If you have been diagnosed with Parkinson’s disease, you are not alone.
According to the Parkinson’s Foundation, roughly one million people in the United States suffer from Parkinson’s, with that number expected to jump sharply in the next seven years.
Exercise is one of the most important interventions for Parkinson’s patients; in this article, we’ll take a look at why Parkinson’s disease exercise is so important, and we’ll explore several options to aid in your Parkinson’s journey.
The Importance of Exercise for Parkinson’s Disease
Parkinson’s Disease can have a wide range of effects on your well-being including tremors, rigidity, difficulty walking or initiating movement, displaying smaller-than-usual movements, and speaking unusually softly.
Exercise is considered neuro-protective since it helps the brain to maintain and build new pathways and increased the utilization of dopamine – the central brain chemical involved in PD.
In some cases, neuroplasticity, or brain adaptation from exercise can even outpace the effects of neurodegeneration from Parkinson’s Disease. (1)
Exercise during early disease onset also contributes to a slower decline in function and improved quality of life compared to that of inactive patients, or those who started exercising later in the disease process. (1)
Let’s take a look at some specific Parkinson’s disease exercise programs and how they might be useful as you navigate the terrain of Parkinson’s.
Types of Exercise for Parkinson’s Disease
While there is no single best method recommended for all patients, consistent exercise has been proven to slow the progression of Parkinson’s, reducing the overall impact of the disease.
Parkinson’s is generally associated with smaller, slower movements that diminish over time without intervention. For this reason, exercises for Parkinson’s Disease usually emphasize large-amplitude body movements to restore or maintain normal motor patterns.
Here are some general categories you might explore with your physical therapist:
Strength training exercises
Strength exercises may include bodyweight resistance exercises, resistance band workouts, or weight training. The goal of strength training is to build muscle mass and function which can help reduce the slowing of movement known as bradykinesia.
A strength training exercise program might include specific skills like squatting to get up and down from a seated position or other functional exercises.
Balance exercises and stretching
Balance exercises are useful for teaching you how to move safely to reduce fall risk, especially as Parkinson’s progresses, while regular stretching can help to maintain flexibility and reduce stiffness.
Besides the prescribed exercise regimen from your PT, balance and stretching-based exercises are commonly found in classes like yoga or Tai Chi.
Aerobic exercise promotes cardiovascular health and endurance, improving the body’s ability to utilize oxygen efficiently through activities like swimming, walking, or biking.
Studies show that aerobic exercise can lead to increased blood flow to motor regions of the brain to improve movement function. (2)
Cognitive & Skill-Based Exercise prescription
Cognitive skill-training challenges like playing memory recall or pattern recognition games –especially during exercise – require increased mental focus and brain stimulation typically associated with learning a new skill. (2)
Skill-based exercises are goal-oriented and accuracy-based, like learning a new sport or trying to remember a dance sequence. Based on animal studies, skill-based exercise can increase the number of synapses per neuron, leading to greater neuroplasticity. (2)
Research by The Parkinson’s Outcomes Project found that a minimum of two and a half hours of exercise, spread across your week, is optimal for improvement.
As you can see, a combination of strategies based on your needs and abilities creates the most effective path to minimizing the effects of Parkinson’s Disease.
Envato Image: Senior Man in Rehabilitation Therapy
Parkinson’s Disease-Specific Exercise Programs
LSVT-BIG & LOUD Therapeutic Exercise
LSVT-BIG (The Lee Silverman Voice Treatment) is a specialized, physical therapist-guided program that uses large-amplitude body movements to improve speed and reduce hesitation. (3)
LSVT-BIG is individualized to help patients recalibrate their movement patterns to restore the “normal” amplitude of movement, promoting neuroplasticity to minimize degeneration as well as exploring and acknowledging emotional and cognitive changes.
LSVT-BIG has been shown to improve motor performance and overall quality of life in patients after only four weeks of training, with more significant improvements across longer treatment periods. (3, 4)
LSVT-LOUD is an associated program administered by a certified speech therapist with a focus on normalizing speech.
Similarly to BIG’s emphasis on movement, LOUD encourages patients to speak up, again by “recalibrating” their perception and countering a minimized speaking voice. (5)
LSVT-LOUD focuses on frequent, high-intensity treatments. Research shows not only improvements in loudness of voice but also overall improved communication ability and articulation of words. (5)
Other Group Exercise Classes for Parkinson’s Disease
Fortunately, there is also a wide range of Parkinson’s-specific group exercise classes that utilize several of these components both online and in-person around the United States.
