Can You Work Out With Parkinson’s Disease?

Exercise has become a standard treatment for Parkinson’s disease (PD), with strong evidence showing its boost to functional capacity. Regular walking is particularly helpful for mobility. Cardio, muscle strengthening, stretching, and balance training are examples of fitness programs. The top suggestion to counter the progressive nature of Parkinson’s is finding a physical therapist (PT) to individualize and maximize your workout routine.

Parkinson's and physical activity

Beginning in the early 1980s, Parkinson’s studies indicate that movement and physical therapy are not only safe, but also truly benefit those living with the condition. Research demonstrates that exercise improves functional capacity in PD in large part because of a co-occurring bump in endogenous or natural dopamine. Interestingly, data from animal research suggests that dosed exertion offers some degree of neuroprotection for the brain cells targeted by PD.

Barriers to exercise

A 2011 study showed people around age 70 who had lived with PD for several years were essentially a third less active when compared to healthy older adults. The following factors made engaging in physical activity more difficult for participants:

• Disease severity
• Gait impairment
• Assistance needed in daily living tasks.

Mobility is the top concern for those with PD and so, unsurprisingly, they name walking as the most important aspect of treatment. Gait disturbance does correlate with disability and quality of life. Perceived barriers to participating in exercise or movement-based therapies are that people with PD do not believe they can exercise well and therefore are not convinced it helps.

Current knowledge & recommendations

Setting exercise goals with PD requires a look at the specific changes the condition has caused in your body, and seeking professional healthcare treatment.

Motor dysfunction

Motor ability refers to the body’s capacity to coordinate movement via normal, functioning muscular and nervous systems. Not everyone is affected in the same way, but most people with Parkinson’s have motor problems.

The motor signs and symptoms of PD that respond to PT and exercise interventions are:

• Slow, shuffling gait
• Tremor
• Imbalance and falls
• Stiffness and rigidity
• Freezing
• Weak grip strength
• Motor coordination.

Treatment timing

Experts recommend seeing a physical therapist early on in the disease. Adopting a workout routine is a leading indicator of continued success, especially if a person can make it to 12 weeks into a regular exercise routine. There are plenty of choices for exercise, and finding one or more you enjoy cultivates and encourages consistent participation.

Checking back with your therapist is crucial in order to adjust exercises as your condition changes. You likely see your neurologist twice a year for medication adjustments; sprucing up your workout routine, too, is a foundational piece of living well with Parkinson’s.

Effective exercises for people with Parkinson's:

Exercises for PD include cardiopulmonary, resistance and strength training, flexibility, gait and balance training, and movement strategies.

Cardiopulmonary

These workouts increase muscle stamina, including those of the pulmonary or respiratory system. The stronger the lungs, the more efficiently oxygen energizes the brain and muscles under training. PTs recommend working toward a moderate degree of exertion, which means sweating and increased work of breathing.

For people with Parkinson’s, this type of exercise includes activities like:

• Overland walking
• Treadmill walking
• Biking (road or stationary)
• Swimming
• Boxing

Resistance/strength training

Muscle strengthening might include lifting weights using machines or free weights. It could also involve supporting one’s own body weight or working with therabands — also known as resistance bands. Weight lifting or resisting weight as part of a workout promotes muscle growth. People become stronger.

Posture, gait speed, tremor, and grip strength all improve under this type of conditioning. Progressive strength training — lifting more or heavier amounts over time — also reduces fall rates.

Strengthening specific leg muscles is particularly helpful in PD. These target areas are:

• Trunk extensors
• Hip extensor and abductors
• Knee extensors
• Gastrocnemius and the soleus muscles (calves)

Flexibility

This type of physical activity addresses rigidity and stiffness. Muscle tightness and joint pain are often associated with these manifestations of Parkinson’s and will improve with stretching and flexibility work.

Types of stretching that are suggested for those with PD are:

• Yoga (standing, chair, or mat)
• Range of motion exercises

Gait and balance training

Remember that loss of mobility is a leading concern in Parkinson’s and that early intervention makes a difference. The best activity is a regular and progressive walking routine.

The key is to keep going and increase the distance or frequency as you are able and under the guidance of an exercise professional who is familiar with your condition. This is to insure safe and reasonable goals are set. PTs can be certified in neurology, so be sure to ask.

In addition to walking, Tai chi and dancing are popular activities that enhance balance and gait programs. In fact, studies have proven positive functional results from either practice for those with Parkinson’s. And because they include other people, they boost social interaction and possibly mood.

Movement strategy

This exercise approach aims to develop compensatory strategies. Compensatory means “in place of” another pattern of activity, gesture, or performance. People with PD who freeze, for example, benefit from increasing the length of their stride rather than the speed of their steps.

Preserving control over your movements prevents falls and other injuries. Additional techniques are:

• Dual tasks. This requires completing a motor and cognitive task simultaneously.
• Cues. Using music to help track and coordinate steps, for instance.

Working out with Parkinson’s is not only possible, but it is strongly advised by health experts. Regular and continued exercise provides functional stability and allows for gains in activity despite the motor challenges caused by PD. There are many options to improve symptoms including walking or biking to boost gait performance and stamina or tai chi for balance problems. Physical therapists are the appropriate partners in establishing an evidenced-based exercise program tailored to your specific needs.