Exercise

Key Facts

  • All patients, regardless of disease state, should exercise.
  • Aerobic and anaerobic activities as well as yoga, tai chi, and others can be beneficial for your patient.
  • There is a growing consensus that vigorous exercise should be encouraged. 

Clinical Best Practices

  • You should recommend that all PD patients perform some form of exercise as tolerated.

Parkinson's disease experts agree that exercise is beneficial for PD patients at most stages. The benefit of exercise is supported by an ever-expanding body of research, indicating positive effects on many aspects of daily living and performance.  There is a growing body of research pointing towards vigorous exercise, with careful consideration of patient safety, as a potentially being neuroprotective.

Table of Contents 

Exercise

  • Exercise may improve the motor symptoms in PD.
  • Ideally, this exercise would include both aerobic and muscle strengthening/stretching exercise.
  • Exercise can improve mood, possibly help cognition and even reduce the chance of dementia, and improve mobility and endurance.
  • Exercise may also stimulate the generation of stem cells in the brain.
  • Tai chi, yoga, dance, swimming, and other activities, can all be helpful as a part of total care in a PD patient.

Tai Chi and Yoga

  • Promotes conscious awareness of movement and actions (beneficial since automatic motions are affected by PD)
  • Increases awareness of proper body alignment/posture
  • Improves balance with reduced fall risk (supported by numerous studies)
  • Enhances flexibility
  • Affords a greater sense of well-being
  • Offers relaxation, which can help to lessen PD symptoms (tremor, rigidity) or manage medication side effects such as dyskinesia
  • Improves breath support and control
  • Helps to build healthy bones through weight-bearing activities (important in fighting osteoporosis)
  • Increases strength, especially in core muscles (abdominals, hips, and back)
References: 

Ridgel AL, Vitek JL, Alberts JL. Forced, not voluntary, exercise improves motor function in Parkinson's disease patients.  Neurorehabil Neural Repair. 2009;23(6):600-608. 

Ahlskog JE. Does vigorous exercise have a neuroprotective effect in Parkinson disease? Neurology. 2011 Jul 19;77(3):288-94.