Tips for Exercise in Parkinson's Disease During the COVID-19 Crisis

In the next few days our new book Living with Parkinson’s Disease: A Complete Guide for Patients and Caregivers will be published by Robert Rose. With the COVID-19 pandemic growing and Parkinson’s patients stuck in their homes, we thought this would be a great time to talk about tips drawn from our book on exercise in the home setting.

The first question for Parkinson’s patients is how often should I exercise?

The answer really depends from person to person, but in general exercising for 30 minutes or more per day seems to be helpful for most Parkinson’s disease patients.

If you have walking or balance problems make sure you have a care-partner and assistive devices to guard against falls and bone fractures. There are exercise programs that can be initiated even when sitting (under desk “ellipticals” and cycles for example). There are some exercise programs available on YouTube and through the Parkinson’s Foundation and other sources.

What are some tips when identifying a good therapist?

If you are stuck at home under COVID19 precautions it may not be an ideal time to identify a new therapist. Your existing therapist may perform tele-medicine or have videos you can watch to learn how to do exercises at home. Here is a table from our book on some tips (above) to finding a good therapist: GOADS.

What are the desired effects from exercise therapy with Parkinson’s disease?

In general most expert neurologists now prescribe exercise as a drug in Parkinson’s disease populations. There is a growing amount of data to support that this notion is correct. There are now reported benefits in both motor and non-motor features of exercise. The benefits we see are symptomatic. We do not yet know if exercise in the human will modify disease progression or prove to be neuroprotective.

What type of exercise should I perform?

There are so many exercises to choose from in Parkinson’s disease and there are so many studies suggesting many possibilities- I am sure your head is spinning. We have observed benefits in aerobic exercise, Tai Chi, strength training, stretching and many other modalities. The best exercise is the one you will do. Additionally, we recommend that any exercise you choose should ideally lead to an increase in heart rate during exercise and sweating. These are good indicators that the exercise therapy will have a positive effect!

I get confused when trying to read studies about exercise therapy and Parkinson’s disease in the journals. Can you give me a brief review of the the key exercise terms?

Many people ask about the key exercise terms used in the literature and also by therapists and doctors experienced in the field. Here is a table we use in our new book to explain this to patients and caregivers.

If I want my exercise in Parkinson’s disease to be effective at helping me what are the key components to enhance my success?

Choosing exercises that you will be able to do with regular consistency and to perform safely should be your number one priority. These two aspects of any exercise plan are perhaps the most important. Here is a list of components that may also be helpful.

What are some tips and pearls for Parkinson’s disease exercise to be performed at home during the Corona virus Pandemic?

The Corona Virus pandemic has added a layer of complexity to the Parkinson’s patients who require daily exercise. It is important to stay socially distanced and if possible stay in your own home. Do not bring in therapists from the outside into your own home as this may put you at risk to contract the Corona virus. If you take occasional walks go with a care-partner, avoid crowds and stay socially distanced from others (a minimum of 6 feet separation). In home gym equipment can be useful (desk cyclers or ellipticals included as well as treadmills and rowers) but always use them with a care-partner who will be actively participating in a focused effort to help you to avoid injury.

Here are some pearls from our new book (Living with Parkinson’s Disease: A Complete Guide for Patients and Caregivers), but unfortunately you won’t be able to use some of these tips until the Corona virus pandemic passes. Good luck and happy exercising!

To read more books and articles by Michael S. Okun MD check Twitter @MichaelOkun and these websites with blogs and information on his books and http://parkinsonsecrets.com/

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