Parkinson's and Physical Activity

Imagine if, tomorrow, you couldn’t take a walk with your Dad or play tennis with your Mom.

Painfully, families and friends of those with Parkinson’s watch these precious moments with their loved ones slowly slip away as the disease progresses. 

The physical and emotional challenges of those with Parkinson’s cannot be understated. Symptoms like shuffling or Parkinsonian Gait, involuntary muscle contraction, and loss of balance make physical activity incredibly difficult (and possibly dangerous).

Not only does this leave many unable to enjoy hobbies like hiking or biking, but also to perform basic functions like walking around the house, bathing, or cooking. The loss of independence often leads to increased feelings of loneliness and depression.

However, there is a treatment option that many have not considered.

Exercise regimens, as well as physical therapy, have emerged as new non-invasive treatments helping those with Parkinson’s regain both their mobility and confidence. In fact, science indicates that they may help combat neurological and physical symptoms of the disease.

Benefits of Exercise

The physical symptoms of Parkinson’s are characterized  by damage to the basal ganglia, a key area of the brain for bodily movement. As cells in this region die, there is a drop in dopamine, a key neurotransmitter helping impulses travel from the brain to the limbs.

By the time many receive a diagnosis, they’ve already lost 40-60% of the dopamine neurons in their body.  That generally means the brain’s instructions to the body are already having difficulty getting through, and some physical symptoms, such as shuffling or Parkinsonian Gait may be evident as a result.

Recent clinical trials have shown that exercise can enlarge synapses, stimulate brain cell growth alongside resumed dopamine production, helping those with Parkinson’s maintain mobility. Beyond its physical benefits, exercise combats mental symptoms like memory and attention issues, as well as poor sleep quality and depression.

In addition to treatment, physical activity can help people develop physical cues that can be used to mitigate freezing episodes and prevent falling. Physical therapists recommend those prone to freezing of gait practice movements including: raising a hand, shifting weight from side to side and marching in place. These movements will allow those experiencing freezing of gait to consciously initiate movement that will prevent the episode from worsening.

Exercise Program Design

As the popular saying goes, “when you've met one person with Parkinson's, you've met one person with Parkinson's.” This is especially true for physical treatments. Since those with Parkinson’s have diverse and specific needs, there isn’t a one-size-fits-all solution.

Most medical professionals suggest that exercise should begin soon after a diagnosis, to have the best chances of controlling symptoms. Each participant is recommended to workout when their medication is in effect, to ensure balance.

Each routine should help a participant divide movements into small pieces, focus their attention on maintaining correct form.  The use of multi-sensory cues, such as music or chants, are also recommended to help the participant bypass the damage caused to their brains, and consciously initiate movement.

While many studies indicate that high intensity workouts increase effectiveness against Parkinson’s, experts indicate that any amount of exercise is helpful. There is a general agreement that regularity of exercise helps increase the positive benefits against Parkinson’s.

When finding a particular training activity, it’s best to target particular symptoms. For example, yoga can increase flexibility while combined aerobic and strength training can improve gait speed. Additionally, many participants in group training tend to decrease negative emotional symptoms including depression.

Here are some of the most popular exercise routines for people with Parkinson’s. Each of the available methods have their own unique benefits and methods to help each person reach their goals.

Treadmill

Excercise helps people with Parkinson's overcome symptoms.


In recent years, treadmill-based training has become one of the most common athletic Parkinson’s treatments. Participants can engage in varying levels of intensity, usually in forms of multidirectional walking.

Some studies suggest that the rhythm of a treadmill acts as a physical cue, allowing participants to consciously focus on their movements.

Many with mild-to-severe symptoms who engaged in regular routines gradually increased intensity showed a considerable increase in walking speed, endurance and stride length.

Boxing

Boxins is an effective tool for people with Parkinson's to reconnect damaged neural pathways.


As boxing has gained popularity in the fitness community at large, it has also seen a boom in Parkinson’s treatment.

Gyms like Rock Steady boxing have developed specialized boxing, consisting of conventional bag training, paired with other forms of exercise (including aerobics and strength training) ensuring a holistic workout. Unlike conventional boxing, it avoids sparring with other class members.

Multiple studies indicate that boxing helps those with mild or severe Parkinson’s improve their gait, step velocity, endurance, and balance, sometimes at a greater rate than those engaging in conventional exercises.



Dancing

Dancing changes the intention behind movement and helps Parkinson's patients move more freely.


One critical aspect of dancing programs for Parkinson’s is use of multiple cues, helping participants consciously monitor their movements.

The most common form of dance for Parkinson's treatment is tango, which involves several sudden movements that require constant attention and varying speeds. Other forms include Irish Set Dance and Ballroom dances, including the Foxtrot.

Since dancing acts as a social activity, as well as exercise, it provides both physical and psychological relief. The most up-to-date research suggests that dancing positively impacts balance, bradykinesia, muscle rigidity, as well as feelings of loneliness and depression.

Aquatic Exercise


Aquatic exercises are a low-risk, high-reward method for people with Parkinson's to new movements.

Another popular treatment for those with Parkinson’s include aquatic exercise routines. This is a relatively broad category ranging from Ai Chi (aquatic Tai Chi) and Aquarobics to water walking. These routines provide strength training by reducing stress on joints and providing resistance to light movements.


Some studies indicate that aquatic exercise may provide greater benefits than land-based exercise in balance capacity and fall prevention.

Those who exercise in the pool must take proper precautions, including the use of rails to enter a pool, wearing flotation devices and use of the shallow end to reduce all possible risk.


Conclusion

When searching for an exercise regimen for someone with Parkinson’s, it is important to ensure that they find the right fit. After considering all the important factors, consult with your loved one’s doctor or physical therapist for any advice or instructions.