Parkinson’s Wellness Recovery (AKA PWR!) is led by certified physical therapists or other fitness professionals. PWR! focuses on four main movements that mimic necessary skills, which can be practiced in varied positions and progressed both physically and cognitively for greater challenges. (6)
Currently, PWR gyms are mostly located in Arizona, but online classes, instructors, and resources can also be found online here at Physio Ed. (6)
The Southern California-based Parkinson’s Exercise Program 4 You (PEP4U) offers free exercise programs with a focus on balance, coordination, and strength. They also provide online classes to those outside of California. (7)
OhioHealth offers Delay the Disease, a symptom-specific training for the mind, and body, which can also be accessed online. (8)
Finally, check with your local YMCA or community center for Parkinson’s-specific classes near you, and be sure to ask the members of your healthcare team about other local resources.
If you’re eager to get moving but wary of in-person classes, the American Parkinson’s Disease Association has links to many free online resources to help you get started. (12)
And don’t forget to visit Physio Ed.’s YouTube channel for free classes ranging from yoga to pilates to neuroboxing and dance classes with step-by-step instructions, clinically tailored to older people.
Sports for Parkinson’s Disease
Participating in a sport is another great way to stay active and healthy. Many sports are skill-based (requiring increased brain power) and aerobic in nature, which can benefit those living with Parkinson’s Disease by boosting weekly exercise time.
Boxing is rigorous and requires large movement patterns, rhythm/skill, strength, and balance, making it a popular choice for Parkinson’s patients.
Rock Steady Boxing offers Parkinson’s boxing classes around the world, led by skilled, trained coaches. (9)
Golf is another safe and popular option for people with Parkinson’s disease. One study even found that golf produced greater improvement in walking test results for some participants than for others who participated in Tai Chi, which has as also been established as highly beneficial for people with Parkinson’s disease. (10)
Research continues for a variety of activities, including martial arts like karate and qigong. While initial results appear to show positive effects for people with Parkinson’s, it is clear that physical activity and exercise, regardless of the variety, are highly beneficial in combatting Parkinson’s disease, especially in its earlier stages. (11)
Starting an exercise program during the early stages of Parkinson’s is one of the best things you can do to boost your balance skills and combat movement challenges that many people with Parkinson’s disease experience.
Specific exercises focusing on big movements and motor function combined with aerobic activity and muscle strength, can not only help with disease management but can also improve memory and improve longevity.
Different exercises will be prescribed for different patients but staying active with a carefully selected exercise routine can be your first defense against the later stages of Parkinson’s Disease.
Parkinson’s Foundation. Exercise. https://www.parkinson.org/living-with-parkinsons/treatment/exercise
Jakowec, M. W., Wang, Z., Holschneider, D., Beeler, J., & Petzinger, G. M. (2016). Engaging cognitive circuits to promote motor recovery in degenerative disorders. exercise as a learning modality. Journal of human kinetics, 52, 35–51. https://doi.org/10.1515/hukin-2015-0192
Peterka, M., Odorfer, T., Schwab, M., Volkmann, J., & Zeller, D. (2020). LSVT-BIG therapy in Parkinson’s disease: physiological evidence for proprioceptive recalibration. BMC neurology, 20(1), 276. https://doi.org/10.1186/s12883-020-01858-2
LSVT Global. Locate an LSVT Certified Clinician. https://www.lsvtglobal.com/LSVTFindClinicians
LSVT Global. LSVT LOUD: Speech Therapy for Parkinson’s Disease and Similar Conditions. https://www.lsvtglobal.com/LSVTLOUD
Parkinson’s Wellness Recovery. PWR! Moves. https://.pwr4life.org/moves/
Parkinson’s Exercise Program 4 You. PEP4U Mission. https://www.pep4uwellness.org/
Ohio Health. Delay the Disease. https://www.ohiohealth.com/services/neuroscience/our-programs/delay-the-disease/classes-and-training
Rock Steady Boxing. About. https://rocksteadyboxing.org/
Johnson, R., Plummer, L., Chan J., Will, A. Feasibility and tolerability randomized clinical trail of golf versus Tai Chi for people with moderate Parkinson’s Disease. Neurology. 2021. 96; 15 Supplement. https://n.neurology.org/content/96/15_Supplement/1962
Fleisher, J. E., Sennott, B. J., Myrick, E., Niemet, C. J., Lee, M., Whitelock, C. M., Sanghvi, M., Liu, Y., Ouyang, B., Hall, D. A., Comella, C. L., & Chodosh, J. (2020). KICK OUT PD: Feasibility and quality of life in the pilot karate intervention to change kinematic outcomes in Parkinson’s Disease. PloS one, 15(9), e0237777. https://doi.org/10.1371/journal.pone.0237777
American Parkinson’s Disease Association. How To Stay Moving in a Virtual World. https://www.apdaparkinson.org/article/online-exercise-classes-and-resources/