Hi. I have been trying to research how much and what type of exercise is required to obtain the potential benefits of slowing down PD. I can find lots of references to the benefits but I cannot find an easily understood exercise regime. I presume it is a mixture of aerobic and stretching exercises but what type of aerobic, for how long and how frequent? I feel that if i had a specific target I would aim for that rather than the random way I am approaching it at the moment. Anyone have a good regime they can recommend. At present I do 15 mins on the exercise bike set to the mountain programme, then some stretching and balancing exercises and if i am lucky a walk as well but I suspect much more might be required.
I do not want to sound too pessimistic about exercise and progression, but I think the benefits of exercise are more a case of simply maintaining your fitness and feeling of wellbeing(afterwards) than that this will be slowing PD progression. There comes inevitably a time when you start to do less, when you just do not have the energy anymore,. the strength, etc. The people who go on exercising longest are the lucky few whose disease progression is slower than the norm, whether they exercise or not.
Camargue do you have access to a physiotherapist? Ask your GP for referral.
Hi Kate, yes I have been referred to a physiotherapist by the PD nurse as I have been having trouble on and off with my back as well as a pain in my right arm. She wanted an assessment to see if the pain is PD related or something else as I have had on and off back pain for quite a few years. I guess I could talk to the Physio about exercise when i get my appointment. In the meantime i will keep doing what I am already doing but i know i probably could do more!
I am a strong believer in exercise as a means of delaying the progression of symptoms and in some cases improvement but I should confess that I have been a very keen runner training at least once a day since 1973.
As with all exercise regimes you need to take stock of your start position. How fit/healthy are you? What exercise background have you got?
Having identified your baseline a gradual increase in terms of frequency; length and intensity of sessions is the best way ahead.
As for what exercises - core stability, balance, stretching and basic fitness (walk, run, swim, bike). It is very important to ensure you are doing the exercises correctly.
Stay positive! Stick with it!
Hi Camargue,
In my in-depth on-line research, I`ve found countless articles where people who routinely exercise have gone for years with minimal symptom progression.
In fact routine exercise has been proven to have a profound effect on cognition as well.
I say treat exercise as if it were as essential as any drug you take.
We all know that exercise is helpful to good health - but can it change the brain ? and might these changes have an impact on Parkinsons?
I firmly believe the answer to both these questions is yes.
It's great to read that research and experience suggest that exercise does help to slow the progression of the disease. I do aerobic exercise and weights work and have done regular exercise for 20+ years. Now that I have been diagnosed with PD I plan to add flexibility, strength and balance work to my programme. It's definitely good for your mood 
Hi,
I swim (twice a week; 1 hour each time) and find it works well for me. I also saw a research study report showing that exercise had a measurable positive impact on PD (actually it was one of the few things that I saw that looked like it had reasonable scientific evidence showing a measurable positive impact)... so, I'm also on the "strongly recommend" camp.
In terms of what type of exercise, my working hypothesis is that (a) Parkinson is linked somehow to cortisol de-regulation, and that (b) stuff that fixes our cortisol de-regulation helps with PD. If my hypothesis is correct, then we should focus on the type of exercise that helps with fixing our cortisol levels - which apparently seems to involve "moderate" exercise (especially when they combine some form of relaxation to it - like moderate level yoga, etc). You can google exercise and fix cortisol and find lots of examples of what is recommended (though sometimes you find contradictory advice too).
Chers,
lfs
Hi everyone
thanks for all the input. In my past life (i am now 62) i played basketball whilst young, ran after three children for years then joined a gym when i was back at work as well as going out for bike rides at weekends. This slowed down about four years ago when i had an operation on my foot although I tried to keep up with some cycling. I now feel I need to do a bit more and swimming is a possibility as we have a swimming pool walking distance away. I did a fair amount this summer whilst camping at the mediteranean and the combination of sun and warm sea was wonderful as it was both energetic and relaxing and i never felt I had PD when i was swimming. Yoga might be another possibility and I will investigate that. I also knit a lot in the evening, not really exercise but it keeps my hands and arms moving so i dont get the dead feeling in my arm or pins and needles in my hands. It is too easy to slip into a more sedentary life so i have to treat exercise like medication and make time for it.
Which exercise, how long for and how to keep going:
Take heart, the evidence that exercise is beneficial comes form studies of many different types of exercise, so which type you do is secondary, the important thing is to do it. PD patients, like anyone else, need to maintain bone density to protect against adverse effects of falls, maintain healthy circulation to combat respiratory disease and dementia. So any exercise is better than no exercise. In my personal experience thee main barriers to doing exercise regularly on a long term basis in the face of diminishing ability are access, boredom and the temptation to compare your current ability with that of your former self
Some solutions are:
1.Use Youtube demos/DVDs to exercise at home on the days when you dont have access to an exercise facility away from home
2. Choose things that you enjoy, do them until you peak then switch to something different.
3. When returning after a break to an exercise type you did in the past, dont be tempted to make comparisons with your previous achievements, set achievable goals for the here-and-now.
