Exercise is beneficial to everyone, at any age, but in Parkinson’s disease exercise is one of the most effective treatments. Exercise is as important as taking medication for Parkinson’s as it helps preserve mobility and independence over time. Physiotherapists can help to provide appropriate and effective exercises for Parkinson’s disease.
What is Parkinson’s Disease?
There are around 6-7 million people worldwide living with Parkinson’s disease, and the numbers are expected to go up over the next 2 decades because of our ageing societies. Most people are over 60 years old when they get diagnosed, although a small percentage get symptoms before the age of 50 and this is called young onset Parkinson’s.
Parkinson’s disease is a progressive neurological condition caused by the gradual loss of those cells in the brain which produce a neurotransmitter called dopamine. Dopamine is involved in regulating movements of the body. In Parkinson’s disease there is less dopamine available to control body movements, and so the main type of medication used to treat Parkinson’s is a form of dopamine to replace what the brain cannot produce by itself.
Parkinson’s disease causes both motor symptoms (movement related symptoms) and non motor symptoms (not movement related). The main motor symptoms are slowness of movement, stiffness in the muscles, and tremor, and there are many non-motor symptoms including constipation, problems sleeping, fatigue, and depression/anxiety.
Why Is Exercise So Important?
There are lots of studies that clearly show the importance of exercise in Parkinson’s disease, and those people who take regular exercise and who stay active, do better over time than those who are sedentary. Exercise can help to counteract many of the symptoms of Parkinson’s disease, and will help someone to stay as fit and active as possible for as long as possible.
- Exercise helps improve strength, posture, walking and balance all of which are affected by Parkinson’s.
- Exercise helps to prevent falls by staying strong and keeping mobile. Falls are common in Parkinson’s disease due to the problems with balance.
- Exercise is also beneficial in helping to maintain stronger bones, so exercise helps in reducing the risk of fractures if a fall does happen.
- Exercise can also assist with managing constipation, with regulating sleep, and improving mood, all of which are common Parkinson’s symptoms.
- Exercise enhances general brain health, by stimulating blood flow to the brain and thereby supplying the brain with oxygen, glucose and promoting nerve growth factors.
How Much Exercise?
It’s actually important to do quite a lot! Guidelines for exercising in Parkinson’s disease recommend at least 150 minutes per week of exercise that is of a moderate to vigorous intensity. This equates to 30 minutes of exercise, five times a week. Doing even more exercise than this is likely to be better in terms of overall benefits, and some would recommend an hour a day.
The exercise should involve some strengthening to stay strong, some stretching to stay flexible, aerobic exercise for stamina, as well as some balance training. The main thing is to try and find exercise that is enjoyable, as that means it is more likely to be a regular, ongoing habit.
How can Physiotherapy help?
Physiotherapists will assess someone with Parkinson’s disease to identify any specific difficulties with movement and balance, posture and walking, and work out how best to exercise safely and effectively.
If symptoms are in the early stages, are relatively mild, and the person is otherwise healthy, then taking part in any form of exercise of a moderate to vigorous intensity is helpful, such as hiking, cycling, or working out in the gym. If you are already used to exercising, great! Keep it up!
If you are new to exercising and recently diagnosed with Parkinson’s disease, then a physiotherapist can assist in getting you started with the right amount and type of exercise. The aim is to try and keep the symptoms controlled as much as possible in the early stages, and to stay as active as you can.
But as the Parkinson’s symptoms progress over time, movement might start to become more problematic, and day-to-day activities can be affected. There may also be safety issues with some forms of exercising, such as the risk of falls if balance is a concern.
This may mean more supervision or assistance is needed when exercising, and more targeted exercises and strategies to work on the specific symptoms of Parkinson’s.
- A physiotherapist can provide a safe and effective exercise programme, and will ensure that any movement related symptoms are being taken into account.
- Exercise can be modified over time, and physiotherapists can help with continuing to exercise safely and at the best level of intensity whatever stage of Parkinson’s someone is at.
- Physiotherapists can also teach strategies to help overcome some of the movement difficulties caused by Parkinson’s disease, to help stay active and independent.