Exercise Physiology for People with Parkinson’s Disease

Parkinson’s disease (PD) leads to physical issues such as stiffness, difficulties balance, tremor, gross motor functions and mobility difficulties. Parkinson’s also affects brain function and has an effect on metal health. As an evidence based approach, exercise physiology plays a vital role in managing symptoms and supporting optimal function for those living with Parkinson’s disease. Regular Exercise plays an important role in slowing the progression of PD. The team at Exercise Matters designs a tailored exercise program for each individual with Parkinson Disease to best facilitate.
For people with PD, an accredited exercise physiologist can design an exercise program tailored to your needs, goals and preferences.

What is Parkinson’s disease?

Parkinson’s disease is a common disorder of the nervous system. It results from damage to nerve cells deep within the brain that produce dopamine, a chemical which is essential for movement control.

What causes Parkinson’s disease?

Parkinson’s disease is a common disorder of the nervous system. It mainly affects people aged 65 and over, although it can occur in much younger people. It results from damage to nerve cells deep within the brain that produces dopamine, a chemical which is essential for movement control.

What are the symptoms of Parkinson’s disease?

PD can lead to a wide range of symptoms including:

  • muscle stiffness (rigidity) which can lead to pain and movement limitation

  • a tremor which often starts in one arm

  • slowed movements and ‘freezing’ (being unable to start moving)

  • balance problems and falls

  • stooped posture

  • difficulties with speech and swallowing

  • fatigue

  • sleep disturbance

  • reduced facial expression

  • changes to bladder and bowel function

  • anxiety or depression

  • drop in blood pressure leading to dizziness.

How can exercise help with Parkinson’s disease?

Research has shown that exercise has numerous significant benefits for people with PD. For example, exercise has been shown to improve gait (walking) performance ii and freezing symptoms iii. Not only does exercise help with the physical symptoms of PD, but it can also aid with mental health, fatigue, confidence and independence. Here are some ways exercise physiology for Parkinson’s disease can help you.

 

Increased fitness

Fitness of the heart, lungs and circulatory system plays a vital role in maintaining physical health and reducing your risk for developing a range of other health conditions, including heart disease, type 2 diabetes and some cancers.

Fitness can also help to maintain your mobility and ability to participate in activities you enjoy, thereby supporting greater independence and a better quality of life.

 

Increased muscle strength

Adequate muscle strength is essential for performing everyday tasks like climbing stairs, walking, opening jars, and rising from a chair or the toilet. Strong muscles are also important for maintaining your balance.

 

Better balance

Balance is usually affected in people with PD. Exercise can improve your balance control and assist with fall prevention.

 

Improved posture

Stooped posture is common in people with PD. This may lead to back and neck issues and affect your function. Exercise can help to maintain your spinal flexibility and improve your posture.

and neck issues and affect your function. Exercise can help to maintain your spinal flexibility and improve your posture.

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Exercise physiology has numerous benefits for people with Parkinson’s disease

Improved sleep

Adequate sleep is vital for physical and mental wellbeing and reducing the risk of various health conditions, including heart disease, high blood pressure, diabetes and even premature death iv. Exercise can help you sleep better.
 

Improved mental wellbeing

Exercise releases mood-boosting chemicals like endorphins and serotonin. Regular exercise helps to reduce stress and alleviate anxiety and depression symptoms. By pumping blood to the brain, exercise can also help with memory, concentration and nerve cell health v.


Reduced fatigue

While it may seem counterintuitive, exercise can actually enhance your energy levels. If you have PD, you may experience neurological fatigue, so it’s important to find the right type and amount of exercise for you


Social connectedness

Research has shown social connectedness is a key factor in good health vi. Exercising with others can help you experience these benefits. It can also help you to stay motivated and reduce feelings of loneliness and isolation.

How can an exercise physiologist help?

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An AEP can design an effective exercise program for Parkinson’s disease symptoms

Despite the known benefits of exercise, people with PD often have low levels of physical activity. Not only does this mean missing out on the benefits, but it can also place you at higher risk for developing the health complications of a sedentary lifestyle – such as heart disease, type 2 diabetes, and high blood pressure. Lack of exercise may also worsen PD symptoms such as constipation, sleeping difficulties and depression. This is where exercise physiology for Parkinsons can be helpful.

That said, it’s understandable that PD symptoms may make exercise seem more difficult. This is where working with an accredited exercise physiologist (AEP) with experience supporting people who have neurological conditions can make all the difference. As university-qualified allied health professionals, AEPs have extensive training in prescribing exercise programs for people with health conditions. In addition to understanding PD and how it can affect you, they are up to date with research into how exercise can help.

Armed with that knowledge, they can prescribe safe and effective exercise interventions targeted to your specific needs and circumstances. This will be based on an assessment of your health, current level of function and the goals you want to achieve. An AEP will also consider your preferences, because the key to effective exercise is finding something you’ll enjoy and stick with.

Your AEP can also train your support people to assist with your exercise program. This helps ensure it becomes part of your everyday lifestyle and delivers maximum benefits.

What type of exercise is best for Parkinson’s disease?

If you or your loved one has PD, you may be wondering what the best type of exercise is. Fortunately, research has provided some helpful clues for prescribing exercises for someone with Parkinson’s disease.
 

