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Why Exercise is Critical to Treat Parkinson's


If neurologists and movement disorder specialists could pick the number one prescription they could write for Parkinson's disease (PD), most would say exercise. Exercise is an important part of healthy living for everyone, but for people with PD, exercise is medicine. Physical activity has been shown to improve many symptoms, from balance and mobility issues to depression, constipation, and even thinking skills.


​In addition, research shows that exercise may have a protective effect on the brain and slow progression of the disease. It is also an active way of coping with PD. Establishing early exercise habits is an important component of overall Parkinson's management. Regular physical exercise can improve mobility and coordination, boost your mood, reduce stiffness, and minimize soreness and fatigue. Exercise may also help your body and brain find new ways to move. Research has proven that PD damages part of the brain, and exercise aids your brain in discovering new nerve cell connections, known as neuroplasticity.


Research has shown the following positive impacts of exercise:

  • Engaging in any level of physical activity is beneficial and can improve motor symptoms.

  • For people with mild to moderate PD, targeted exercises can address specific symptoms. For example: aerobic exercise improves fitness, walking exercises assist with gait, and resistance training strengthens muscles. One study shows that twice-a-week tango dancing classes helped people with PD improve age-related changes in executive function, a type of thinking that is affected in Parkinson's.

  • People who start exercising earlier experience a significant slower decline in quality of life than those who start later.

  • People with advanced PD who exercise show greater positive effects on health-related quality of life, so it is important to keep exercising and finding new ways to facilitate exercise as the disease progresses.

Reported benefits of exercise include improvements in the following areas:

  • Gait and balance

  • Flexibility and posture

  • Motor coordination

  • Endurance

  • Working memory and decision-making

  • Attention and concentration

  • Quality of sleep

And reductions in the following concerns:

  • Falls

  • Freezing of gait

  • Depression and anxiety

Exercise Provides Positive Cognitive Results as Much as Physical Results

About half of people with PD experience challenges with executive function, which involves planning activities, keeping a schedule, staying organized and similar tasks. Executive dysfunction can appear as problems with working memory or focusing on a task and responding to changes.


​The parts of the brain that perform executive function tasks are the same ones that help you adapt to changing environments. For example, you use your executive function center when you go from walking inside the house to walking outside. You also use them when you learn a new skill or improve an old skill. As a result, by incorporating certain forms of exercise, you benefit the brain not just physically but mentally. These exercises, include:


  • Cognitive Dual Tasking: When two activities are performed at once - one with a cognitive focus and another with a motor focus - this is considered dual tasking and this is why movement classes, boxing, and dance have proven to be very helpful for those living with PD.

  • Aerobic Exercise: In addition to heart health, studies also show it can improve age-related changes in executive function.

  • Skill-Based Exercise: Focuses on complex movements of the whole body, such as balance, hand-eye coordination, and reaction time.

In addition to physical and mental benefits, exercise also brings great social and emotional benefits to help fight against depression and anxiety, both common symptoms of those living with PD.


Professionals Providing PD Exercise

One of the first things your physician may do is recommend physical or occupational therapy assessments. And if they don't, it's ok to ask for a referral. These assessments allow these therapists to put together a personalized and tailored exercise program that you can replicate at home or in a local gym specific to your needs. These therapists are wonderful at being able to develop a specific exercise routine that keeps you safe and targets your specific symptoms.


​But there are also exercise professionals with credentials that can also design personalized exercise routines, which may include personal training, group fitness instruction, or small-group training. They regularly work with clients once they are no longer receiving physical or occupational therapy, or in combination with physical and occupational therapy. The important thing to remember is to tailor and adapt programs to best meet your needs for safety and overall enhancement.


​Certified personal trainers and certified group fitness instructors generally work at fitness centers, senior centers, private gyms, and in the home. Certification is available through several national organizations. Make sure your trainer is certified and ask about their knowledge and experience working with people with PD. Trainers do not have degree requirements, but are qualified to lead individual or group sessions.


​Certified strength and conditioning coaches, certified clinical exercise physiologists, or certified medical exercise specialists are required to have degrees. These exercise professionals have additional training on how exercise impacts the mind and body. Prior to joining any gym or fitness organization, you may want to ask specifically about their staff credentials and ability to support your needs to develop and monitor your program.

​Working with an exercise professional is a good way to supplement your therapy or to continue with your exercise routine once you are no longer receiving physical or occupational therapy. Encourage your physical or occupational therapist to review and explain your program to your trainer to ensure a smooth transition.


Fitness Tips to Manage PD Symptoms:

  • Choose an exercise program that you will actually do: Don't design a great, Parkinson's specific program and then skip it because it's too hard or not fun.

  • Follow a varied routine: Perform simple stretches and posture exercises daily, and make sure to include aerobic and strengthening exercises several times per week.

