Can exercise help?
People with Parkinson's disease can improve their ability to move and their coordination by doing exercise. Regular exercise can help to cope better with everyday activities.
Parkinson's damages brain cells that produce the hormone dopamine. One of dopamine's tasks is to send electrical signals along the nerves from the brain to the muscles. These signals control our movements. Typical Parkinson's symptoms include restricted movement, stiff muscles and tremor at rest. You may also have trouble with your sense of balance. That increases the risk of falling and breaking bones.
Sports and exercise in addition to medication
Treatment with medication generally aims to replace the lack of dopamine. That often relieves symptoms, but doesn't slow down the progression of the disease. Because people with Parkinson's can no longer move as much, their muscles become weaker. The aim of doing sports and exercise is to counteract that. Research also suggests that exercise has a positive effect on the brain, for instance by stimulating the formation of brain cells and the secretion of dopamine. But longer studies are needed in order to find out whether this effect is large enough for people with Parkinson's to noticeably benefit.
Research on the benefits of exercise
Many studies have looked into the benefits of exercise in people with Parkinson's. In these studies, one group of participants was offered exercise programs, and the other group was not. These direct comparisons are needed in order to be able to evaluate how effective the treatments are.
The studies looked at a wide range of different types of exercise: stretching, endurance training, muscle activation and relaxation, weight training, balance training, dancing, tai chi, qigong, and walking and running. A number of more recent studies also looked at a technique called cueing: Here the participants receive acoustic or optical cues designed to do things like help them start movements. These cues may include marked lines on the floor that provide orientation when walking, or clicking sounds to provide a walking rhythm.
The exercises themselves differed between studies, as did the frequency and duration of the exercise sessions. In most of the studies, the exercise programs were led by physiotherapists. Some of the studies involved group training, while in others the training was done individually. Most studies lasted several weeks or a few months. So it's only possible to tell what sort of an effect the exercises would have over a time period of one year at the most. This time period is too short to be able to say whether the exercises can slow down the progression of the disease.
Improved movement and coordination
Studies show that exercise programs can have a positive effect. People who took part in exercise programs were better able to move, able to walk slightly faster and kept their balance better than people who did not take part. Some studies suggest that people who have Parkinson's fall less often if they do exercises regularly.
In the studies, the exercise programs improved people’s ability to move their body and get around in daily life. To determine this, tests such as the following were carried out: Participants were asked to stand up from a chair without help, walk a short distance, and then sit down again. Those who had taken part in exercise programs performed better.
Some studies looked at whether the severity of the illness changed. This was measured using a scale that included the following criteria: mental abilities and mood, performance of everyday tasks, coordination and ability to move. The studies found that exercise programs improve movement and coordination, and can therefore also help people to perform everyday activities.
There is a lack of research on possible side effects such as injuries. Some kinds of sports may actually increase the risk of falling.
Which exercises are most suitable?
Overall, there are too few studies on specific exercise programs to be able to say whether certain exercises are more effective than others. The most suitable choice of exercises will depend on your personal preferences and on your individual physical and mental state. For example, more strenuous exercises are possible in earlier stages of the disease.
Here are some places that offer sports activities and exercise programs:
- Sports clubs
- Adult education centers
- Support groups
- Fitness studios or gyms
Sometimes, special Parkinson's exercise classes are offered. You can also have physiotherapy prescribed by a doctor. Health insurers may cover the costs of certain sports classes.
De Dreu MJ, van der Wilk AS, Poppe E, Kwakkel G, van Wegen EE. Rehabilitation, exercise therapy and music in patients with Parkinson's disease: a meta-analysis of the effects of music-based movement therapy on walking ability, balance and quality of life. Parkinsonism Relat Disord 2012; 18 Suppl 1: S114-119.
Dos Santos Delabary M, Komeroski IG, Monteiro EP, Costa RR, Haas AN. Effects of dance practice on functional mobility, motor symptoms and quality of life in people with Parkinson's disease: a systematic review with meta-analysis. Aging Clin Exp Res 2018; 30(7): 727-735.
Klamroth S, Steib S, Devan S, Pfeifer K. Effects of Exercise Therapy on Postural Instability in Parkinson Disease: A Meta-analysis. J Neurol Phys Ther 2016; 40(1): 3-14.
Shen X, Wong-Yu IS, Mak MK. Effects of Exercise on Falls, Balance, and Gait Ability in Parkinson's Disease: A Meta-analysis. Neurorehabil Neural Repair 2016; 30(6): 512-527.
Tomlinson CL, Patel S, Meek C, Herd CP, Clarke CE, Stowe R et al. Physiotherapy versus placebo or no intervention in Parkinson's disease. Cochrane Database Syst Rev 2013; (9): CD002817.
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