Exercise for People with Parkinson's Disease

Overview

Why is exercise important for people with Parkinson's disease?

Everyone should exercise for physical and mental well-being. But being active is particularly important for people with Parkinson’s disease. Exercise is an important way to slow the disease and control its symptoms; it helps you maintain your ability to do everyday activities, and it protects your brain cells.

What is Parkinson’s disease?

Parkinson’s disease is a neurodegenerative disorder that affects a specific part of the brain.

Symptoms develop slowly over time and may include:

  • Bradykinesia, or slow movement.
  • Problems with balance and gait (walking).
  • Rigid or stiff limbs and joints.
  • Tremors, or episodes of involuntary muscle shaking.
  • Trouble speaking or swallowing.

Procedure Details

When should I start exercising if I have Parkinson's disease?

You should begin an exercise program immediately. People who start earlier in the Parkinson’s disease process have better outcomes and overall well-being.

What type of exercise should I do if I have Parkinson's disease?

Exercise is a planned, structured, repetitive activity that is intended to improve physical fitness. There is no “right” exercise for people with Parkinson’s. Everyone’s regimen will differ, depending on overall health, symptoms and previous level of activity. Any exercise helps, and a variety of exercise types may provide well-rounded benefits.

Aerobic exercise

Aerobic exercise involves activities that challenge your cardiorespiratory system (heart and lungs) such as walking, biking, running, and activities in the pool. Participating in aerobic exercise at least three days a week for 30-40 minutes may slow Parkinson’s decline.

Strength training

Strength training involves using your body weight or other tools to build muscle mass and strength. Strength training two days per week, starting with low repetition and weight, may be beneficial in Parkinson’s disease. A focus on extensor muscles, or muscles in the back of the body, can help with posture.

Flexibility training

Stretching two or more days per week can be beneficial to maintain range of motion and posture. Holding each stretch of major muscle groups for 30 to 60 seconds can improve muscle length.

Balance and agility training

This type of training often combines aerobic exercise, strength training, and flexibility training. Examples include:

  • Dancing.
  • Gardening.
  • Golfing.
  • No-contact boxing.
  • Water aerobics.
  • Tai chi, yoga or Pilates.

How hard should I exercise if I have Parkinson's disease?

A rating of perceived exertion (RPE) is a good way to measure intensity. On a scale from 0 to 10, 0 (nothing at all) would be how you feel while sitting or lying down, while 10 (maximum effort) would be the maximum effort you can give. Building up to an effort between 5 to 8 (heavy to very heavy) means you are exercising at a high intensity. A good gauge is, if you can have a conversation with someone while exercising, you should probably increase your intensity.

What kind of exercise can I do if I have trouble standing or walking?

Even with advanced Parkinson’s symptoms, you can still reap the benefits of some activities. If you have trouble walking or balancing, hold a bar or rail to exercise and stretch. If standing or getting up is tough, exercise and stretch in a chair or bed. Physical exercise performed in a seated position, such as biking on a recumbent bike (bike with a seat and back support) can allow you to exert yourself in a safe manner.

Facial exercises may help combat difficulties speaking or swallowing:

  • Chew your food longer and more vigorously.
  • Exaggerate your face and lip movements when you speak.
  • Make faces in the mirror.
  • Sing or read out loud.

Mental exercises give your brain a workout and can improve memory. For example:

  • Name as many animals (or colors, or cars) as you can in 1 minute.
  • Play brain games and do puzzles.
  • Solve math problems in your head.

You can also add activity in small bits throughout your day:

  • Park further away from stores so you walk longer distances.
  • Stretch or do leg exercises while watching TV.
  • Swing your arms more when you walk, and take long strides.
  • Take the stairs instead of the elevator.

Risks / Benefits

What are the benefits of physical exercise?

Exercise can help you in many ways, both physically and emotionally. Being active:

  • Builds strength.
  • Fights fatigue and improves sleep.
  • Eases symptoms like constipation.
  • Helps your brain cells stay healthier.
  • Improves balance, flexibility and posture.
  • Maintains your mobility so you can still perform everyday activities.
  • Prevents falls and gait freezes (when you are suddenly, temporarily unable to move).
  • Provides opportunities for social interactions.
  • Reduces stress and depression.
  • Slows disease progression.

Are there any risks of exercising with Parkinson’s disease?

Some symptoms, like Parkinson’s tremors, may seem worse during exercise. But exercise generally improves tremors and other symptoms in the long run.

Reduce challenges by stretching before and after exercise. Use good form to prevent injury. And avoid slippery floors, poor lighting and tripping hazards. If you have pain, stop and rest.

Pushing yourself too hard during exercise can lead to injury. Start slowly and increase intensity and duration over time. Keep a log to track your exercise choices and how you feel. Eventually, you’ll learn what works best for you.

Recovery and Outlook

If I exercise, will I still need my Parkinson’s medications?

Some people find that exercise helps them reduce the doses of Parkinson’s medications over time. But exercise is not a replacement for your medications. In fact, some people need more medications so they can stay active. Don’t make changes to your medications without talking to your healthcare providers.

When to Call the Doctor

Should I talk to my healthcare provider before I start exercising if I have Parksinson's disease?

Talk to your neurologist and your primary care provider before starting a new exercise regimen. They can:

  • Counsel you on how intense your exercises can be.
  • Recommend exercises appropriate for your individual health.
  • Refer you to a physical therapist to create a personal exercise program.
  • Warn about exercises to avoid based on your particular challenges or limitations.

Additional Details

Where can I find support if I have Parkinson's disease and want to exercise?

You can find exercise support in your community. For example, many gyms and community centers offer seated exercise classes for people who struggle with balance. Ask your healthcare provider for ideas if you have Parkinson’s disease and want to exercise.

A note from Cleveland Clinic

Exercise is an important part of managing Parkinson’s disease. Talk to your healthcare provider about your exercise program and choose activities you enjoy so you stay motivated to get up and move every day.

Last reviewed by a Cleveland Clinic medical professional on 04/08/2021.

References

  • Michael J. Fox Foundation for Parkinson’s Research. Accessed 4/13/2021.Exercise. (https://www.michaeljfox.org/news/exercise)
  • Parkinson Society of Canada. Accessed 4/13/2021.Exercises for People with Parkinson’s. (https://www.parkinsons.va.gov/NorthWest/Documents/Pt_ed_handouts/Exercise_for_PD_1-20-12.pdf)
  • Parkinson’s Foundation.Accessed 4/13/2021. Exercise. (https://www.parkinson.org/Understanding-Parkinsons/Treatment/Exercise)
  • Journal of Parkinson’s Disease. Accessed 4/13/2021.The Universal Prescription for Parkinson’s Disease: Exercise. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7592674/pdf/jpd-10-jpd202100.pdf)
  • Centers for Disease Control and Prevention. Accessed 4/13/2021.Perceived Exertion (Borg Rating of Perceived Exertion Scale). (https://www.cdc.gov/physicalactivity/basics/measuring/exertion.htm)
  • Neurotherapeutics. Accessed 4/13/2021.Current Perspectives on Aerobic Exercise in People with Parkinson’s Disease. (https://pubmed.ncbi.nlm.nih.gov/32808252/)

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