There is a large amount of research happening around the benefits of exercise for people with Parkinson’s. Most people want an easy answer. Unfortunately, there isn’t one.
Below is a list of common Parkinson’s symptoms. Each symptom is improved by a different type or style of exercise.
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SYMPTOM
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BENEFICIAL EXERCISE TYPE
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EXERCISE EXAMPLES
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Tremor or shaking at rest
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Aerobic – moderate to intense – puffing
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Running, fast walking, bike riding, boxing
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Loss of muscle strength
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Strength training
moderate to intense
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Weightlifting, body weight, rock climbing
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Muscle stiffness (rigidity) affecting posture, mobility, and movement
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Flexibility, stretching
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Yoga, stretching exercises
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Slowness of movement
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Speed and agility training
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Sprinting, obstacle course, boxing
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Fatigue
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Aerobic and strength
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As above
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Depression/anxiety
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Exercise you enjoy
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Team sports, dancing, painting
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Restlessness
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Rhythmic/repetitive activity
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Boxing, dancing, cooking, yoga,
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Localised muscle pain
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Flexibility, stretching
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Massage, heat, stretching
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Balance difficulties
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Balancing exercises
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Yoga, Pilates, Tai Chi
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Speech changes – slower/quieter
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Speech therapy, vocal exercises
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Singing, loud speaking
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Eating and swallowing difficulties – increased saliva production
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Speech therapy, vocal exercises, medication
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Singing, loud speaking, throat exercises
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Sleep problems
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All and any exercise.
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More intense exercise increases fatigue
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Handwriting – small and messy
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Occupational therapy, writing exercises
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Writing, drawing, painting
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Constipation
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Aerobic – moderate to intense exercise AND
2-3 litres of water per day
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Running, fast walking, bike riding, boxing, all sports
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Cognitive changes – memory difficulties, slowness of thought
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Cognitive exercises, problem solving
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Games i.e. crosswords, sudoku, puzzles, learning something new.
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The above table is a simplistic, brief overview of what types of exercise benefits some of the common symptoms of Parkinson’s.
However, please keep in mind that no two people living with Parkinson’s will have the exact same combination of symptoms, nor will those symptoms progress at the same rate for everyone.
Many other factors will affect Parkinson’s symptoms daily including how busy or how stressed you are, and how well you’ve slept – along with the food and water you’ve consumed and even the weather will have an effect.
Subsequently, in a Parkinson’s journey someone may be at Stage 1, Stage 3 or further along at Stage 5 and each of these stages will appear and impact each person differently. Every hour of each day Parkinson’s symptoms may also change and will subsequently impact each individual differently.
However, there are three consistent goals that should be incorporated into every exercise program no matter what stage of Parkinson’s you are experiencing.
Aerobic exercise – Moderate to intense aerobic exercise benefits the central nervous system. Gradually increase exercise intensity and duration as tolerated, aiming for at least 30 minutes on most days.
Task specificity and complexity – Exercise programs focus on an individuals’ movement issues. This can initially commence with simple activities, and gradually introduce more complex and varied motor and cognitive challenges.
For example, if someone experiences freezing when walking they can start by practicing walking with big steps using visual cues with no interferences, and progress to walking with lots of distractions such as combining cognitive exercises whilst walking (e.g. talking or counting) and physical (e.g. carrying a glass of water) tasks.
Individual Choice – The type of exercise hugely influences whether a person starts and continues to exercise long term. If a person doesn’t enjoy the activity, they simply won’t do it consistently.
There are many methods of doing each mode of exercise as is shown in the table above. For example, an individual may have balance issues. This could be addressed by doing balance exercises in private at home, in a class environment or by doing through Tai Chi or dancing.
Strength training exercises could be performed using machines at a gym or using body weight exercises at home. Individual choices of exercise type, location and delivery methods need to be included in any exercise program to maximise enjoyment and adherence.
One size can’t fit all when it comes to exercise and Parkinson’s. There is no ‘best’ exercise. Someone living with Parkinson’s needs to do a variety of types of physical activity to address the variety of symptoms they are experiencing.
It is about doing something regularly and altering the exercise to consider the individual’s choice, and their physical and mental capabilities.
Parkinson’s progresses over time, and changes hourly and daily. All exercise programs will need to be evaluated and updated to meet the safety and ever-changing needs of a person living with Parkinson’s.
References:
Prepared by Professor Graham Kerr (Queensland University of Technology) Updated by Dr Natalie Allen and Prof Colleen Canning (The University of Sydney).
Role of Physical Activity in Parkinson’s Disease
