Benefits of Exercise and Physical Therapy for Parkinson’s Patients

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Physical activity is a simple yet effective way of managing the symptoms of Parkinson’s. Learn how regular movement benefits the mind and body and how to create a personalized Parkinson’s disease exercise program.

How Does Physical Activity Benefit Parkinson’s Patients?

Leading an active lifestyle is beneficial for people of all ages and protects against chronic conditions like heart disease, type 2 diabetes, certain cancers, osteoporosis and even dementia. If a senior is not already an active person in their daily life, it is never too late to start. Some of the preventive benefits may not be as strong for those beginning an exercise regimen later in life, but doing so can still have immediate effects like improving sleep, reducing feelings of anxiety and lowering blood pressure.

For elders with Parkinson’s disease (PD), frequent exercise is vital. PD is a progressive neurodegenerative condition that mainly affects movement but can cause mental and behavioral changes as well. Although the exact cause is still unclear, PD occurs when neurons in areas of the brain that regulate movement are damaged or die. Primary physical symptoms of Parkinson’s disease include rigidity, resting tremor, bradykinesia (slowness of movement), akinesia (hesitancy), and balance problems, all of which can increase a patient’s fall risk and cause difficulties with activities of daily living (ADLs). Non-motor symptoms include fluctuations in blood pressure, digestive issues and fatigue.

Fortunately, numerous studies have shown that physical activity is an effective therapy for managing Parkinson’s symptoms. Research suggests that exercise has a neuroprotective effect, causing changes in the brain that result in more efficient use of neurotransmitters (often referred to as the body’s chemical messengers) and reduced susceptibility of certain neurons to damage. Specific benefits differ depending on the nature of a patient’s fitness routine, but exercise can reduce stiffness and improve tremor, posture, balance, strength, and gait. The overall impact this has on PD patients is undeniable. In addition to supporting mobility and extending independence, exercise also helps combat depression, prevent complications like falls and boost patients’ confidence.

Two studies conducted as part of the Parkinson’s Outcomes Project found that consistent exercise is associated with improvements in mobility and a better quality of life. After tracking nearly 3,000 PD patients over two years, one of these investigations found that those who exercised for at least 2.5 hours per week experienced a better health-related quality of life and slower decline in functional mobility. Additional research has shown that vigorous physical activity may also have a positive impact on aspects of cognition like thinking and memory.

How to Develop a Parkinson’s Exercise Program

The Parkinson’s Foundation recommends intense exercise as often as possible for those who have been diagnosed with PD and to people who are concerned about developing PD due to their family medical history. However, every patient is different and each experience with Parkinson’s is unique. When developing a fitness plan for Parkinson’s, it’s important to consider a senior’s abilities, limitations, PD symptoms, overall health, resources and energy level.

Consult a Physical Therapist

A skilled physical therapist (PT) can recommend exercises and activities to help clients with all kinds of conditions manage their symptoms. Physical therapists are also well versed in how medication and exercise can work together, ensuring patients get the most from their comprehensive treatment plans.

It is important to make PT part of the care plan for Parkinson’s disease upon diagnosis. In the past, physical therapy for Parkinson’s patients would often be delayed until the later stages of the disease, usually after an accident like a damaging fall. Now, it is thought that earlier intervention may potentially help slow the progression of symptoms. Establishing with a PT early on will ensure a senior’s symptoms, mobility and functional abilities are carefully monitored and provide them with the personalized guidance they need throughout the disease process.

A physical therapist can create a program that targets PD symptoms by building strength, increasing flexibility, and improving balance. A custom home exercise program for Parkinson’s disease can supplement the work done in therapy sessions and after discharge from therapy. PTs and occupational therapists (OTs) can also perform home safety assessments to ensure a patient’s living environment is safe and maximize accessibility. This can include simple things like rearranging a room to create clear and level pathways to minimize fall hazards or recommending mobility aids and assistive devices to increase home safety and extend independence.

