Exercise is essential for people with Parkinson’s.

Exercise is important for maintaining health for everyone. For people with Parkinson’s, exercise can improve quality of life and may help improve some of the motor and non-motor symptoms of the disease. Overall, exercise can benefit people with Parkinson’s in the following important ways:

Motor Symptom Management:

Research has shown that exercise can improve flexibility, balance, coordination, agility, gait, and strength.

Non-Motor Symptom Management:

Exercise may positively impact depression, apathy, cognition, and sleep difficulties.

Delay Mobility Decline:

Studies suggest that exercise may help delay some of the common symptoms of the disease.

This page provides an overview of exercise for Parkinson’s to help you get started using the tools and resources on this website.

How do I exercise safely with Parkinson’s?

Exercise is essential for people with Parkinson’s but balance problems and other motor symptoms can increase the risk of falling. Here are some things to consider when starting or engaging in an exercise routine:

Talk To Your Health Care Provider

Whether it’s your neurologist, physician or physical therapist, make sure you’ve talked to a healthcare provider about your exercise program, especially if you’re considering a new physical activity or experiencing new or worsening symptoms.

Time Your Medications

Many people with Parkinson’s have “on times” when their medications are most effective at alleviating symptoms. Exercising during on times may help reduce the risk of falling and other problems associated with Parkinson’s. Talk to your healthcare provider about medication timing for optimal exercise.

Stay Hydrated

Low blood pressure and dizziness are common in Parkinson’s. Staying hydrated with water or sports drinks may help reduce the risk of falling.

Be Mindful Of Symptoms

Both motor and non-motor symptoms can increase fall risk. Be mindful of your symptoms and check in with your healthcare provider if you’re experiencing new or worsening symptoms.

How often and how hard should I exercise?

Any exercise is better than none! However, experts recommend that people with Parkinson’s exercise with as much intensity as is safely possible for as long as possible. The exercise sessions should be challenging, requiring focus, effort and full attention. People with Parkinson’s should aim for the following for how much and when to exercise:

  • Begin training in the early stages of Parkinson’s
  • Train most days of the week, for at least 150 minutes per week
  • Add mental and physical challenges when appropriate and safe
  • Train at higher intensity levels, meaning you can still talk while training but in short bursts

What types of exercises are recommended for people with Parkinson’s?

Above all, do what you enjoy! When you engage in activities that make you feel safe and confident, exercise can be fun as well as healthy. For people with Parkinson’s, aerobic exercise, stretching, and strength and balance training form the foundation of a good exercise program. There are many different activities that you can choose within these categories. For example, walking, cycling or dancing are great ways to get aerobic exercise. Here are some suggestions for building a good foundation for your Parkinson’s exercise program:

1. Build endurance through aerobic activity.

  • Research suggests aerobic activity supports positive changes in the brain.
  • Aerobic activity can include high intensity walking or biking.
  • Aim for 3 days per week, 30-40 minutes per session of aerobic exercise.

2. Improve and maintain flexibility with stretching.

  • Improving flexibility can facilitate better posture and better movement.
  • A whole-body stretching routine that includes breathing can be particularly beneficial.
  • Aim to stretch for 2-3 days per week, for 20-30 minutes.

3. Strengthen muscle groups, with a focus on extensor muscles to improve posture.

  • Strength training with weights, resistance bands or body weight can help Parkinson’s symptoms.
  • Extension muscles, including back, hips, and triceps, can help improve posture.
  • Aim for 2-3 days per week, 20-30 minutes per session of strength training.

4. Add balance training to reduce the risk of falls.

  • Balance problems are common in Parkinson’s and can be improved through training.
  • Activities that challenge balance can be added to aerobic, stretching, and strength training.
  • Aim for 2-3 days per week, 20-30 minutes per session of balance training.

How do I tailor a Parkinson’s exercise program to my unique symptoms?

A visit to a physical therapist is a good place to start building an exercise program that is tailored to you. Physical therapists can talk with you about your symptoms and personal goals to design an exercise program that is effective and enjoyable. They can also help you find exercise classes in your area.

