mobility is at its best.
Exercise tips for PD
Exercising regularly, and gradually increasing the intensity of the exercise, will provide greater benefits.
Before someone with PD begins a new exercise program, they should speak with their neurologist, doctor, and physical therapist about what would be the best for them individually.
Use a pedometer
Also known as a step counter, this will tell the person how many steps they take on an average day. They can then work their way upwards from there.
The best way for people with PD to see benefits from exercise is to do it on a consistent basis. People with PD who have been on exercise programs for 6 months or more have shown significant gains in comparison with those who do shorter programs.
Greater intensity, greater benefit
People with PD should exercise, as often as possible, for as long as possible. The amount they can do will vary, depending on their symptoms, but the general rule is that the more the person does, the more they will benefit.
Integration and variation
People with PD can start to add exercise to their lives with minor changes, such as:
- walking instead of driving whenever possible
- climbing stairs instead of taking an elevator
- avoiding long periods of being inactive
Also, varying the exercises and where they are, for example, indoor or outdoor, will not only help PD symptoms but also ease boredom and increase motivation.
Allowing a proper cool down slowly decreases the heart rate and stops the muscles from becoming stiff. A proper warm-up and doing stretches are also vital for this.
Enjoyment of exercise will make it easier to undertake. Group activities, including exercise classes, are often beneficial for this.
When to see a physical therapist
When someone is first diagnosed with PD, they should also have an appointment with a physical therapist to work out an exercise program tailored to them.
All people with PD should ideally have an exercise program for their individual needs. Seeing a physical therapist will help them avoid risks, get advice about their specific type of PD, and give them confidence.
As the disease progresses, a person should continue to meet with the physical therapist to maximize the benefits from their exercise program by changing it whenever necessary.
There are so many benefits of exercise for people with PD. Those with the condition should speak with their doctor or an advisory group to work out a specific program to help them start or maintain an exercise program.
It is also helpful to find out more information about the many PD-specific exercise classes going on throughout the country. There may be a group nearby that someone can link with for advice and support.