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  • Writer's pictureHarrison Brown

Exercise for Parkinson's Disease

Parkinson’s disease (PD) is a neurological condition which causes degeneration of dopamine producing cells in the substantia nigra. Dopamine is vital for smooth and controlled coordination of movement. The cause is still unknown although genetic and environmental factors have been linked to the disease.


Symptoms of Parkinson's Disease

  • Tremor, mainly in the hands at rest.

  • Slowness and freezing of movement. Also called bradykinesia or hypokinesia.

  • Stiffness of muscles (rigidity).

  • Trouble with balance and walking (Postural instability).

There are also many non-motor or “hidden” symptoms. These symptoms are depression, anxiety, hallucinations, constipation, orthostatic hypotension, problems sleeping and cognitive impairments.


Medications for Parkinson's Disease


Medications can manage PD by increasing or substituting dopamine to improve movement, tremor and walking.


Evidence-based Exercise for Parkinson's Disease


Although exercise cannot stop the progression of PD, it can manage or improve symptoms. PD progresses slowly by gradually reducing motor control, physical function and movement. High intensity aerobic exercise has been shown to slow progression of the disease by preventing the loss of dopamine producing cells. While being good for the brain it also can improve fitness, endurance and prevent the development of comorbidities such as cardiovascular disease and diabetes. Current evidence suggests people with PD should aim to do aerobic exercise 3 x per week for 30-40 minutes at 70-85% heart rate max.


Other forms of Recommended Exercise

Resistance training: As discussed above, those with PD are less likely to be active which can cause a reduction of muscle mass and strength. Resistance training is therefore very important to prevent this. Leg strength is also important for walking initiation, step length and speed and sitting-to-standing transfers.


Treadmill walking: Treadmill walking has been shown to be very effective as it allows people with PD to work on their step length and walking speed. A common symptom of PD is small “shuffling” walking which can be reduced by regular treadmill walking.


Dance: Exercise that incorporates dance can help improve balance, coordination and reduce rigidity. Exercising to the beat or rhythm of music can really help break cycles of freezing and improve initiation of movements.


Hydrotherapy: Pool exercises can help those experiencing a lot of pain doing land-based exercise as the buoyancy in the water can reduce the loads placed on the body and it's joints. It may also provide the opportunity to achieve movements and range of motion not possible on land.


With all these exercises it is important to tailor them to the individual and their goals. It is vital to continue practicing “large” movements to break the circuit in the brain that is causing very small movements. Exercise can improve quality of life and the motor symptoms of Parkinson's disease. To achieve this, an Accredited Exercise Physiologist can assist you in finding the best-suited, individualised exercise program.



References

Ernst, M., Folkerts, A.K., Gollan, R., Lieker, E., Caro-Valenzuela, J., Adams, A., Cryns, N., Monsef, I., Dresen, A., Roheger, M., Eggers, C., Skoetz, N., Kalbe, E.. Physical exercise for people with Parkinson's disease: a systematic review and network meta-analysis. Cochrane Database Syst Rev. 2023 Jan 5;1(1):CD013856. doi: 10.1002/14651858.CD013856.pub2. PMID: 36602886; PMCID: PMC9815433.

Alberts, Jay L. and Rosenfeldt, Anson B. ‘The Universal Prescription for Parkinson’s Disease: Exercise’. 1 Jan. 2020 : S21 – S27.


Ahlskog, J.E. Does vigorous exercise have a neuroprotective effect in Parkinson disease? Neurology. 2011 Jul 19;77(3):288-94. doi: 10.1212/WNL.0b013e318225ab66. PMID: 21768599; PMCID: PMC3136051.



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