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The Importance of Exercise and Understanding the Most Effective Program for you

As published in Parkinson Voice

Often people tell me they know exercise is important but do not know what is the best for them.  Others tell me they know it is important but do not have the motivation to exercise.  Exercise should change what you are able to do each day.  Having more energy to do the things that are meaningful to you should be a part of your goal setting.  This will increase your motivation to exercise and may also result in changes such as faster walking speed and increased safety on stairs. Individual goals such as hiking, traveling and/or a better golf game will be enhanced by consistent exercise.

You may have read or heard certain types of exercise such as Tai Chi, yoga, tango, cycling or boxing are beneficial for people with Parkinson’s disease.  Research shows they are beneficial with but for various reasons.  Interest and benefit depend on what you need to improve to reach your goal.

  • For example if you want to improve your turning while skiing then you may need to find an exercise that incorporates weight shifting such as Tai Chi or dance.  Tango is one style of dance most similar to walking challenging the balance systems with stepping in multiple directions, turning, and being aware of your partner’s movements and other dancers on the dance floor.  It also improves postural awareness and coordination. 
  • If you want to be flexible but stiffness limits your mobility consider yoga or Tai Chi which include stretching and reciprocal movements.  They both may also improve your posture and balance with various positions and weight shifting.
  • If you want to improve your aerobic capacity boxing and cycling helps.  Boxing can also increase speed of movement, reaction time and balance.

There are so many ways to exercise. Finding something you enjoy will automatically increase regular performance.  You will not reap the benefits of exercise if you are not enjoying it, and avoid doing it.  You can also modify almost any exercise so you can continue what you like to do. The fun of dancing, cycling or boxing may surprise you and become your new passion.

  • Does your exercise program help you reach your goals?
  • Does it improve your posture, flexibility, strength, movement speed, walking, balance, and/or coordination?
  • Or do you need a combination of different types of exercises to real your goals?

Consultation with someone with the knowledge of the options is time well spent.

There is also extensive research on the benefits of music and movement.  So put on your favorite tunes while exercising to help motivate and get you moving!  One of the main movement problems due to basal ganglia disorder is the failure to automatically maintain an appropriate amplitude and timing of sequential movements.  Cueing tackles this problem.  The use of auditory cues using music or metronome along with visual cues will immediately enhance the size and timing of your movement and therefore maximize your overall performance. Cueing from a therapist, trainer or external cues will help you improve your quality of movement in both speed and size of movement.

You may already be aware of the benefits of exercise to improve your heart, strength, endurance and mood but are you aware of the benefits it can make on the brain and your everyday function and quality of life?  Exciting neuroscience research is showing the benefits of exercise that can delay degeneration, reorganize your brain map, and recover some of your lost function.

The neuroprotective effect preserves nerve cells that are at risk for damage by slowing degeneration. If there is damage in one area of the brain, neuroplasticity drives rewiring of pathways; increases use of other parts of the brain; and makes new connections to improve function.  The neurotransmitter dopamine becomes more efficient by modifying the areas of the brain where the dopamine signals are received. High intensive aerobic exercise shows the most promise of neuroprotection.  Higher intensity, higher duration and task specific paradigms that are continually challenging and complex may be required to accomplish the changes in the brain. 

TIPS:

  • It is beneficial to stretch every day especially if you experience bradykinesia (slowing of movement) and rigidity (stiffness).  This may help you feel loose and ease movement.  After stretching, try to use that movement in function to maintain your range of motion.
  • With PD you may not fully complete your movements.  The smaller motion limits strengthening the muscles to their full capacity and full range of motion.  You may also use one side more than the other and may need to work the less used side harder to make the movements equal.  Cues or focused attention to your technique will improve the movement.
  • Use of auditory cues using music or metronome combined with visual cues will immediately enhance the size and timing of your movement and therefore maximize your overall performance.
  • Always remember to consult your MD prior to starting any new program and a physical therapist can help provide a comprehensive evaluation, assessment and exercise plan to help you reach your goals.

Erica DeMarch, Physical Therapist