Parkinson’s disease is a neuromuscular degenerative disorder that robs those afflicted of their motor functions over time. The disease is generally slow moving, but studies have shown that persons with Parkinson's that were active before their diagnosis and continue to be so afterwards, seem to have a much slower progression of the disorder. One of the things that seem to go hand in hand with physical activity though, is the social component of staying connected with others.
Because of the nature of the disease, there may be some confusion as to what types of exercises to do, as well as the level of intensity that should or can be done so as not to injure oneself. If recently diagnosed, it’s recommended to stay the course of whatever physical activity that was being done before the diagnosis. The positive benefit of that is as the disease progresses, if need be people can adapt the things that are already well known, to the new reality of their muscles and mobility.
If physical activity was not a large part of the patient's life before diagnosis, this is an excellent time to incorporate it in their lives as they can create a program from the ground up building as they go and while assessing their current strengths and weakness, which may also be useful in planning a course of treatment as disease symptoms appear. It’s been suggested that the more vigorous the exercise program engaged in, the more symptoms are slowed.
That however doesn’t mean that patients should overextend themselves as this may cause more harm that could. Hurting themselves to the point of having to sit out for a long recovery period may hasten the progression of the disease. Many studies have shown that sedentary lifestyle can not only have an impact on Parkinson’s, it also increases the risks for cardiovascular disease, cognitive impairment, diabetes, depression and may make non-motor symptoms such as insomnia and constipation worse.
How To Stay Active
Physically, Parkinson’s patients start out just as physically fit as anyone else. As the disease progresses however, they will gradually lose range of motion particularly in the back and neck, in addition tremors, freezing, slowness, changes in balance and a decrease in muscle strength will make it difficult to maintain as active a lifestyle as they once may have led.
Up until fairly recently, it was thought that a sedentary lifestyle that minimized the chance of falls was the best option for Parkinson’s patients. But new research has proven that to not be the case. There have evolved two schools of exercise that focus on keeping patients healthy and slowing the course of the disease, organized exercise and physical activity both are valuable, but which is better for a person with Parkinson’s?
Structured Exercise Routines
The benefit of a structured exercise program is that it’s usually conducted under the watchful eye of a professional that can monitor the patient's vital signs for abnormal fluctuations in heart and respiratory rates. Structured routines can also be easily tailored to an individual's strength and activity level focusing on the things that are most important such as flexibility or cardiovascular conditioning which tends to decline with disease progression.
Although a new area of research into Parkinson’s disease, studies have shown that structured exercises that involve some combination of physical therapy with treadmill use, along with activities such as martial arts or dancing can help a person with the disease take bigger steps, extend range of motion, and maintain balance better.
Finding the right physical therapist that can create a structured exercise program is key in having a program that’s tailored to your needs. If for instance you struggle with balance or strength, a physical therapist will evaluate the patient’s level of capability and work with them to either increase their range or maintain what they currently possess. If the disease hasn’t progressed to a degree where range of motion, strength or balance has been lost, other low impact structured routines like yoga, pilates or tai chi are ones that can be done without the aid of a physical therapist.
General Physical Activity
These are activities that can be done outside of a structured program. These activities also carry a social component to them that help the Parkinson’s patient stay connected to others that may not have the disease. Group activities such as hiking, cycling, joining a gardening club or low impact racquet sports are ones that are not only great for conditioning the body while maintaining range of motion and balance.
Physical activities also serve to lessen the isolation and resultant depression that many with the disease can feel. Many Parkinson’s patients can become apathetic in their isolation because of the perceived dependence on others for their care and safety. As a result they can become withdrawn and sedentary, which may then lead to becoming less conscious of their overall health leading to a host of other non-motor symptoms thus not only amplifying the symptoms of the disease, but can cause other illnesses to appear.
Emotional distress can become just as dangerous to patients as the physical discomforts the disease causes them. Forcing themselves to go out and engage with other in these regular activities along with structured ones, can help to alleviate other non motor symptoms such as sleeplessness. But physical activities needn’t be as strenuous as hiking, a simple walk around the neighborhood if that’s all that can be managed can be good as well, lifting light weights or a low impact cardio program in the home are other great options.
Although there is proof that exercise can slow the progression of symptoms in Parkinson’s, there is little evidence that it halts the loss of brain cells that the disease causes. Studies are currently underway to determine if it does have an impact, and if so just how much exercise at what level is sufficient to have a significant impact. That being said physical activity still has many perks that shouldn’t be neglected simply because the prognosis of the disease may remain the same.
What the Research Says
Physical activity for anyone is a great way to stay healthy and maintain mobility, even people without Parkinson’s have a difficult time with mobility and joint issues after being sedentary for too long. Although this population study is new, what little data is available shows that physical deterioration is slowed with exercise. Dementia and other cognitive disorders are also linked with the progression of the disease, the studies have shown as well that the rate of depression, dementia and other neurological deficits seem slow down as well, this correlates with what non Parkinson’s trial have shown us as well, that cognitive and emotional deficits associated with mental illnesses often decrease in the general population with exercise.
It’s advisable to discuss everything with a neurologist and a physical therapist before starting any new exercise program. They will be best able to determine the patient's current activity level and determine where they should start, and how vigorous the activity can or should be. Clearly this is not a fix for Parkinson’s disease, at best it’s a patch that will help patients live a more symptom free life for a long as they can.