What type of exercise is best for people with Parkinson’s?

Exercise is increasingly recognised as a cornerstone of Parkinson's disease management. Studies now show that exercise can help manage symptoms, slow disease progression, and even potentially reverse some aspects of PD when performed consistently. Michel Planquart, in a recent meetup for PD Buddy, shared insights into how different types of exercises benefit people with Parkinson's and provided recommendations to help incorporate physical activity into daily life. Why Exercise Matters for Parkinson’s Research has consistently shown that exercise is not only beneficial for the physical symptoms of Parkinson’s but also has neuroprotective effects. Engaging in physical activity increases dopamine transporter availability in the brain, which is crucial as dopamine deficiency is central to PD. Notably, a recent study by Yale School of Medicine found that high-intensity exercise could induce brain-protective effects that may not only slow down neurodegeneration but, in some cases, even reverse it. What Does Exercise Do? Helps with Symptoms: Exercise is known to reduce rigidity, tremors, and improve mobility. Slows Progression: Regular exercise has been shown to slow the progression of PD symptoms. May Halt or Reverse Disease Progression: While more research is needed, initial findings suggest that intense exercise may have disease-modifying effects. Types of Exercise Beneficial for Parkinson's: According to data collected from nearly 2,000 PD Buddy users, there are popular exercise routines that people with PD are gravitating towards. Here are the top exercises based on suggestions from PD Buddy users: 1. Strength Training (Weights): Strength training is twice as popular as walking, with many people finding it effective for maintaining muscle mass and strength. 2. Walking: Including fast and Nordic walking, which helps with endurance and balance. 3. Cycling: An effective cardiovascular workout that also reduces stiffness. 4. Boxing: Programs like “Rock Steady Boxing” are popular, focusing on agility, strength, and balance. 5. Aerobic Exercise: Activities such as jogging, jumping, and other aerobic activities increase cardiovascular health. 6. Dancing: Engaging in dance routines can help with motor coordination and is beneficial for mood. 7. Yoga and Pilates: These improve flexibility, strength, and help with relaxation. 8. Tai Chi: A balance-focused martial art that improves posture and reduces the risk of falls. 9. Swimming and Water Aerobics: Water exercise is gentle on the joints and supports full-body movement. 10. Personalised Sports: Many people als continue with hobbies they enjoyed pre-diagnosis, like golfing, kayaking, or horseback riding. Tailoring Exercise Intensity for Parkinson’s: Professor Bas Bloem, a leading PD researcher, suggests focusing on breathing patterns rather than heart rate to gauge exercise intensity. Parkinson’s affects the autonomic nervous system, which can alter heart rate, making heart rate a less reliable indicator. Instead, aim for an intensity level where you're breathing heavily but can still maintain a conversation. This ensures you're working hard enough to gain benefits without overexertion. How Often and How Much? Michel recommends a minimum of three sessions per week, ideally increasing to 5-6 days per week. Sessions should last at least 30 minutes each for effectiveness, though up to one or two hours would maximize benefits. However, “exercise snacking”—short, frequent bouts of activity—also counts. This can be as simple as taking a 10-minute walk or doing a quick stretching routine several times a day. Beyond Parkinson’s Benefits Exercise provides broad health benefits beyond PD management, including: Improved Heart Health: Cardiovascular exercise reduces the risk of heart disease. Stronger Bones: Weight-bearing exercises help maintain bone density. Reduced Dementia Risk: Physical activity has been shown to lower dementia risk. Enhanced Muscle and Lung Strength: Regular movement supports muscle growth and lung function. Better Mental Health: Exercise is linked to improved mood and reduced anxiety. Anti-Aging Effects: Physical activity can delay the effects of aging on the body and brain. Practical Tips for Getting Started: Motivation to exercise can be challenging, especially when dealing with fatigue or physical discomfort. Here are a few tips Michel recommends: - Hire a Trainer: A personal trainer can provide guidance and motivation. - Find an Exercise Buddy: Working out with a friend increases accountability. - Reward Yourself: Set goals and reward yourself when you achieve them. PD Buddy’s point system is one way to gamify progress. - Watch Movies While Exercising: Use entertainment to make home workouts enjoyable. - Choose Activities You Love: Exercise doesn’t have to be a chore—choose activities that bring you joy, like walking in scenic areas. - Staying Motivated with Visual Reminders For Michel, a simple comparison of shoes worn before and after his PD diagnosis serves as a reminder of why exercise is essential. The scuffing on his old shoes from shuffling has lessened significantly, thanks to his consistent exercise routine. Such visual cues can remind individuals of the benefits and help keep them motivated. In Summary Exercise should be viewed as a critical component of Parkinson’s management. Not only does it offer symptomatic relief, but it can also slow disease progression and has the potential to impact the neurodegenerative process itself. Whether it’s strength training, walking, or dancing, the key is consistency. Michel’s advice to the PD Buddy community is clear: exercise as often as possible, at an intensity level that challenges you without overexerting, and choose activities that you enjoy for sustained motivation.