You’ve likely heard this before: Exercise is good for you. It helps your heart, bones, back and more.
But here’s one thing you might not have heard: Ongoing aerobic exercise may slow the progression of Parkinson’s disease, a progressive disorder of the nervous system.
“Aerobic exercise means vigorous exercise, which makes you hot, sweaty and tired” says J. Eric Ahlskog, Ph.D., M.D., a neurologist at Mayo Clinic. This could include activity such as walking briskly or using an elliptical machine.
That doesn’t mean stretching or balance exercises are not helpful, Dr. Ahlskog notes. Those types of exercises help with Parkinson’s symptoms, such as rigid muscles, slowed movement or impaired posture and balance.
But to help fight the progression of Parkinson’s disease, including dementia — one of the most feared long-term outcomes of the disease — Dr. Ahlskog points to scientific studies that show aerobic exercise enhances factors that potentially have a protective effect on the brain. For instance, aerobic exercise liberates trophic factors – small proteins in the brain that behave like fertilizer does when applied to your lawn. Exercise helps maintain brain connections and counters brain shrinkage from Parkinson’s disease as well as from brain aging, says Dr. Ahlskog, author of “The New Parkinson’s Disease Treatment Book,” which further explores the benefits of aerobic exercise.
In an editorial published online today in JAMA Neurology, Dr. Ahlskog makes the case that modern physical therapy practices should incorporate aerobic exercise training and encourage fitness for patients with Parkinson’s disease.
As a society, Americans are becoming increasingly sedentary. It is a particular challenge for people with Parkinson’s disease to begin and maintain aerobic exercise. “That is where a physical therapist might serve a crucial role in helping to counter Parkinson’s disease progression,” Dr. Ahlskog says. “The physical therapist could identify the type of exercise that would appeal to the individual, initiate that plan and serve as exercise coach.”
For anyone with or without Parkinson’s disease, an aerobic exercise routine takes hard work and ongoing commitment.
Dr. Ahlskog offers the following tips:
Start slowly: Talk to your doctor before you begin an exercise program, and then work your way up — 15 minutes, 30 and more. “Life is a marathon rather than a sprint,” Dr. Ahlskog says.
Set goals: Aim for an average of 45 minutes to an hour of vigorous activity four times a week.
Do what you love (or tolerate): If you hate riding a stationary bike, try a ski machine or stair climber. Take a brisk walk – outside, at the mall or on a track. “There is no one-size-fits-all program for exercise, and all aerobic exercise options should be on the table,” Dr. Ahlskog says.
Push yourself a little: If you’re walking a track, for example, try to pass other walkers. If you’re doing repetitive exercises, slowly increase the number of repetitions.
Dr. Ahlskog emphasizes one important component of an exercise program for Parkinson’s disease:
Be certain that you have worked with your doctor to optimize your medication, specifically carbidopa/levodopa. Once patients with Parkinson’s disease slow down, adequate carbidopa/levodopa is necessary to optimize quality of life and facilitate engagement in exercise.
About this Parkinson’s disease research
Source:Susan Barber Lindquist – Mayo Clinic Image Source: The image is in the public domain Original Research:Abstract for “New and Appropriate Goals for Parkinson Disease Physical Therapy” by J. Eric Ahlskog, PhD, MD in JAMA Neurology. Published online January 19 2016 doi:10.1001/jamaneurol.2015.4449
New and Appropriate Goals for Parkinson Disease Physical Therapy
Physical and occupational therapy have long been components of Parkinson disease (PD) treatment. Prior to the advent of levodopa, this was a primary therapeutic modality. What is the current role for physical therapy in PD? Should everyone with PD be referred? Is it cost-effective? What should be the therapeutic goals and program content?
In the United Kingdom, cost-effectiveness is an especially relevant consideration in the context of its single-payer National Health Service. The cost-effectiveness of routine referral of patients with earlier-stage PD for physiotherapy and occupational therapy was addressed in an article in this edition of JAMA Neurology.1 Half of more than 700 patients with PD from across the United Kingdom were randomized to standard practice physiotherapy and occupational therapy (median, 4; hour-long therapy sessions). Compared with the control group, this therapy intervention failed to meaningfully influence the activities of daily living or quality-of-life measures, with follow-up at 3 and up to 15 months. The investigators concluded that, “This evidence does not support the use of low-dose, patient-centered, goal-directed physiotherapy and occupational therapy in patients in the early stages of PD.” The authors cited prior studies that tended to support this conclusion.
“New and Appropriate Goals for Parkinson Disease Physical Therapy” by J. Eric Ahlskog, PhD, MD in JAMA Neurology. Published online January 19 2016 doi:10.1001/jamaneurol.2015.4449