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Exercise for Parkinsons

Published: 11 Apr 2019

For everyone, exercise is a vital component for healthy living.  Recent research has shown that regular exercise improves the quality of life for people with Parkinson’s disease as it helps to reduce stiffness and benefits overall daily living activities.

The greatest benefit comes from doing things that you enjoy. Some activities will give you more benefit than others, however, consistency is more important than the activity itself. Begin with activities that you can do comfortable and listen you your body. Choose the time of the day that is best for you to do your exercises, preferably after medication where the effects are still present.

Why is exercise important?

Studies[1] have demonstrated a range of benefits of regular exercise for people with Parkinson’s disease including:

• Better control over gross motor movements (like walking)
• Increased muscle strength and flexibility
• Enhanced cardiovascular fitness
• Improved balance and coordination
• Improved posture
• Decreased muscle cramping
• Reduced stress levels
• Improved joint mobility
• Enhanced confidence in performing daily activities
• May assist with delaying progression.

The best way to achieve these benefits is to be consistent with exercising. The most significant gains in function and movement have been achieved when people with Parkinson’s disease participate in greater intensity exercise programs for longer than 6 months. Intense exercise involves those which raise your heart rate and makes you breathe heavily (such as running and cycling).

How does exercise change the brain?

• It allows the brain cells to use dopamine more efficiently by modifying the areas of the brain where dopamine signals are received (substantia nigra and basal ganglia)
  • In the brain, dopamine functions as a neurotransmitter – or more simply put, it’s a chemical released by neurons (nerve cells) to send signals to other nerve cells
• Reduces the vulnerability of dopamine neurons to damage

Exercise recommendations

• Aim for 15-30 minutes of exercise each day
• Spend a few minutes warming up and cooling down – marching on the spot and gentle stretches
• Start with easier exercises and increase as your fitness improves
• Stop and rest when tired as overexertion can make symptoms worse
• Exercises need to remain pain free
• If you suffer from fatigue, aim to exercise earlier in the day
• Try to make exercise fun! – exercising with others or to music may boost your motivation

Exercise Prescription:

• Moderate to high intensity cardiovascular exercises (treadmill training, cycling or dancing) for at least 30 minutes 3-4 times per week
  • Walking is great for overall fitness, although ensure the terrain is flat and obstacle free
  • If walking, running or cycling is not an option for you, try water aerobics
• Resistance training 2-3 times per week
  • Light ankle/wrist weights (or household items) are useful for strength training. Aim for three sets of 10 repetitions
• Balance training in group exercise classes, such as Tai Chi, pilates and yoga
• Stretching exercises to increase flexibility
  • Best when incorporated into your warm-ups and cool downs
  • Hold stretches for 30 seconds and repeat twice
  • Should remain pain free and not cause discomfort

For those with a more advanced stage of Parkinson’s disease, sessions with specialised physiotherapists is recommended.

Safety first

Safety tips for those who are at risk of falling or freezing (sudden inability to move):

• Exercise sitting down
• Hold onto a chair for exercises in standing
• Do not attempt floor exercises if you are unable to get up by yourself
• Exercise when others are at home who can help if necessary

Before you devise or commence any exercise program, you should consult closely with your doctor and physiotherapist. The type of exercise you choose to do is up to individual choice

what is more important is that you do exercise and you do it regularly

Find an exercise you like and stick with it. Achieving a balance that works best for you and engages you in the program will help you to start, maintain and eventually expand upon – that is the goal!  Our team offers dedicated Parkinson’s classes, call us if you would like more information.

If you need help creating an exercise program or would like a more detailed assessment and discussion, our Physiotherapists are trained to assist you in this process. For more information have a look at this exercise PDF provided by “Parkinson Canada” which has some great tips and exercises to follow.

References
[1] da Silva et al. (2016), Salgado et al. (2013), and Goodwin et al. (2008)