Exercise types which build core muscles (Tai Chi, pilates, dance) help maintain balance and reduce falls. Tai chi has the advantage of being meditative, and there is evidence that meditation increases the nerve cell density in parts of the brain affected by PD.
Resistance training can help build muscle strength useful for everyday tasks and, like treadmill training, dance, kicking activities, can improve gait length. Kayaking and exercises designed for kayakers will help with trunk rotation and upper body strength.
How long? most clinical studies choose two to three sessions of around 40 minutes a week. How hard to work yourself? it is important to balance the wish to improve/maintain your fitness with the risk of injury. Physiotherapists advise "moderate intensity" - whatever that is for you.
A range of exercise regimes have been designed for Parkinson's patients with different capabilities http://www.
A further benefit of exercising is that it helps you regain a sense of control over your symptom management. Enjoy being in the driving seat!
Thank you for all the interesting information about exercise. I would definitely agree that it has great benefits for all us PWP s.I was referred by the GP to a local exercise class run for people with medical conditions. It has helped me a great deal with reduction of pain, balance and stamina. I am also seeing a physio who has given me stretches to do plus I walk every day for about 30 mins. Physically and psychologically this has all helped me to increase my energy.
All pros and no cons except it can sometimes feel like too much effort but always feel better when I ve done it.
Bw. Samdog
I hope I'm not too late to add to this thread. A little bit like Zatopek I am a runner who has Parkinson's. Camargue says she "never felt she had PD when she was swimming". That is exactly how I feel and what I tell people about my running. I am astonished at what I can still do and for me it is a personal miracle. Having said that there are also times when I can hardly cross the room, let alone run a 10km race. I have a lot of thoughts about this topic but I'll leave it there for the moment. Suffice to say, exercise? From me big yes!
Well Camargue thats interesting to compare, however i'm not convinced that we can slow down the advance of PD?
I exercise to take command of PD instead of passive acceptance, probably psychological for me.
My regime consists of Situps aprox 10. Press ups aprox 10 (more than this increases my tremors)
Some Stretching and a lot of walking with occasional stagger!
I am accompanied with my personal trainer (a small wired haired terrier rescue dog)
Changing the subject slightly, I wonder if anyone has weaned themselves off of all medication completely or "gone cold turkey" and what the effects were. (Much worse than before or the same?)
Be interesting to hear about this
Best wishes to you and all
Beano
Hi Camargue and all,
I am 63, normally very active. I swim once a week, hope to go more, helps a lot with stiffness. Also go for walks, with a stick, this helps. With swimming, best if water is not too cold?I also sent for 'Keep moving' book from PD, very good. 2 little grandchildren come, play with them! EAsier to kneel on floor than to bend!
Yes not always easy to start exercises, especially after a bad night , but really helps.
Brenda
As an ex PE teacher with Parkinson’s I initially tried quite a few online videos on YouTube for balance, strength and flexibility. I ended up developing my own regime that suited my needs and was one I could stick too. I think this is the best solution as if you don’t ‘use it’ you ‘lose it’.
Every morning I do stretches of my lower legs (hamstrings, quads and calf muscles) backwards and forwards walking, heel toe heel toe etc., sidestepping, figure of eight walking x10, practice falling and recovering backwards, forwards and to the side, balance on one leg for 30 seconds (I upped this to with eyes closed later) heel toe in line balance, alternate foot balance,
Circling arms backwards and forwards, hip circling, dexterity exercise for hand wrists and arms, simple yoga for lower back (hyperflexion dropping hips to ground x 5) 30 easy sit ups (only go 45 degrees) and lastly 25 press ups.
That sounds a lot but only takes 10-15 minutes. Later in the day I do 40 minutes gentle pedalling on my indoor bike (for my heart) whilst watching TV and then (also in front of TV) do some arm exercises with TheraBand and finally seated squats with two legs and single leg.
That also sounds a lot but only takes an hour. If I have a bad day I drop one part of the routine. Now you might want to do more or less than this.
I’ve been doing this ‘religiously’ for 4 years and my balance has improved, my handwriting has improved and I even beat my wife at table tennis.
All I can say is it improves your mental well being and if I can still do 25 press ups I can, well, still do 25 press ups so it keeps a track of your physical regression in a way.
Watch a few YouTube videos and yoga videos chose the parts you like or address your particular needs devise your own routine and stick to doing it but don’t be afraid to modify it if it is boring, dangerous or too easy (no pain no gain).
I found standing on one leg easy enough so I have now gradually developed to doing it with my eyes closed, this was a challenge but was pleasing when I did it. I have only fallen once in 4 years outdoors (not whilst exercising). Exercise works if you don’t like the word exercise substitute ‘activity’, good luck. Use it or lose it! Lastly, only do gradually and SAFELY at first.