It’s something everyone should do, and yet, not enough of us exercise regularly. Time and time again, exercise has been proven to be beneficial for all aspects of our health, but it is still hard to start—and harder to maintain— a regular regimen. For people with Parkinson’s disease (PD), which directly affects range of movement, exercise can be even more daunting. However, for people with PD, the benefits of exercise take on a whole new level of importance. PD is diagnosed most commonly between the ages of 50-70, an age range that also corresponds with increased risk for cardiovascular issues. It is known that regular exercise lowers the risk of heart attacks and strokes, and current medical opinion is that exercise may slow the progression of PD [1] and encourage the brain to regulate dopamine use more efficiently. In short, exercise can be a neuro-protective agent.
So what’s the catch?
Most of the issue comes from how we think of exercise. More often than not, it is running/jogging
that comes to mind, when one hears the word ‘exercise’. While a good cross-section of the public does
it, only a few probably enjoy running. Moreover
the mobility issues associated with a disease like PD may make running or
jogging more unappealing.
The good news is that you don’t have to run. You don’t even have to jog. You can just walk.
Thirty minutes of walking, be it on the street, on the
track, or in the park is just as beneficial to you as running. A 2013 study
published in Arteriosclerosis,
Thrombosis, and Vascular Biology concluded that equivalent energy
expenditures by moderate (walking) and vigorous (running) exercise produced
similar risk reductions for hypertension, hypercholesterolemia, diabetes
mellitus, and possibly coronary heart disease (CHD) [2].
The Center for Disease Control and Prevention (CDC)
recommends regular moderate exercise for all people, especially those over the
age of 50. Specifically, the CDC states
that exercise helps to maintain the ability to live independently and reduces
the risk of falling and fracturing bones, and the risk of dying from coronary
heart disease and of developing high blood pressure, colon cancer, and
diabetes, and reduces blood pressure in some people with hypertension. For people with diseases like PD, exercise
helps improve stamina and muscle strength, reduces symptoms of anxiety and
depression, fosters improvements in mood and feelings of well-being, and can
help maintain healthy bones, muscles, and joints, helping control joint swelling
and pain associated with arthritis [3].
Activity is the
key word for PD patients and you will find activity encompasses a lot more than
walking and running. Things like yoga,
tai chi, dancing, and boxing workouts (non-contact) are all types of activities
proven to be beneficial in helping to manage PD symptoms. While more research is needed, initial
studies on the benefits of a regular low-impact activity (e.g. tai chi) show
that balance and coordination improve, reducing the risk of falls [4].
When it comes to activity, along with the possible benefits
of increased well-being and stability, what should be highlighted is
dose/frequency. A symptomatic medication
only works if you take it regularly, in a dose high enough to combat
symptoms. The same is true for the
benefits of exercise and activity; walking once a week for 10 minutes isn’t
going to help much, but walking 5 days a week for 20-30 minutes will.
So back to the opening sentence, how to start and maintain a
regimen? Our colleagues at the NPF have
created a one-page tip list that could be beneficial in kick-starting your
exercise routine.
The take-home message is that people with PD don’t have to
run marathons to access the protective benefits of exercise. Moreover, there is a wide swath of activities
that can help with PD issues. Before
embarking on any exercise program, it is important that you consult with your
primary care provider and they agree that your plan is realistic and safe for
you. A check-in with your neurologist
would be good as well, but less essential (you may prefer to impress them with
the results down the road). What is
important is that you don’t start and stop because you aren’t seeing the
results after a couple of weeks. As our
medical director is fond of reminding patients, when it comes to
neuro-protective agents, you’ll never know how well it’s working, because none
of us can predict the progression of your PD.
It is crucial, however, for body and mind to remain active, healthy, and
engaging in life.
Stay Active!
PDCRC Team
1. Ahlskog JE. Does vigorous exercise have a neuroprotective
effect in Parkinson disease?. Neurology.
2011; 77(3):288-94.
2. Williams PT, Thompson PD. Walking versus running for
hypertension, cholesterol, and diabetes mellitus risk reduction. Arterioscler Thromb Vasc Biol. 2013;
33(5):1085-91.
3. http://www.cdc.gov/nccdphp/sgr/olderad.htm, accessed on
June 3, 2015.
4. Li F, Harmer P, Fitzgerald K, et al. Tai chi and postural
stability in patients with Parkinson's disease. N Engl J Med. 2012; 366(6):511-9.