Strength training

Also known as resistance training, strength training is any type of exercise designed to build or maintain muscle strength. Examples include exercises using dumbbells, weight machines, exercise bands or body weight. Studies of lower limb resistance training in people with PD vii have shown it can improve leg strength, quality of life, gait performance and balance capacity. A recent trial viii showed that supervised high-intensity strength training in people with PD improved nerve function, maximal muscle strength, and functional performance.


Cardiovascular training

This is any type of exercise designed to build your cardiorespiratory fitness. Examples include walking, cycling, boxing, dance, swimming and rowing. Studies have looked at various types of cardiovascular exercise in people with PD, with those involving repetitive and rhythmical movements showing particular promise.

Walking, either over ground or on a treadmill, for example, can help to maintain your mobility as well as your fitness. A 2019 analysis of 16 trials of treadmill training ix found that it improved comfortable walking speed and step length in people with PD.

Cycling, including stationary cycling, is another good option. A 2021 analysis of 22 studies found that cycling improved measures of balance, walking speed and capacity, and overall quality-of-life in PD patients x.

Dance is also a popular and effective way to facilitate functional movement. For example, one recent study comparing various types of exercise for people with PD found tango was an effective option for improving functional mobility in PD patients xi.

Balance training

This is any activity designed to improve your balance. Strength is important for balance and some cardiovascular exercises, such as walking and dancing, also involve a balance component. You may also be prescribed specific exercises for balance. Slow, controlled movements, such as those performed in Tai Chi, may be beneficial. A 2019 analysis of five studies found that, compared to no intervention or other physical training, Tai Chi significantly improved balanced and decreased fall rates in people with PD xii.

Flexibility exercises

Depending on your symptoms, you may also benefit from specific stretches for tight muscle groups.

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Exercise physiology and Parkinson’s disease

The type of exercise that is best for you will depend on your symptoms, goals and preferences. It can also vary over time as your symptoms change. For most people, a blend of exercises to target different symptoms and optimise your function and independence will be best. Exercise physiology for Parkinsons should be a tailored program as no one person’s symptoms are the same as another’s.

An accredited exercise physiologist experienced in PD – like the AEPs at Exercise Matters – can work with you to develop a personalised plan to target your needs and goals. They will tailor your program to suit your lifestyle and preferences and modify it as your function or circumstances change. Importantly, they will ensure your exercise program is safe and, where needed, train your supports to help you with it. This helps to reduce your need for visits from us and ensure you get the most benefit from it.

With no waiting times or travel fees, you can get started right away and make the most of your NDIS funding. Along with our NDIS registered AEPs, Exercise Matters have NDIS physiotherapists. This allows us to provide multidisciplinary support to help you achieve greater health, independence and quality of life.

To learn more about how we may be able to help you, contact our friendly team on  (02) 8678 7874,  email admin@exercisematters.healthcare  or complete our contact form.

REFERENCES:

[i] – Neurology. Long-term Effect of Regular Physical Activity and Exercise Habits in Patients With Early Parkinson Disease. https://n.neurology.org/content/98/8/e859. Accessed online 6.5.2022.

[ii] – Neurorehabilitation and neural repair. Exercise Guidelines for Gait Function in Parkinson’s Disease: A Systematic Review and Meta-analysis. https://pubmed.ncbi.nlm.nih.gov/30265211/. Accessed online 6.5.2022.

[iii] – NPJ Parkinson’s disease. A systematic review on exercise and training-based interventions for freezing of gait in Parkinson’s disease. https://pubmed.ncbi.nlm.nih.gov/34508083/. Accessed online 6.5.2022.

[iv] – Healthdirect. Sleep. https://www.healthdirect.gov.au/sleep. Accessed online 6.5.2022.

[v] – Healthdirect. Sleep. https://www.healthdirect.gov.au/sleep. Accessed online 6.5.2022.

[vi] – Better Health Channel. Strong relationships, strong health. https://www.betterhealth.vic.gov.au/health/healthyliving/Strong-relationships-strong-health. Accessed online 6.5.2022.

[vii] – Frontiers in Neurology. Lower Limb Resistance Training in Individuals With Parkinson’s Disease: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials. https://www.frontiersin.org/articles/10.3389/fneur.2020.591605/full. Accessed online 6.5.2022.

[viii] – Journal of Applied Physiology. Maximal strength training in patients with Parkinson’s disease: impact on efferent neural drive, force-generating capacity, and functional performance. https://journals.physiology.org/doi/full/10.1152/japplphysiol.00208.2020. Accessed online 6.5.2022

[ix] – Physiotherapy. Treadmill training may be an effective form of task-specific training for improving mobility in people with Parkinson’s disease and multiple sclerosis: a systematic review and meta-analysis. https://pubmed.ncbi.nlm.nih.gov/30876717/. Accessed online 6.5.2022.

[x] – Parkinson’s disease. Parkinson’s disease patients benefit from bicycling – a systematic review and meta-analysis. https://www.nature.com/articles/s41531-021-00222-6. Accessed online 6.5.2022.

[xi] – Journal of clinical neuroscience. The effects of exercise interventions on Parkinson’s disease: A Bayesian network meta-analysis. https://pubmed.ncbi.nlm.nih.gov/31526677/. Accessed online 6.5.2022.

[xii] – Hindawi Parkinson’s Disease. Effects of Tai Chi Exercise on Reducing Falls and Improving

Balance Performance in Parkinson’s Disease: A Meta-Analysis. https://www.hindawi.com/journals/pd/2019/9626934/. Accessed online 6.5.2022.