  • Keep intensity at a level that feels somewhat hard for you: You will get stronger by increasing the difficulty of the exercise.

  • Consider joining an exercise class or group: Classes are a good motivation and also provide an opportunity to socialize and receive guidance from trained instructors.

  • Try exercise videos or home exercise equipment if it is difficult to get out: Exercise at home can be just as valuable as at a gym or in a class.

  • Music can enhance performance: by providing rhythm to coordinate movement.

  • Be creative with your fitness: Challenge yourself and have fun!

Movement Based Support Groups

In many cases, various classes often have support groups for Parkinson's available. For example, the PD Fight Club meets after classes once a week. Movement is part of our daily lives, from waking up in the morning to taking a walk around our neighborhoods. Nobody deserves to lose the freedom of movement. We're here to help you stay active. Movement classes have a variety of benefits that may help combat Parkinson's disease, such as improving balance, endurance, and motor skills. To see a listing of Movement Classes that also include Support Groups - CLICK HERE


Paying for Fitness

Most people know that insurance will pay for therapy sessions. But did you know it can also pay for some of your gym memberships or fitness fees too? Most Medicare Advantage (Part C) Plans include a SilverSneakers membership. First, you must be signed up for the Original Medicare. Then you can select a Medicare Advantage Plan that includes SilverSneakers. There is no cost to you if you have SilverSneakers included in your Medicare Advantage plan. If you're 65 or older and have Original Medicare, you're eligible for SilverSneakers. Just be sure you're enrolled in a Part C Medicare Advantage plan that includes SilverSneakers benefits.


Once you have enrolled in a Medicare Advantage plan that includes SilverSneakers, you can go to the Silversneakers website to sign up. When you register, you'll receive your own personalized ID card with your SilverSneakers number. Once you receive your ID card, you can attend fitness classes online or at thousands of SilverSneakers locations nationwide. In addition to SilverSneakers, there are many FREE, online exercises available online.


Not Yet 65?

If you aren't yet qualified for Medicare, it can be difficult to find the extra funds needed to cover the gym memberships. You can apply to the PAA's Movement Class Scholarship Program. The PAA gives more than $30k toward the support of PD specific movement and fitness classes annually for anyone that doesn't qualify for insurance coverage and needs to offset the cost of attending a PD specific movement class. We believe no one should be turned away from these excellent local programs. ​If you are interested in receiving more information or want to apply to the PAA's Movement Class Scholarship Fund, please CLICK HERE.


Types of Exercise

There is no one exercise prescription that is right for every person with Parkinson's. The type of exercise you do depends on your symptoms and challenges. For sedentary people, just getting up and moving is beneficial. More active people can build up to regular, vigorous activity.


​People with PD are recommended to do at least 2.5 hours of exercise every week for a better quality of life as reported from the Parkinson's Foundation Parkinson's Outcomes Project. To help manage the symptoms of PD, be sure your exercise program includes a few key ingredients: aerobic activity, strengthening exercises, and stretching. There are many types of exercises you can do to incorporate all three elements, including but not limited to the following:


  • Running and walking

  • Biking / Cycling

  • Tai Chi, Yoga, Pilates, or Dance

  • Weight training

  • Non-contact boxing

​Some exercise programs focus on functional movements - things that are part of daily life, such as walking, standing up, or lifting and reaching for objects. Researchers are also studying the impact of novelty: trying something new. When you begin a new activity, your brain -- not just your muscles--learns the movements. So be creative, and vary your routine: exercise indoors and outside, by yourself, in a class setting, or one-on-one with a trainer or physical therapist. Just be sure to get guidance from your healthcare team.

​Exercise for people with Parkinson's can help at any time, and the earlier you start, the better. That said, it is never too late to add more physical activity to your daily life. If you're just starting an exercise program, build up to the recommended 30 minutes of exercise five times a week. For example, walk for 10 minutes three times a day instead of one 30-minute walk.


​Any form of physical exercise you can do without injuring yourself will provide benefit. Even gardening and housework count. Before beginning any new exercise, consult with your physician, and if available, a physical therapist that has experience with Parkinson's. Check with your physician if you have health concerns that affect your ability to exercise. Seek a physical therapy referral for help planning your exercise program.

​Many approaches work well to help maintain and improve mobility, flexibility, and balance and to ease non-movement PD symptoms such as depression and constipation. The most important thing is to keep moving!


Sources:

Davis Phinney Foundation for Parkinson's. Exercise - Chapter 9. Every Victory Counts, Your Go-To Resource of Essential Information and Inspiration for Living Well with Parkinson's. "Manual." Sixth Edition, 2021.


Parkinson's Foundation. Fitness Counts. A Body Guide to Parkinson's. "Booklet."


​Parkinson's Foundation. Exercise and Parkinson's. Living with Parkinson's. "Brochure."


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