You have Parkinson’s and your doctor recommended exercise. I don’t have to explain why. All PWP know that exercise is one of the few things you can do to help slow the progression of the disease and new research suggests that exercise may decrease neuron injury in PD as well. So what exercises should you do? My answer is easy, any and all. Which ever you most enjoy and are most likely to keep doing. Which exercises are most beneficial for PWP? The vote is in. All research points to dance for cognition and fitness, Tai Chi for balance, LSVT Big to maintain and recover movement amplitude, and high intensity interval training to slow the progression of the disease as four of the best forms of exercise that people with PD can do.
PWP may have difficulty walking. They take short shuffling steps and have problems with posture, freezing and balance particularly when turning or walking backwards resulting in an increased risk of falls leading to injury. Dance involves learning specific movement strategies and improves strength, flexibility, agility, coordination, gait, sequencing, balance, and overall fitness. Dance class installs confidence and joy and leaves me feeling that I can move better when the class finishes. Partner dancing involves the brains executive functions that benefit cognitive processes of working memory, planning, and task initiation. Partner dancing promotes socialization and adds complexity because you have to continually adjust your movement to that of your partner and other dancers around you. Dancing to music teaches you to adjust your movement to external cues. Dance is a great workout combining physical activity, social interaction, and mental stimulation. It can enhance your social life, promote self-confidence, reduce stress and depression, promote relaxation, be a wonderful outlet for self-expression and creativity, and it is fun.
My neurologist said that balance cannot be treated medically. You are on your own. Tai Chi is one of the most recommended forms of exercise for maintaining and improving balance because it involves a constant shifting of weight from one foot to the other and from one part of the body to another. It is a set of low impact gently flowing movements believed to have mental, physical, and spiritual benefits. The movement patterns are preset and performed in a slow, focused manner accompanied by deep breathing. It has been likened to meditation in motion. Tai Chi teaches you to land heel first and then roll your foot down which prevents stubbing your toe and tripping. As an extra incentive, researchers found that seniors who do tai chi several times a week have improved memory and thinking skills and are less likely to fall. You can do it by yourself once you learn the routines.
LSVT Big is a movement therapy based on the principles of the Lee Silverman Voice Therapy speech program. Its goal is to restore and maintain normal movement amplitude that has been lost to PD by recalibrating the way a person moves. Through multiple repetitions of high intensity, increasingly complex, large scale movements involving the whole body LSVT Big reteaches you to move normally as before PD. It enables PWP to move with more confidence and safety by improving mobility, gait, posture, skeletal alignment, freezing, and balance. Both large motor tasks such as walking faster, taking bigger steps, standing up, and dressing and small motor tasks like buttoning a shirt, tying shoes, and writing are often improved within a month of dedicated practice. LSVT Big emphasizes high intensity, multiple repetitions, and complexity which is key to activity dependent motor learning and neuroplasticity.
Many PWP find cycling, non contact boxing, and ping pong beneficial. Others do yoga for flexibility and relaxation and weight training for muscle tone and strength. Do whatever works best for you. Start slow. Try to exercise 60 minutes a day. Multiple 20 minute sessions are also good. Researchers specifically recommend high intensity interval training (four rounds, each round consisting of 4 minutes of high intensity forced exercise and 3 minutes rest). Be happy with whatever you can do and build on it. Think of every time that you exercise as a victory over PD. If you do nothing else walk. Walking is wonderful. Good for the whole body and also gets you out and into the world.
