Medical treatment has made an enormous difference in the lives of people with Parkinson’s disease (PD). But in recent years, it has become clear that the way to deal with this disease is not just to take medicine—no matter how good that medicine may be. Living with PD now also means living actively.
This may be more easily said than done for PD patients. The very nature of PD makes it hard for people to move properly. The disease causes tremor (shaking of the hands, arms, legs, jaw or tongue) and rigid muscles. It generally slows down movement and disrupts balance and coordination. No matter how helpful PD medications are, the disease worsens as time passes.
And then there’s the reaction to exercise that many PD patients may have. It can be difficult and frustrating for them to simply move, let alone exercise. Feelings of fatigue, discomfort and self-consciousness can lead to inactivity and cause withdrawal.
But PD patients at any stage of the disease are urged to get up and get active—because the benefits of exercise for them far outweigh any of the drawbacks. People with PD who keep their bodies fit are better able to meet the many challenges of the disease. They reduce the impact of symptoms at every stage of the disease, stay healthier for longer and may even slow down the progression of the disease.
In addition, PD patients who exercise also reduce their risk for other types of diseases, such as cardiovascular disease and osteoporosis, and boost mood and cognitive ability.
Find out why exercise is so crucial for PD patients…
PD is a condition in which some brain cells function poorly and gradually die. Particularly affected are neurons that produce the messenger chemical dopamine in the area of the brain, the substantia nigra, that is part of the finely tuned brain circuitry that controls movement.
This is why as PD progresses it becomes much harder to move properly. Tremors and rigidity or stiffness of muscles slow patients down and disrupt their balance and coordination.
Exercise can counteract this downward spiral. Research shows that exercising activates “muscle memory circuits” in the brain that govern how muscles work together—and even in PD patients, exercise keeps these brain circuits strong and functioning well.
In addition, exercise has been shown to augment the production of proteins, such as brain-derived neurotrophic factor (BDNF) and glial cell line-derived neurotrophic factor (GDNF), that promote the growth and health of neurons and strengthen connections among them.
In fact, evidence from animal studies suggests that physical activity counteracts the loss of brain cells in PD that otherwise leads to decline.
Research shows that many different types of exercise benefit PD patients. Activities that emphasize agility, coordination and rhythm, such as tai chi, yoga and dance, are especially beneficial since they help to maintain the ability to perform complex movement combinations that may otherwise be undermined by PD’s stiffness and slowness.
Tai chi for PD patients made headlines when researchers at the Oregon Research Institute recently published a study in The New England Journal of Medicine reporting that tai chi improved balance and functional ability in people who have mild-to-moderate PD. It also was found to reduce falls.
Tai chi, which involves slow movement and shifting weight from one foot to another, was previously found to help older people gain balance and strength.
In general, PD patients also benefit from an exercise program that includes stretching, aerobic activity and strength training.
Aerobic exercise—activities such as swimming or walking that raise the heart rate—has also been studied for PD patients.
In one 2010 review of eight trials published in The Cochrane Database of Systematic Reviews, German researchers found that treadmill walking improved walking speed and normalized gait in PD patients.
Strength training also has been found to be beneficial. A small study by researchers at the University of Illinois at Chicago found that lifting weights and doing other muscle-building exercises helped reduce the severity of symptoms in PD patients.
The areas of the brain that respond to music are closely linked to those that control body movement. Music makes you want to move, and rhythm organizes and normalizes how you move.
Many people with PD are troubled less by tremor and can walk faster and with a smoother gait when listening to music, according to a 2012 study in Parkinsonism & Related Disorders.
PD patients can either listen to their own music while exercising, or find out more about music therapy by searching for the topic at www.Parkinson.org.
How much exercise. The more you are able to do, the better. In addition, the more intense you can make the exercise, the better—as long as the intensity is compatible with your general health and level of physical fitness.
PD patients should check with their doctors before starting an exercise program—and work with a doctor or physical therapist to tailor the program to their particular needs. This is especially important if a patient’s ability to move is impaired or if the patient has other medical problems, such as joint pain or low blood pressure.
It is also crucial to work with a health-care professional as the disease progresses—to ensure that the exercise program matches and augments the individual’s specific capabilities.
Where and how. Exercise programs designed specifically for people with PD are becoming increasingly common in hospitals, Ys, community centers, churches and synagogues. Your doctor or physical therapist may be able to help you find one.
Or reach out on your own—even if they don’t have organized classes for PD, many community centers with gym facilities are very welcoming to people with all sorts of physical challenges.
Parkinson’s support or online discussion groups often are a good source of information about exercise and exercise programs. You can find more resources for PD patients in your area by calling the National Parkinson Foundation at 800-327-4545.
If you have PD: Make exercise a priority, and take it as seriously as the medications you take.
It is not very easy for most people to stay motivated when it comes to exercise. For the PD patient, fatigue, difficulty moving and feeling self-conscious about his/her condition can lead to a sedentary lifestyle. But like anyone who exercises, you will feel better and move with more ease if exercise is a regular part of your life.
Source: Alessandro Di Rocco, MD, professor of neurology at New York University (NYU) School of Medicine and director of the Parkinson’s and Movement Disorders Center at NYU Langone Medical Center. He has published many articles in professional journals, including The Journal of Neuroscience and Movement Disorders.