I am often asked what exercises are the most appropriate for an individual Parkinson's disease patient. This question is complex, but we are beginning to get some answers. Aerobic exercises (treadmills etc.), weight training, and other exercises such as Tai Chi have been gaining popularity and also gaining an evidence-base in the Parkinson's disease literature. The biggest problem we have encountered in exercise for Parkinson's disease have been patients that are trying to do "too much" making them fatigued.
Our best recommendation is to choose exercises that increase your heart rate, cause you to sweat, but that do not lead to fatigue for the rest of the day, or the following day. Choose exercise in moderation. Exercise leads to trophic factor release in the brain, and this and other general health effects seem to be very helpful for Parkinson's disease patients.
I asked the physical therapist at the NPF Center of Excellence at the University of Florida how she would answer the question as to the best exercises for a Parkinson's disease patient. Here is her response:
Appropriate exercises need to be specific to the individual. More challenging/dynamic exercises should be performed early in the disease process. During mid to later stages, the person with PD needs to work on specific tasks and muscles that will help to maintain their performance in everyday tasks such as sit to stand which is an exercise that will enable them to get into and out of chairs.
That being said, there are NO contraindications to exercising with Parkinson’s disease. I have found that many personal trainers that are unfamiliar with the disease tend to “go easy” on the clients due to their diagnosis. But unless the client has a pre-existing heart condition, orthopedic condition, etc. they will benefit from being challenged in personal training, such as using physioballs, bosu balls, and incorporating standing exercises vs. supervising them on a piece of strengthening equipment that they could perform well on their own following proper instruction. Screen for any balance deficits or impairments before starting the exercise program. The greatest risk working with patients with PD is the potential to fall if they have postural instability (balance problems).
For additional resources, check the National Parkinson’s Foundation website for a copy of their manual “fitness counts”
Meredith DeFranco, PT, DPT
Staff Physical Therapist of the UF Center for Movement Disorders and Neurorestoration