The Evidence for Exercise
The Summary
Research shows that increased activity level, especially higher intensity aerobic exercise leads to reduced loss of dopamine neurons in the brain and modification in the progression of Parkinson’s disease. Exercise leads to brain growth (i.e. Neuroplasticity) to halt and even reverse the disease process.
The benefits of exercise are wide ranging including improved function of PD drugs, reduced PD symptoms, improved overall fitness, slowing and evening reversing disease progression, and even preventing onset of PD itself.
Dose Matters: You need a high level to rescue the dopamine neurons and use alternative brain pathways to get maximal benefits
Frequency Matters: Research shows you need to exercise at least 3x/week of sustained effort to have significant benefit
Intensity Matters: The most significant changes in function and slowing of disease progression in both animal and human studies occurred with aerobic training (heart rate increase) at >80% of your maximum heart rate. If you are unable to figure out your heart rate, then use a BORG Rate of Perceived Exertion Scale as an alternative way to measure intensity.
Specificity Matters: Loss of automatic skilled movements occurs with people with Parkinson’s, especially for those with bradykinesia. Repetition and frequent practice of your activity goals are important to maintain function.
The Data breakdown
The Guidelines
The Parkinson’s Foundation created a list of exercise guidelines in 2020 with experts/leaders in the field coming together for consensus.
Aerobic activity: 3 days a week for at least 30 minute per session of continuous or intermittent movement at moderate or vigorous intensity
Strength training: 2-3 non-consecutive days per week of at least 30 minutes per session for 10-15 repos for major muscle groups; resistance, speed, or power focus
Balance, agility and multitasking: 2-3 days per week with daily integration if possible
Stretching: 2-3 days per week with daily stretching being most effective
Bradykinesia: speed and/or amplitude dysregulation across ALL movement symptoms (limbs, breathing, eyes, voice, etc). Leads to slowed/small movements and balance responses
TO IMPROVE WE NEED TO ACTIVATE: high speed and large amplitude movements
Rigidity: Increased muscle tone and spine stiffness, especially of those that tend to lead to more stooped/flexed posture (I.e spine, hips flexors, hamstrings).
TO IMPROVE WE NEED TO PREPARE: sustained holds, rhythmic movements, focus on flexibility
Impaired Sensory integration: altered ability to process sensory input from your body (specific movements at each joint, head/eye position, relationship to gravity, acceleration, etc) leading to a “perceptual mismatch”
TO IMPROVE WE NEED TO BE SPECIFIC: training for the challenging task, use A LOT of external focuses, challenge your balance.
Incoordination: unreliable and inconsistent sequencing of movements (including limbs, breathing voice, hands, eyes, etc)
TO IMPROVE WE NEED TO FOCUS: challenge your fine motor, think, and moving abilities and in varying ways with focus on motivating tasks
Postural Instability: Difficulty maintaining balance due to reduction of loss of postural reflexes
Understanding the symptoms
