2019 Parkinson’s Awareness Month- 12 Rules of Life With Exercise

“If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health.” Hippocrates

“Patients should have rest, food, fresh air, and exercise – the quadrangle of health.” William Osler

Introduction: April is Parkinson’s Awareness Month. I am convinced of the benefit of exercise to improve the quality-of-life of someone with Parkinson’s. And the people that have worked with me over the last several years have further convinced me that it matters not if you were just diagnosed or have lived with it for years, start exercising now, it will make a difference in your Parkinson’s.

“Physical fitness can neither be acquired by wishful thinking nor by outright purchase.” Joseph Pilates

Jack LaLanne and Exercise: For many years Jack LaLanne tried to convince us all of the positive health benefits of exercise. In hindsight, he was right, totally correct. Jack LaLanne once said, “Physical fitness takes commitment to exercise just as it requires good nutrition. But it doesn’t have to be painful. Just the opposite: Vigorous exercise actually is stimulating. It boosts your energy levels, invigorates your mind, and just feels good afterward. The hardest part, of course, is getting started.”

“The reason I exercise is for the quality of life I enjoy.” William H. Cooper

Part 1 of Parkinson’s Awareness Month is Dedicated to Exercise: To continue what Jack LaLanne lived his life by, what follows are some guidelines to consider if you have Parkinson’s. I genuinely want you to believe as I do that exercise is medicine. There are probably three kinds of people-with-Parkinson’s with regards to exercise: (i) some of you have never done it or simply just don’t enjoy it; (ii) when you were younger and had more time, you exercised; and (iii) exercise is still an important part of your life. This post is aimed at those in groups (i) and (ii), and hopefully, to stir-up-the-exercise-fire in those of you in group (iii).

Are you one of those people who keeps making a promise to your family and closest friends that one day soon, you’ll start exercising (again)? Or are you one of those people that can start but not sustain the workout sessions? Could a new set of rules help? Would 12 straightforward suggestions be the new key to unlock a healthy lifestyle that lasts (especially with your most unwelcomed guest named Parkinson’s)?

“If you don’t do what’s best for your body, you’re the one who comes up on the short end.” Julius Erving

12 Rules of Life With Exercise in the Presence of Parkinson’s:

1. Be safe.
The benefit of an exercise routine/program will only work if you have (i) talked it over first with your Neurologist; (ii) consulted with a physical therapist/certified personal trainer about the available exercise programs for Parkinson’s; and (iii) realize that most people-with-Parkinson’s (PwP) typically have gait and balance issues.

2. Defining exercise.
Exercise is an activity requiring physical effort, carried out especially to sustain or improve health and fitness. Movement disorders clinicians, physical therapists, and certified personal trainers consider exercise to be a key medicinal ingredient in both treating and enabling patients at all stages of Parkinson’s.

3. What is good for your heart is good for your brain.
Think about it this way; blood circulates to your heart and the brain through the same blood vessels.  Therefore, it is reasonable to assume that good heart health through exercise is going to be beneficial for good brain health too.

4. Strenuous exercise is better than just exercise; however, both are far better than no exercise.
Plan to exercise 60 minutes per day with a goal of 5 days/week, and try to not go more than 3 days without exercising. Within that 60 minutes, set a goal of 30 minutes 3 times per week to get your heart rate elevated. Aim for the “Orange zone”, which is ~80-85% of your maximum heart-rate (on the ‘Perceived Exertion’ Chart this is 7-Intense or 8-Very Intense). This is your uncomfortable zone. At your peak of shape, you should try to stay in this zone for 12 to 20 minutes of this 30 minute workout.  Yes, you are going to feel it.  That is what it is going to take.  Get it to this level with sustainable benefits to potentially be neuroprotective, and it may be even neurorestorative.  Please go back and re-read point #1 above before starting this strenuous of a workout program, built up to it.

5. You are what you eat.
There is no special diet for Parkinson’s; however, a well-balanced, nutritious diet is extremely beneficial. Staying well-hydrated is also very important.

6. Do not put off doing your exercises until tomorrow, especially when there is time dedicated to today for exercise.
The time you exercise is minimal compared to the quality-of-life you are gaining from exercising. Thus, the time you commit to exercise matters a lot.

7. Sleep matters.
You need rest to build muscle, to replenish your body, and to remove the toxins from your brain built up from the day’s activities.  Simply put, sleep matters to keep the ledger turned in your favor.

8. Give it time because time will tell.
You learned to crawl before you walked; likewise, you will learn to run a 5K race before you run that first half-marathon. Whatever form of exercise you perform it should bring you joy, and it should feel good (you know, “that good kind of pain from exercise”). Most importantly, find an exercise that when you wake up tomorrow, you can’t wait to go exercise today. Moreover, the practice of exercising comes renewal and help with Parkinson’s symptoms.

9. Neuroplasticity describes how neurons in the brain compensate for injury/disease.
Neuroplasticity is something to strive for and repetition, over time, will provide the circuits for your brain to re-wire the neural networks diminished by Parkinson’s.  However, there are no shortcuts. It is going to take a lot of repetition and much time to accomplish this feat.

10. Go “FAR” with your exercise program.
In planning your exercise program or routine, try to incorporate the following types of exercise, using the acronym “FAR’: Flexibility (and stretching) exercises; Aerobic activity; and Resistance training with strengthening exercises.  Here are some examples of exercise and exercise programs for Parkinson’s disease (PD): PWR!Moves; Rock Steady Boxing; LSVT BIG; Dance for PD; LIM Yoga; Tai Chi for PD; jogging; biking; weight-training; and walking (with or without poles).

11. Exercise is medicine.
For many years we have seen the benefit of exercise in experimental animal models of Parkinson’s.  More recently, these benefits have been shown in clinical trials with human subjects with Parkinson’s.  Strenuous exercise is medicine for Parkinson’s.

12. Ultimately, you should strive to maintain effective brain health.
With or without Parkinson’s disease, taking care of the brain is all-important to one’s overall well-being, life-attitude, and health.  For a balanced-healthy brain, strive for the following: proper nutrition and be cognitively fit; exercise on a regular basis; reduce stress; work and try to stay mentally alert; practice mindfulness/meditation; sleep enough; stay positive and hopeful.

“Most of us think we don’t have enough time to exercise. What a distorted paradigm! We don’t have time not to. We’re talking about three to six hours a week – or a minimum of thirty minutes a day, every other day. That hardly seems an inordinate amount of time considering the tremendous benefits in terms of the impact on the other 162 – 165 hours of the week.” Stephen Covey

Cover photo credit: http://www.pdsgsnm.org/wp-content/uploads/2013/06/tulips-copy.jpg

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