Parkinson Secrets
Expert Tips and Interviews on Living with Parkinson's Disease
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Hot Topics in Parkinson’s Disease

Michael Okun Indu Subramanian Jonny Acheson

 

Is 30 minutes a day of exercise enough for Parkinson's disease?

One of the most frequent questions I (M.O) receive in the clinic and also when lecturing to the worldwide Parkinson’s community is, “what is the right dose of exercise?” The answer is simple. We don’t know. We point to various research articles; all of which may be out of touch with reality. Many articles are difficult to interpret and impossible to translate into the practical real-world. It was refreshing to read NY Times columnist Gretchen Reynolds piece on whether 30 minutes a day of exercise is enough. Gretchen’s piece was admittedly not written specifically for Parkinson’s disease, however the findings could have important implications in this population. In this week’s blog I will attempt to translate some of the exercise research for the Parkinson’s disease community. Consider when you read this week’s blog that the CDC has said that about 10% of all deaths ages 40 to 70 resulted from not enough exercise.

Is there a correlation between number of steps

and how long you live?

Research in the journal JAMA Network Open from the University of Massachusetts, revealed an

association between the number of steps you take each day and how long you live..

  • Taking a minimum of 7,000 steps a day resulted in a 50% less risk of dying early.

  • This benefit increased to 70% less chance for > 9,000 steps a day.

  • The benefit did not increase past 10,000 steps.

  • In a Mayo clinic study exercising 2.6-4.5 hours a week resulted in a 40% decrease risk of dying (this may have translated to 7,000-10,000 steps).

  • A group in the Mayo study participating in 10 or more hours of activity a week actually lost about 30% of the benefit, suggesting that there may be a “too much exercise” factor we need to more closely study.

    If I have Parkinson’s how much should I

    exercise a day?

    Though there are no firm answers (yet) to this question most experts recommend 30-40 minutes a day and about 150 minutes a week.

    How vigorously do I have to exercise?

    Though we do not have firm answers on this question early research is revealing that super intense exercise regimens may not be necessary. For Parkinson’s disease we recommend choosing a safe an enjoyable daily exercise and trying to push yourself a little harder than if you were doing the activity for leisure. Sweating and increasing the pace or intensity should be encouraged.

    How often do I have to exercise?

    This is one of the most interesting questions in Parkinson’s. Though studies are showing that “weekend warriors” may get many of the benefits of exercise we do not recommend this in Parkinson’s. Parkinson’s is a cueing disease (disease of timing) and I recommend to my patients a minimum of 30 minutes of exercise each day for a minimum of 5 days a week to reach a 150 minute a week goal. If you are walking I recommend 7,000-10,000 steps a day. Reynolds suggests in her article that it is not a one size fits all. This means that some folks may prefer to separate their routines into 10 minute or shorter intervals each day rather than one long session.

    Is there an exercise “machine” I need to buy

    to change my fortunes with Parkinson’s?

    In general, the answer to this question is no. Experts tend to agree on one thing with Parkinson’s and exercise; the best exercise is the kind you will consistently do; in other words choose something that is safe and that you enjoy.

Selected references:

Paluch AE, Gabriel KP, Fulton JE, Lewis CE, Schreiner PJ, Sternfeld B, Sidney S, Siddique J, Whitaker KM, Carnethon MR. Steps per Day and All-Cause Mortality in Middle-aged Adults in the Coronary Artery Risk Development in Young Adults Study. JAMA Netw Open. 2021 Sep 1;4(9):e2124516. doi: 10.1001/jamanetworkopen.2021.24516. PMID: 34477847; PMCID: PMC8417757.

Schnohr P, O'Keefe JH, Lavie CJ, Holtermann A, Lange P, Jensen GB, Marott JL. U-Shaped Association Between Duration of Sports Activities and Mortality: Copenhagen City Heart Study. Mayo Clin Proc. 2021 Dec;96(12):3012-3020. doi: 10.1016/j.mayocp.2021.05.028. Epub 2021 Aug 17. PMID: 34412854.

Oftedal S, Holliday EG, Attia J, Brown WJ, Collins CE, Ewald B, Glozier N, McEvoy M, Morgan PJ, Plotnikoff RC, Stamatakis E, Vandelanotte C, Duncan MJ. Daily steps and diet, but not sleep, are related to mortality in older Australians. J Sci Med Sport. 2020 Mar;23(3):276-282. doi: 10.1016/j.jsams.2019.09.018. Epub 2019 Oct 1. PMID: 31615727.

Kraus WE, Janz KF, Powell KE, Campbell WW, Jakicic JM, Troiano RP, Sprow K, Torres A, Piercy KL; 2018 PHYSICAL ACTIVITY GUIDELINES ADVISORY COMMITTEE*. Daily Step Counts for Measuring Physical Activity Exposure and Its Relation to Health. Med Sci Sports Exerc. 2019 Jun;51(6):1206-1212. doi: 10.1249/MSS.0000000000001932. PMID: 31095077; PMCID: PMC6527133.

Michael Okun