The simple task of initiating walking can be one of the most impacted activities for those with Parkinson’s, but physical therapists are the experts in gait training (improving walking). PTs can teach PD patients and their caregivers visual and auditory cues that help them overcome “freezing” episodes (a fleeting and involuntary inability to move) and how to use these techniques independently. For example, sometimes the rhythmic sound of a metronome can cue steps during walking and prevent freezing. Seniors with PD may also develop a shuffling gait. Visual cues, such as properly spaced lines of tape on the floor, may encourage increased step height and stride length, which decreases the risk of trips, falls and fall-related injuries.


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Explore Different Types of Exercise for Parkinson’s

There are countless forms of physical activity out there, and finding one that fits a Parkinson’s patient’s unique needs and abilities may be difficult, depending on the severity of their symptoms. In some cases, seemingly impossible activities like dancing or riding a bicycle are feasible (with necessary adjustments and careful supervision) for seniors with PD who struggle to even walk. Proceed with caution, though, and always consult a physician before starting a new exercise regimen.

The Parkinson’s Foundation offers the following examples of exercises for Parkinson’s disease:

  • Intensive sports training
  • Treadmill training with body weight support
  • Resistance training
  • Aerobic exercise
  • Alternative forms of exercise (yoga)
  • Home-based exercise (YouTube videos, videotapes, app-based workouts)
  • Stretching
  • Practice of movement strategies

Incorporating elements of yoga, Pilates, tai chi, dancing or boxing can improve core strength and balance and facilitate rotational movement to combat rigidity. While any kind of movement is beneficial, there are specialized programs designed to address the challenges that PD patients face. One such program is the LSVT BIG Treatment—an exercise treatment program for people with PD based on the principle that the brain can learn and change (neuroplasticity).

LSVT BIG has been formulated from an existing program to help with Parkinson’s-related speech difficulties called the Lee Silverman Voice Treatment (LSVT LOUD). This one-on-one treatment focuses on the limb motor systems, helping participants use self-cuing and attention to their actions to make bigger movements in all aspects of life. It targets bradykinesia, which causes PD patients to move slowly and ultimately underestimate the amount of effort required to produce a normal movement.

Establish a Regular Exercise Routine

Outside of seeking physician approval, it’s important to understand that the best exercise for Parkinson’s disease is the kind that patients enjoy and will stick with. Forming a new habit can be daunting, but long-lasting physical fitness regimens are the most effective against PD symptoms regardless of their intensity. Activities that raise your heart rate and promote deep breathing are ideal, but every little bit helps. If an activity isn’t clicking after giving it a fair try, then move on to something else that might be more promising.

Build a Support System

Support comes in many different forms. Family caregivers, friends, physical therapists, fitness coaches and peers who are also living with Parkinson’s can all play a vital role in keeping a PD patient motivated and active. Working out with a partner or a group provides valuable social interaction and tends to encourage consistency and commitment.

PD-specific group exercise programs like Dance for PD and Rock Steady Boxing are offered through a sizeable network of partners and affiliates to help patients stay active, socialize and manage their symptoms.

When confidence in mobility and functionality are lost, seniors with PD gradually begin moving less, avoid leaving the house or even cease caring for themselves. While this behavior is understandable, a sedentary lifestyle will lead to more severe stiffness, rigidity and depression. Being still only exacerbates symptoms, lessens quality of life and speeds up progression of the disease. There is no one best exercise or physical therapy plan for Parkinson’s—only what works best for each patient.

Sources: Benefits of Physical Activity (https://www.cdc.gov/physicalactivity/basics/pa-health/index.htm); Parkinson’s Disease (https://www.nia.nih.gov/health/parkinsons-disease); Exercise‐induced behavioral recovery and neuroplasticity in the 1‐methyl‐4‐phenyl‐1,2,3,6‐tetrahydropyridine‐lesioned mouse basal ganglia (https://doi.org/10.1002/jnr.20162); Triggering endogenous neuroprotective processes through exercise in models of dopamine deficiency (https://doi.org/10.1016/s1353-8020(09)70778-3)

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