Parkinson’s Disease and Exercise
‘Exercise is medicine’
Research shows that exercise in people with Parkinson’s Disease is not only an integral part of self- management but can actually slow down disease progression. Did you know that newly diagnosed groups with Parkinson’s Disease are already 30% less active and are taking 30% fewer steps? (Lord Et al, 2013). So time is of the essence!
Ideally exercise should be prescribed alongside medication to optimise quality of life and function. However we know it’s hard for people to make changes to their day to day routine, especially if you are not used to exercising. It is even more overwhelming to know what kinds of exercise may help you. This is where physiotherapists can help!
What do we mean by Neuro –Active Exercise?
Neuroactive means delivering exercise which drives neurological changes in the brain. We know that Parkinson’s disease affects the production of dopamine ( an important neurotransmitter) and the uptake of dopamine in the brain due to fewer dopamine receptors. But how does exercise influence this?
- An emerging body of evidence suggests exercise triggers several plasticity related events:
- Increase in cortico-motor excitement
- Increase in grey matter volume
- Increase in BDNF levels (Hirsch, Iyer and Sanjak, 2015)
- Physiological mechanisms in humans may improve the efficiency of existing dopamine circuits i.e. the brain can do more even with less dopamine
- Exercise may unlock the full potential of dormant/unused available circuits (Alberts et al 2016)
In simple terms exercise helps our brains to be more effective and ready to learn!
What type of exercise?
Research shows that people with early stage Parkinson’s Disease are safe to exercise at high intensities (must exclude co-morbidities first). Exercise should be vigorous! This means exercising at 80% of rate of perceived exertion.
So vigorous aerobic exercise for example treadmill training or static cycling is well tolerated and effective. It is thought this level of exercise impacts connectivity through priming the brain environment to promote synaptic plasticity leading to altered circuitry.
However it is not just aerobic exercise that is beneficial, yes this primes neurons to learn but …..
- Exercise needs to be skill based, goal oriented and include repetition, intensity and challenging for motor learning – this helps drive neuroplasticity! Boxing could be a great way to achieve this!
- Exercise needs to be cognitively engaging – activities which demand increased attention, planning, processing of information and/ multitasking.
- Maintaining flexibility is also important and needs to be included in an exercise routine for example Yoga or Pilates.
For how long?
Recommendations are that 2.5 hours of exercise a week can help slow down disease progression and have positive effects on sleep, mood and fatigue. This can be a combination of different types of exercise and don’t forget walking is an excellent way to exercise.
How can we help?
It can be daunting for anybody embarking on a new exercise routine, especially if you are unsure about what your body may be able to manage. At physio.co.uk we have a team of experts that can help you reach your goals and devise a programme specific to your needs.
A physiotherapy assessment with one of our specialist neurological physiotherapists will identify your impairments and select a programme of exercises which will suit your needs. Not everybody will be suitable for vigorous exercise! It will entirely depend on what stage you are and the specific symptoms you have. Be sure that whatever level you are our physiotherapists will support you to be the best you can be for as long as possible. It’s time to take action against Parkinson’s Disease with exercise!