Incorporating activities that have been shown to address specific symptoms can help you practice and maintain everyday motor functions that directly impact quality of life. Some exercise principles to consider for your exercise program include:

1. Use BIG, full amplitude, whole-body movements. Vary patterns and sequence.

  • Big movements that use the whole-body help improve slow, small movements.
  • Thinking BIG when practicing a movement helps you move BIG.
  • Move in all directions, practice turning and emphasize weight shifting.

2. Practice dual tasks and cognitive challenges.

  • Practicing two exercises together (dual task) can help with performing more than one task at a time or shifting from one task to another in daily life.
  • Adding counting or singing and other more complex cognitive challenges to a movement can help with cognitive decline.

3. Practice self-initiated and self-paced movement.

  • Practicing self-initiated and self-paced movements can help with problems initiating movement, which can lead to freezing.
  • Counting can help keep a pace and imagining yourself doing a movement before you perform it can help initiate movement.

4. Develop reciprocal motions.

  • Practicing reciprocal, coordinated arm and leg movements can help with uneven or non-swinging arms, which can lead to balance problems.
  • Twisting the trunk, like kayaking, can also help improve arm swings and rigidity.

5. Develop erect postural alignment.

  • Practicing tall posture while doing physical activity can help with stooped posture.
  • Chest is lifted upwards, spine is straight, shoulders are back and down, and chin is parallel to the floor.

6. Use strong voices.

  • Practicing strong voices while exercising can help with both voice quality and movement.
  • Be careful not to yell, which can strain the voice and throat.

7. Improve sensory-motor integration for balance.

  • Sensory-motor integration refers to communication between our senses and our muscles.
  • Varying surfaces and inclines can help adapt to changing conditions in the environment.
  • Reducing visual input by darkening the room may also help sensory-motor integration.

8. Encourage speed and quickness.

  • Practicing fast movements, like quick footwork in boxing, can help with slowness.
  • Agility ladders and boxing sequences are a few techniques that can help improve speed.

9. Build mind/body connections.

  • Building mind/body connections can help promote awareness of our own movement.
  • Mind/body connections can also promote relaxation and self-awareness.
  • Doing activities that require planning or sequencing can help build mind/body connections.
  • Connecting breathing patterns to movement such as in tai chi or yoga is also helpful.

10. Do activities that are challenging, engaging, fun, social and safe.

  • You’re more likely to stick with an activity if it’s fun and effective! Make sure you also choose activities that are safe and talk with your healthcare provider before engaging in new exercise programs.

The table below has more information about the movement principles and types of activities that can help manage some of the common symptoms of Parkinson’s.

Parkinson’s Symptom

Movement Principles

Suggested Activities

Rigidity:
Stooped posture and
decreased range of motion
in the neck, trunk, and hips
  • Rotation
  • Reciprocal movement
  • Rhythmic movement
  • Extension exercises
  • Tall, “charge up” posture
  • Torso rotation exercises, like kayaking
  • Upper back strengthening exercises, like rowing
  • Chest stretches
Bradykinesia:
Slow movements
Hypokinesia:
Small movements and
narrow base
  • High effort, whole body movement
  • Wide base of support
  • Extensor muscle strengthening
  • BIG, fast steps
  • BIG, large arm swings
  • Walking and agility exercises
  • Lunging in all directions
  • Boxing
  • Kettlebell swings
Akinesia:
Impaired sequential coordination (includes freezing)
  • Preplanning tasks
  • Quick change movements
  • Practice moving in small spaces
  • Understand and use external cues
  • Dual tasks
  • Sequential movements
  • Walking and agility exercises
  • Obstacle courses
  • Quick turns in corners
  • Lunging in all directions
  • Boxing
  • Kettlebell swings
Impaired Sensory Integration:
Problems processing
sensory information
  • Practice balance on different
    surfaces
  • Reduce reliance on vision and external cues
  • Stability ball exercises
  • BOSU ball exercises
  • Foam pad exercises
  • Exercises with eyes closed
  • Exercises with head turns
Impaired Balance
  • Balance specific exercises adding
    visual and surface changes
  • Weight shifting exercises
  • Strengthening hips and legs
  • Stability ball exercises
  • BOSU ball exercises
  • Lunging
  • Tai Chi

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