Exercise

Good News! Exercise helps.

Good news for people living with Parkinson’s (PWP) – exercise is good for you! The benefits of exercise in Parkinson’s disease (PD) have been demonstrated many times in clinical studies. Exercise is a valuable way to be proactive in the management of your symptoms. There is also evidence that proper exercise may help your Parkinson’s medications work better. Maintaining an exercise program is helpful to everyone, but is particularly important for those with PD to help maintain and improve health and function. Studies have shown that exercise may be neuroprotective and may might slow the advancement of the disease and help restore function. More studies are ongoing, but current evidence supports this principle.

What is the best form of exercise?

This is a very common question among people with PD. There are three general categories of exercise that a person with Parkinson’s should try to include in their exercise program:

1. Strength & Flexibility
2. Aerobic Exercise
3. Skill-Based Exercise

You may notice that these are the same needs for any aging individual. However, the points of emphasis will be slightly different for PWP.

Strength & Flexibility

Improving and maintaining function is always the primary objective. Parkinson’s causes stiffness and slowness, and can lead to weakness from disuse. Pursuing an exercise program that increases muscle strength and flexibility can greatly improve how you feel and move through the day. You should pay particular attention to strengthening the core muscles that support your trunk and help maintain posture.Examples:

1. Free weights or machines
2. Yoga
3. Tai Chi

Aerobic Exercise

People with Parkinson’s often complain of fatigue. Incorporating exercise that stresses the aerobic system can help increase your energy level and build stamina that will help carry you through these difficult times of the day. Pursuing an aerobic training program to optimize cardiovascular function may also improve mood and cognition, allowing you to live a happier and more productive life.Examples:

1. Walking/Running
2. Stationary Bike
3. Swimming

Skill Based Exercise

Combining strength training exercise with sports that require coordinated movements which challenge the central nervous system to respond to external cues may also improve function. PD leads to a loss of dopamine-producing cells in the substantia nigra within the midbrain, which in turn affects another set of structures within the brain known as the basal ganglia, which are very important in the initiation of and coordination of complex movements. Studies have demonstrated that engaging in exercise modalities that require you generate a physical movement in response to external cues, and by being mindful of your own movements as well, you may improve function throughout many daily activities.Examples:

1. Tennis
2. Boxing
3. Ping Pong (Table Tennis)

Why should I exercise if I have Parkinson’s?

In short, it will make you healthier and make you feel better. There are so many ways to exercise that are proven useful for PWP. You may engage in exercise on your own or with friends and family, through the one-on-one guidance of personal training, or through exercise classes which are increasingly geared toward the needs of PD.Find people that will support you in your journey – they may share your exercise goals to help motivate you or have particular training that helps them guide your personal exercise program. Ideally, any trainer you work with would have experience with PD and would also make your exercise program enjoyable and fulfilling.Exercise in PD is important at every stage and at any age, so follow an exercise program that keeps you feeling motivated and adapts over time to your needs and preferences. There are so many exercises that may be helpful, beginning with even just walking, that there is no one exercise program that is best for everyone. Your program should fit you so you continue it throughout your life.

How often should I exercise?

Current research recommends at least 30 minutes a day, 5 days a week. When you are just getting started, this may sound intimidating, but you can start with as little as one day a week, for 10 minutes. Just get started! Over time, work your way up to more days out of the week and longer workout sessions. It is also important to recognize that recuperation and rest time are an important part of your exercise program. Trying to do more than you are ready for may lead to fatigue or even injury. Work your way up gradually. You will feel better and you will find exercise makes a difference in your life. You will be taking a very proactive role in the management of your PD.

How does exercise help?

Studies demonstrate that not only does exercise help with function, it may also improve mood and feeling of well-being. It also has been shown to improve cognitive function and may reduce the risk of cognitive decline over time. It also just feels good to take an active role in improving your physical function, so you can accomplish more of what is important to you in your life.

Parkinson’s Exercise Classes

There are many exercise classes focused on the issues specific to PD available in Los Angeles. In addition to the exercise itself, these classes offer an important social component as well. It’s reassuring to recognize that you are not alone in your journey. Other individuals are struggling with many of the same issues you may deal with, and classes offer an opportunity to meet others who share a similar experience living with PD. This can make exercise and even more enriching experiences. Parkinson’s exercise class times, locations, and descriptions will be provided on the PCLA website.The content on this page has been reviewed and approved by Nicholas R. Szumski, MD, Movement Disorders neurologist with the Cedars-Sinai Medical Group.References:

• Exercise-enhanced neuroplasticity targeting motor and cognitive circuitry in Parkinson's disease
• http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3690528/
• http://www.sciencedirect.com/science/article/pii/S1474442213701236
• Dr Giselle M Petzinger, MDa, b, Beth E Fisher, PhDb, Sarah McEwen, PhDc, Jeff A Beeler,
• PhDd, John P Walsh, PhDe, Michael W Jakowec, PhDa, b
• http://www.nicabm.com/changing-the-brain-can-mindfulness-ease-the-symptoms-of-parkinsonsdisease/

Photo Credit: Jennifer Parkinson