There’s no doubt about it, the benefits of exercise and physical activity are countless and have been known to humankind for centuries. In 1887, the New England Journal of Medicine stated:
Exercise sustains and improves bodily health by expanding the lungs, quickening the circulation, and promoting growth in muscles and bones. But we know that besides doing all these things, exercise may be made to contribute to brain growth and to the symmetrical development of the mental faculties.”
For people with Parkinson’s, exercise is an especially important part of a holistic approach to achieve a better quality of life. People with Parkinson’s claim exercise can reduce symptoms and slow progression of the disease. And the earlier one starts an exercise program, the better. Not only does exercise benefit the body but also the brain. Exercise boosts fitness levels, builds muscles and bones, and improves motor symptoms, which can reduce the risk of falls. According to neuroscientists, exercise stimulates the growth of new neurons which in turn improves cognitive function, including thinking and memory. Further, regular exercise has an anti-depressive effect.
One professor of medicine put it this way, “Our experiments show that exercise can get to the heart of the problem in Parkinson’s disease. People with Parkinson’s who exercise are likely able to keep their brain cells from dying.”
There are several exercise programs on the market that have been developed specifically for those with Parkinson’s. Rock Steady Boxing, a non-contact boxing-based fitness program, consists of exercises that have been adapted from boxing drills designed to improve PD symptoms.
Dance for PD® offers specialized dance classes to people with Parkinson’s in more than 100 communities around the world. Their classes allow people with Parkinson’s to experience the joys and benefits of dance while addressing symptom-specific concerns related to cognition, balance, motor skill, depression and confidence.
LSVT BIG, a component of the Lee Silverman Voice Treatment program, is an exercise program for people with PD, based on the principle that the brain can learn and change. The goal of LSVT BIG is to improve people’s ability to make bigger movements which can be applied for different activities and situations, leading to faster walking with bigger steps, better balance and improved quality of life.
There is not a “one-size fits-all” exercise program for everyone with Parkinson’s. A physical therapist or personal trainer can recommend an exercise routine that’s suited to an individual’s specific needs, goals and fitness levels.
It’s never too late to start exercising. In the beginning, as you embark upon an exercise routine, you don’t need to exercise vigorously, just regularly—daily if possible. A simple walk in the park, a gentle yoga or tai chi session, early morning stretching, an uplifting dance class, a climb up a flight of stairs, or a relaxed bike ride around the neighborhood are fun and efficient forms of exercise to get the body moving.
Once your body adjusts to a regular program, you can increase the level of intensity of exercise and incorporate more challenging and progressive activities, including a Forced Exercise program, where you push your body beyond what it can voluntary do. Speak with your doctor or physical therapist to set exercise goals that are right for you and stick to a plan. Once you start moving, you may not want to stop!
If you’re not feeling motivated to exercise, refer to the Parkinson’s Foundation “Tips for Becoming Physically Active” pamphlet to help jumpstart a physical activity program.
We are particularly partial to cycling as a healthy, enjoyable and low-impact form of physical activity. Cycling is easy and doesn’t require a high level of physical skill, making it accessible to people of all ages.
The benefits of cycling have been widely and scientifically documented and can improve both physical and mental health. Riding a bike improves joint mobility, builds muscles, strengthens bones and increases cardiovascular fitness. Riding a bike can also reduce anxiety, depression and stress.
Further, the positive effects of cycling can be long-lasting and help with everyday functional activities such as balance, standing, walking and climbing stairs, thereby reducing the risk of falls and fractures. Cycling is a therapeutic activity and can be done at varying degrees of intensity—at low intensity to kickstart an exercise program or at high intensity to garner a rigorous workout.
Studies conducted by British scientists comparing older recreational cyclists between the ages of 55 and 79 to older sedentary people and to a group of 30-year-olds found that the reflexes, memories and balance of the older cyclists were similar to those of the younger group of adults. In follow-up studies, using muscle tissue and blood samples as markers, the researchers found that the active aging cyclists were healthier and biologically younger than their sedentary older counterparts.
Research on VO2 max, or maximal oxygen uptake, a measurement used to determine overall aerobic fitness, points to centenarian, Robert Marchand, a French amateur cyclist who did not exercise regularly during most of his working life. Upon retirement, he took up cycling and at the age of 105, became a world record holder in a one-hour cycling event. Mr. Marchand is more aerobically fit than people half his age and appears to be getting even stronger physiologically as he continues to age and bike.
After Dr. Jay Albert’s now well-known tandem bike ride at RAGBRAI, where he observed improved motor functioning in his biking partner, Cathy Frazier, they together founded Pedaling for Parkinson’s, an organization which investigated the hypothesis that improvements in motor function were the result of increasing revolutions per minute (RPM) while cycling. That is, positive motor effects occur when people with Parkinson’s pedal at rates higher than they can normally reach. While most cyclists with Parkinson’s pedal 40–50 RPM on their own, the goal is to achieve 80 RPM or higher, which can be attained either through tandem biking or through Forced Exercise on a stationary bike. Many local YMCAs around the country offer indoor Pedaling for Parkinson’s classes.
Cycling is a simple, safe and rewarding form of exercise that can be done either indoors on a stationary bike or outdoors on the road. While riding outdoors is fun and provides a scenic workout, biking outside may not be attainable for everyone. Indoor stationary cycling offers a tangible workout which can be done in the convenience of your home or gym. Go ahead, get on your bike or Theracycle, take a spin and reap the benefits of good health!
Cognitive Stimulation & Exercise
Research has shown that some of the best approaches to exercise for people with Parkinson’s disease includes simultaneous mental and physical exercise. Another term for this is dual-tasking.
Dance, for example, incorporates movement and stimulation of the brain. One has to remember steps, often complex, and merge them into physical activity. Dancing improves brain function on several levels by incorporating cognitive thought processes with muscle memory.
Dance has received attention because recent studies have demonstrated dance’s ability to improve mobility and health-related quality of life in people with PD, effectively impacting motor (endurance and risk of falls) and non-motor functions (executive functions). A study from the International Journal of Gerontology, Therapeutic Dancing for Parkinson’s disease, suggests that therapeutic dancing can be beneficial for improving motor performance, mobility and balance in people with PD. Dancing can also have a positive impact on quality of life and adherence to physical activity over time. Dancing has been associated with short-term improvements in freezing of gait, walking performance and well being in some individuals. Dance provides a rich experience involving several senses, creative expression and social interaction.
Another form of movement that involves cognitive function is Conductorcise®, created by long-term conductor David Dworkin, which works out the upper body, is low impact and doesn’t require much skill, making it easy for people who are older, overweight or chair bound. The goal is for participants to feel the beat and wave their arms to the music. Conductors have to remember several hundred parts to conduct an orchestra. They’re constantly moving; they’re standing up; they’re dancing. They get a tremendous amount of physical and mental exercise simultaneously. Maestros also claim that conducting is a spiritual experience. Did you know that orchestra conductors live longer than nearly any other group of people?
But you don’t have to take a Conductorcise class to get into the swing of things. Just turn on the music, grab a baton (or stick), and start moving!
Check out these cognitive stimulation activities, from NeuroUP, to enhance cognitive functions frequently affected in people with Parkinson’s disease: attention, visuospatial skills, information processing, and executive function: