Prescription for Parkinson’s: Exercise is Medicine

“Exercise: you don’t have time not to” George A. Sheehan

“It is exercise alone that supports the spirits, and keeps the mind in vigor.” Marcus Tullius Cicero

A Mantra for Prescription for Parkinson’s: Exercise is Medicine
“With Parkinson’s, we need Dopamine.
From Exercise, we make ‘Hope-amine.’
If this is true, choose exercises you enjoy.
Try to maximize your daily dose; and
You will find that Exercise is Medicine!”

Here is a YouTube Video of the Mantra with Exercises:

Exercise and Parkinson’s- Exercise Defined: Exercise is activity requiring physical effort, carried out especially to sustain or improve health and fitness. Exercise can benefit most people, but it is especially crucial to anyone with Parkinson’s. Papers are being published at a substantial rate studying many different aspects of Parkinson’s that are positively modified by exercise, including: motor and non-motor symptoms; gait; hand-writing; cognitive skills ;and changes in composition of various chemical molecules in the brain. At the bottom of this post are links to these publications from 2018-2019.

Living with Parkinson’s takes courage because your enemy is within you, and you always feel its presence. Thus, your hourly-daily-effort to live-fully is a measure of your courage.” Frank C. Church

Exercise and Parkinson’s- Let’s Be “ADEPT” During Exercise: Being adept describes someone who shows knowledge, skill, and aptitude. Using ADEPT as an acronym for exercise means you are bringing the following to your exercise routine: Attitude; Determination; Effort; Persistence; Tenacity. The right Attitude allows one to stay focused and achieve a goal. Showing Determination means you bring a real dedication to the task. Giving Effort means reaching inward and maximizing this period of exercise, even if something driving you is missing that day. Bringing Persistence with you to exercise means you’ll get the result needed. Also, with Tenacity showing indicates that you will surpass any obstacle or hurdle you encounter in an exercise routine. Thus, being ADEPT during exercise will enable you to most effectively attack your Parkinson’s.

“Today renews your lease on the rest of your life, enjoy it (get up, get out, get going). Today acknowledge your Parkinson’s; give it a nudge, because you are ready for the battle and for life.” Frank C. Church

Exercise and Parkinson’s- Go “FAR” in Your Exercise Routine(s): Try to incorporate the following types of exercise into your routine, using the acronym FAR: Flexibility (and stretching) exercises; Aerobic activity; and Resistance training with strengthening exercises.  This makes sense to incorporate Flexibility into your exercise program when you consider that stiffness/rigidity and postural instability are such common features of Parkinson’s. Getting to the level of rigorous Aerobic activity adds the potential benefit that exercise could be neuroprotective, and it may be even neurorestorative. Using Resistance exercises to build strength should also be beneficial. There is evidence that PwP who exercised for 2.5 hrs/week showed a smaller decline in mobility and quality- of-life over a 2 yr time-period. Thus, consider the breadth of going FAR in your exercise program to best challenge your Parkinson’s.

My ideal plan is 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, I set a goal of ~20 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 definitely an uncomfortable zone; you really feel it. For me, this happens using a stationary bike.

Here are some examples of exercise programs for Parkinson’s disease (PD): PWR!Moves Click here to get a nice introduction to all 20 PWR!Moves exercises; Rock Steady Boxing (click here to learn more); LSVT BIG (click here to learn more); Dance for PD (click here to learn more); LIM Yoga (click here to learn more); Tai Chi for PD (click here to learn more); and exercises like jogging; biking; weight-training; and walking (with or without poles). The most important thing is to choose exercise(s) you enjoy because then you’ll keep doing them on a more regular basis.

“I hope exercise allows you to negotiate life on your own terms with Parkinson’s becoming only a nuisance and a bystander.” Frank C. Church

Age and Stage of Your Parkinson’s Matter Not When it Comes to You Starting to Exercise: Maybe you think you are too old to exercise. Maybe you think your Parkinson’s is too advanced to benefit from exercise. The answers to these two scenarios are no and no, respectively. In a very positive Case Study presented at the 4th World Parkinson Congress (Portland, Oregon), Bazan-Wigle et al., described their work with a person-with-Parkinson’s who was advanced in his disorder; however, he wanted to make a positive change in his life. He began exercising, under medical approval, and the best of learning situation at the Parkinson Wellness Recovery Gym. The moral of the story is that it’s never too late, and your Parkinson’s is never too advanced, to try to make a difference by exercising.

Here is the citation: P33.02 “The effects of progressive aerobics and functional, amplitude focused whole body training (PWR!Moves®) in an individuawith advanced PD through an integrated physical therapy and PD-specific community exercise program – a case study” Jennifer Bazan-Wigle, Kevin Moynahan, Emily Borchers, Becky Farley. Abstracts of the 4th World Parkinson Congress, September 20–23, 2016, Portland, OR, USA- Click here

“Each day we wear a cape on our back labeled with the letters PD (Parkinson’s Disease).  Each day we bring a positive reaction to handle our symptoms, I am convinced we begin to fade those letters; we begin to gain control of our symptoms.”  Frank C. Church

Before Beginning to Exercise, Be Safe and Talk it Over With Your Neurologist: 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. However, the benefit of an exercise routine/program will only work if you (a) discuss it with your Neurologist; and (b) talk with a physical therapist/certified personal trainer about the available exercise programs for Parkinson’s.

“Your disorder will challenge your will-power at times. Do your best to stand your ground because you give life meaning. You and your life are still valued.” Frank C. Church

Link Added to “Exercise-related” Posts: I have added a link on the homepage to list all of the blog posts related to exercise; to go there click here.

PubMed Publications on Parkinson’s disease and exercise from 2019: Click here.

PubMed Publications on Parkinson’s disease and exercise from 2018: Click here.

“We follow a path that favors happiness in the background of certain/uncertain Parkinson’s progression. We stay positive, we remain determined, and always with perseverance we stand firm. Finally, combined together with hope, we continue, we live, we continue to live, and we continue to live well and strong in the presence of Parkinson’s.”Frank C. Church

Cover photo credit: https://shorelineobx.com/things-to-do-in-outer-banks-nc-attractions/

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