Can Exercise Slow the Symptoms of Parkinson's Disease?

Bicycling. Boxing. Swimming. Yoga. Dance. Finding the time and motivation to exercise can be difficult for anyone. But if you have Parkinson’s Disease (PD) — or you’re the caregiver or loved one of someone with Parkinson’s — exercise should be a top priority. Research has increasingly shown that regular workouts not only slow symptoms of the disease but also can dramatically improve quality of life.

“Physical exercise influences the plasticity of the brain, and in Parkinson’s patients has been shown to improve motor symptoms, including stiffness, rigidity and bradykinesia (the slowness of movements), as well as non-motor symptoms such as fatigue, cognitive function and constipation,” says Lina Hurtado, M.D., a board-certified physical medicine and rehabilitation specialist at Baptist Health Miami Neuroscience Institute.

An estimated 1 million people in the U.S. are living with PD, according to the Parkinson’s Foundation. A movement disorder, PD occurs when nerve cells in the brain stop producing dopamine and other neurotransmitters that affect movement, among other functions. It has no cure.

Its first symptom is often a tremor of the hand or foot when the muscles are at rest, although not everyone with PD develops a tremor. As the disease progresses, coordination, balance and posture worsen, and many patients end up wheelchair- or bed-bound and need assistance with daily activities. Up to half of all Parkinson’s patients develop dementia.

Where to Start

It’s normal and understandable, Dr. Hurtado says, for Parkinson’s patients to have a fear of movement and to be apprehensive about falling. “But if you don’t move, you fall. We have to break the cycle,” she says. “Start slow. If you can walk for five minutes now, increase it to 10. Even that helps.”

For safety, Dr. Hurtado recommends:

·      Being evaluated by a physical therapist or physiatrist

·      Increasing and modifying your exercise routine slowly

·      Having someone with you when you exercise, when needed

What Type of Exercise is Best?

Each person’s exercise program should be customized and address their specific symptoms and abilities, which is another reason a visit with a physical therapist or physiatrist can help. “It’s important to find things that you enjoy, that target the areas that will be most beneficial for you and that work for you, whether it’s chair yoga, Pilates, tai chi or a group exercise class,” Dr. Hurtado says.

The Parkinson’s Foundation and the American College of Sports Medicine suggest 150 minutes of moderate-to-vigorous exercise a week. Your routine should be a well-rounded program that includes something from each of these four areas:

·      Aerobic exercise such as walking, running, cycling or swimming.

·      Strength training with weights, weight machines, resistance bands or body weight.

·      Balance, agility and multitasking such as yoga, tai chi, dance or boxing. “Exercise that works in multidirectional planes, requiring you to move in different ways, is great,” Dr. Hurtado says.

·      Stretching

Think about starting with small goals in mind and, in addition to an exercise routine, add challenges to your daily tasks. This could be as simple as shifting all your weight to one leg while you brush your teeth or using light weights to exercise your arms while you are watching TV. And don’t be afraid to modify your exercise or adopt new movements as your disease progresses.

In addition to improving PD symptoms, exercise is critical for overall health, says neurologist Samer Tabbal, M.D., director of the movement disorders program at Miami Neuroscience Institute. “Exercise improves cardiovascular health, reduces the risk of diseases like cancer and diabetes and increases muscle and bone mass, which can help lower the odds of a fracture if a patient falls,” Dr. Tabbal says. “We also know that exercise helps with sleep quality and lessens the depression and anxiety that are common in Parkinson’s patients.”

Lina Hurtado, M.D., a physical medicine and rehabilitation specialist at Baptist Health Miami Neuroscience Institute

Samer Tabbal, M.D., neurologist and director of the movement disorders program at Baptist Health Miami Neuroscience Institute

For the latest exercise recommendation from the Parkinson’s Foundation, click here. To learn more about support groups offered by Miami Neuroscience Institute, click here.