People who have Parkinson’s Disease (PD) can benefit from supervised home exercise programs.
Parkinson’s Disease, a gradual onset central nervous system disorder, is characterized by progressive muscle tremor, slow movement, and stiffness. Other less well-known symptoms occur early in the disease. These may include loss of facial expression, reduction of arm swing while walking, and slurring of speech. There is no cure for PD but various therapies can help manage it.
Medications are a cornerstone of treatment for people with PD. However, there are other interventions that can greatly improve a person function, independence, and quality of life.
As a result of the impact on muscle function, a person with PD will likely experience problems with balance and walking efficiency. In addition, changes in eye function can lead to vision deficits and make movement more difficult. Depression, cognitive problems, possible sleep disorders, and fatigue and pain can make exercise more difficult.
Home and supervised exercise are beneficial for people with mild to moderate PD
Exercise has been demonstrated to improve balance, walking ability and speed. Depression may be lessened with exercise for persons with PD. Persons with PD and depression can have problems remaining physically active. Supervised and/or group exercise with a multidisciplinary approach can help increase adherence rates. A two-year study found that resistance training provided under the guidance of a personal trainer was beneficial for motor function. A 2014 systematic review of progressive resistance training (PRET) impact on motor and nonmotor features of PD determined that “PRET can improve strength and motor signs of Parkinsonism in PD and may also be beneficial for physical function in individuals with PD”.
A clinical control trail in 2015 was able to demonstrate that exercise may improve attention and working memory in nondemented patients with mild-to-moderate Parkinson’s disease.
A 2016 study looking at the effects of aerobic exercise training found that persons with PD can increase aerobic fitness. However, what was exciting was that this was the first study to show that exercise (aerobic) could improve motor learning-related brain structures that are consistent with improved behavioral performance. The study authors concluded, “As such, AET can be a valuable non-pharmacological intervention to promote, not only physical fitness in early PD but also better motor learning capacity useful in day-to-day activities through increased plasticity in motor-related structures.”
Structured exercise can improve safety for people with PD. In a 2014 study, people with mild to moderate PD benefited from leg strengthening exercise which reduced falls and improved fitness.
Simple Recommendations for Exercise and Parkinson’s Disease
Even though the evidence on exercise and PD is still in its early stages, it is promising. Simple recommendations include the professional development of a program of aerobic and progressive resistance training, qualified supervision, use of a “buddy system”, and using a multidisciplinary approach to treatment. Exercise should strive for at least 2 sessions per week progressing to greater frequency.