- Regular moderate-to-vigorous physical activity improves the clinical progression of early-stage Parkinson’s disease.
- Different types of activities have different effects on the progression of the condition.
- Regular physical activity may improve the long-term clinical outcome of Parkinson’s disease.
Parkinson’s disease (PD) is one of the most common neurodegenerative diseases, second only to Alzheimer’s disease. The condition affects people of all races and cultures. Globally it affects around 10 million individuals who are generally over 60 years of age, but it can occur in younger people — 1 in 10 are under 50.
It is a progressive disease with symptoms that begin gradually.
- trembling of the face, legs, arms, or hands
- rigidity or stiffness in the limbs and trunk
- slow movement with balance and coordination issues
- cognitive decline in the later stages of the disease
The exact cause of the disease is unknown, but experts believe it develops due to genetic and environmental factors. Research has found that symptoms arise because of the death of dopamine-generating cells in the substantia nigra, the part of the brain responsible for movement, reward, and addiction.
Currently, levodopa, a drug that the brain converts into dopamine, helps manage PD symptoms. However, individuals can experience side effects, and the drug does not delay the progression of the disease.
However, new research from Kyoto University in Japan has shown that exercise twice a week can slow the progression of PD in people in the early stages of the condition.
Health experts have long suggested exercise as a way to alter the progression of PD. Studies have shown that high-intensity exercise can improve
Now, a recent study in Neurology has shown that the effect of exercise extends beyond the duration of the physical activity itself. It also suggests regular exercise can change the progression of PD over the longer term.
The study involved 237 patients with early-stage PD and 158 healthy volunteers. Researchers gave them annual questionnaires to record exercise intensity, frequency, and duration. They also administered cognitive tests to assess their memory and verbal skills.
At the start of the study, the researchers found that the patients with PD had worse motor, cognitive and autonomic functions than the healthy group. However, there was no difference in regular physical activity and intensity levels between the groups.
The study led by Dr. Kazuto Tsukita found that overall regular physical activity had a significant effect on the balance and stability of the participants. Patients with early-stage PD who took 4 hours of moderate-to-vigorous exercise each week had a slower decline in balancing and walking compared to those who took less exercise.
Speaking to Medical News Today, Dr. Tsukita explained: “One very important message from our research is that the domains that are most improved by exercise are those that cannot be improved by drugs (i.e., postural and gait stability, processing speed, etc.).”
He went on to say, “I believe that exercise should be used in conjunction with, not in place of, drug therapy.”
“The vast majority of people with PD, even those who exercise the most rigorously, eventually need medication for PD. The goal of exercise should not be to replace drug therapy, but rather to work with drug therapy to maximize quality of life.”
Dr. Gilbert went on to say that in her opinion, “one of the strengths of the study is that it investigated not just the effects of exercise, but of physical activity, defined as daily life activities performed in the course of work, leisure, or household related pursuits, that require exertion.”
Interestingly, the researchers found that different types of activity had different clinical effects.
“Increased physical activity was correlated with slower deterioration of a number of PD symptoms, implying that energy expenditure of all kinds, and not just formal exercise, is crucial in managing PD symptoms,” commented Dr. Gilbert.
Specifically, the study showed that moderate-to-vigorous exercise increased the balance and stability of individuals over time when compared to household, work, and overall leisure activities. In the same way, work-related activity levels showed a stronger reduction in the decline of processing speed.
The researchers gave participants 90 seconds to match numbers with figures to measure mental processing speed. With a maximum score of 110, those who did less exercise dropped from a score of 44 to 40 over 6 years. People who did more exercise dropped only one point from 44 to 43.
The study showed the progression of the disease was better altered in those who had maintained their physical activity over time, showing an association between maintaining a regular exercise regime and delaying the effects of the disease.
“This suggests that people with PD who may not have been particularly active at the beginning of their illness have much to gain in increasing their activity levels once the disease is underway,” said Dr. Gilbert.
The study authors recognize that self-reporting may reduce the accuracy of the figures and that the “observational nature of our study […] makes it impossible to draw a conclusion regarding causality.” They accept that these are limitations of the study.
Speaking about future research, Dr. Tsukita told MNT: “The next step is certainly a [randomly controlled trial (RCT)] with a long-term intervention of exercise. There is a tendency to emphasize high-intensity exercise in the field of PD exercise, but our study strongly indicates that exercise may modify the long-term course of PD even in small amounts if sustained. Therefore, future RCTs should focus on sustained exercise as well, for example, by using motivational apps.”