Parkinson’s disease and exercise
What is Parkinson’s disease?
Parkinson’s is a progressive disease of the neuromuscular system. Nerve cells die, which reduces the production of the chemical dopamine, the neurotransmitter that is responsible for sending messages to the part of the brain that controls and coordinates movement. The causes of Parkinson’s are still unknown, although genetic and environmental factors are believed to play a role. Males are more likely than females to develop Parkinson’s disease and most people develop symptoms aged 50 years +.
A lack of dopamine can lead to symptoms that disrupt the ability to carry out everyday activities. These include but are not limited to the following:
- Tremors– The body and/or voice can involuntarily shake, which is more prominent when the body is moving or in stressful situations, but these can also be experienced at rest.
- Bradykinesia – Slow movement can affect gait, as it reduces stride length therefore causing shuffling. It also lengthens the time it takes to perform every-day tasks.
- Rigidity– Stiff and inflexible muscles can reduce patients’ range of movement, affecting tasks such as getting in and out of chairs. It can also cause fixed facial expressions.
- Loss of balance– This is caused by freezing, poor posture and general muscle weakness and can increase the chance of falling.
- Insomnia – This is common in people with advanced Parkinson’s disease, when worsened symptoms can disturb their sleep pattern. Around two thirds of those with Parkinson’s disease are affected by troubled sleep.
- Psychological symptoms– These include anxiety and depression and generally relate to feelings of unease surrounding their condition.
- Decreased bone mass– Thought to be caused by reduced mobility in Parkinson’s patients, this can increase the likelihood of fracture if the individual experiences a fall.
Three ways exercise can help
1. Improved motor performance
As mentioned above, Parkinson’s patients commonly suffer from tremors and rigidity whilst additionally having difficulties with functional activity (e.g. gait, balance, turning over in bed, etc.). There is strong scientific evidence to show that regular exercise can help to improve physical functioning, leg strength, balance and gait speed. For example, regularly performing the squat exercise may allow individuals to move from a chair to standing with increased ease. Naturally, this can lead to notable improvements in quality of life
2. Reduction in osteoporosis and falls
Osteoporosis is prevalent in early-onset Parkinson’s disease patients, much more so than in the general population (63% vs 29% in men and 20% vs 12% in women). As Parkinson’s patients are also particularly susceptible to falls, it is crucial to improve bone health in order to reduce the risk of fall-related fractures. Weight bearing exercises, such as light jogging, stair climbing and dancing, have been shown to help improve bone health. Similarly, balance-related exercises such as one-leg-stands and heel-to-toe walking as well as, general strength improvements will reduce the incidence of falls.
3. Psychological well-being
Evidence has shown that physical acitivity can elicit improvements in depression as well as increased self-esteem and sense of achievement. A minimum of 12 weeks is required to begin reducing depressive symptoms with patients experiencing the greatest effects when engaging in regular exercise for at least 3-12 months. Furthermore, promising evidence is now emerging to suggest that aerobic and resistance-based exercise may be beneficial in reducing sleep disturbances in Parkinson’s patients. This is especially true if exercise is implemented in the early stages of the disease.
Actor, Michael J. Fox. (pictured above) was diagnosed with Parkinson’s disease aged 29. He has since become an advocate for research toward finding a cure.
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Goodwin, V. et al. The Effectiveness of Exercise Interventions for People with Parkinson’s Disease: A Systematic Review and Meta-Analysis. Movement Disorders. 23 (5), pp. 631-640 (2008)
Reynolds, G. et al. The Therapeutic Potential of Exercise to Improve Mood, Cognition, and Sleep in Parkinson’s Disease. Movement Disorders. 31 (1), pp. 23-38 (2016)
Speelman, A. et al. How might physical activity benefit patients with Parkinson disease? Nat. Rev. Neurol. 7, pp. 528 – 534 (2011)