The Importance of Exercise in Parkinson’s Disease

Exercise has long been recognised as an important treatment approach for Parkinson’s disease. A growing body of evidence shows that exercise can also help re-wire the brain and have a neuro-protective response. This means the right kind of exercise may not only improve overall physical function; it may also have an effect on disease progression and ultimately slow the symptoms of Parkinson’s. Using this type of exercise, in combination with optimal medication dosing, has shown remarkable results.

Parkinson’s disease is a progressive neurodegenerative disease which depletes dopamine producing cells.  These cells are responsible for initiating and coordinating movement, so as they become depleted movement slows down.  I liked one analogy in the book ‘Living with Parkinsons’ which describes dopamine as more the engine oil, rather than the petrol. Without dopamine you can still move, but the movements are corrupted and become stiff, rigid and slow.

When people are diagnosed with Parkinson’s they have already lost 60-70% of dopamine producing cells. With further disease progression symptoms worsen and lead to severe disability. This disability is caused by tremor, muscle stiffness, slow movement, impaired balance and co-ordination, all of which impact on the person’s ability to complete everyday tasks. The earlier exercise intervention is undertaken the better the long-term results, whereas inactivity can lead to further and faster deterioration.

Most often, even in the very mild stages of Parkinson’s disease, people have started to modify their life. They subconsciously avoid social activities, modify the clothes they wear to avoid doing up buttons and zips, and start ordering different food in restaurants.  Subtle changes they might not even notice. Without treatment they may continue to give up things they enjoy. The right exercise treatment can help people recognise these signs, as well as how to minimise restrictions.

The combination of challenging physical exercise and mental activity has been shown to improve mobility and confidence in people with the degenerative movement disorder.  Whatever functions and movement the disease is affecting, instead of finding another way to do the task I would encourage you to practice, practice, practice until the movement is no longer a limitation.

Since Parkinson’s causes movements to become slow, stiff and small, do the opposite. Make movements big and fast, with high effort and amplitude of movement. When you do this you release your own dopamine by initiating and co-ordinating movement. If you are requiring your body to use and release dopamine in the brain, then the body is more likely to protect and spare what it has left.

It goes back to the good old saying ‘use it or lose it’. Yes it takes more time, patience, effort, motivation and mental fatigue, but you don’t have to let the terms of this disease define you. You can redefine the terms and live a full life with Parkinson’s.

Exercise is medicine and prescribed correctly it can be incredibly powerful. These specialised exercises have given people hope that there is life after Parkinson’s disease. Parkinson’s classes are running in Ulverstone and Shearwater. For more information please phone 6425 5997.

References

  • Giselle M.Petzinger, et al. Enhancing Neuroplasticity in the Basal Ganglia; The Role of Exercise in Parkinson’s Disease. Movement Disorders. Vol 25, Suppl 1, 2010 pp. S141 – S145
  • Deloitte Access Economics, ‘Living with Parkinson’s Disease – update’, Parkinson’s Australia, 2011. Available at http://www.parkinsons.org.au/media-advocacy/docs/AEReportpdf (accessed August 2012)
  • Ahlskog JE. Does vigorous exercise have a neuroprotective effect on Parkinson’s Disease? Neurology 2011; 77:288-294
  • Brauer S, Morris M. Can people with Parkinson’s Disease improve dual tasking when walking? Gait & Posture 2010; 31 229-233
  • Farley B, Koshland G. Training BIG to move faster, the application of speed – amplitude relation as a rehabilitation strategy for people with Parkinson’s Disease. Exp Brain Res 2005; 167 (3); 462-467
  • Riidgel A, Vitek J, Alberts J. Forced, not voluntary, exercise improves motor function in Parkinson’s Disease patients. Neurorehabil Neural Repair 2009; 23 (6): 600-608
  • Rogers G. 2011. Living with Parkinson’s. New Holland Publishers 1st Edition.

About the Author:

Kathryn Kohler is an Exercise Physiologist for Physiotas on the North West Coast.

Kathryn graduated from Queensland University of Technology in 2012 as an Exercise Physiologist. Her clinical interests are neurological rehabilitation, cardiovascular and respiratory conditions, and falls and balance training. She has undertaken further professional development in Parkinson’s disease and is a qualified PD Warrior instructor. She is also one of our group and individual Clinical Pilates instructors.

Kathryn enjoys exploring the great outdoors, hiking, mountain bike riding and participating in Clinical Pilates.