Parkinson’s Exercise Principles

It takes a variety of activities to combat the common symptoms of Parkinson’s. The exercise principles described below can help you design an exercise plan that meets your unique needs. The goal is to incorporate these principles into your fitness routine – and to have fun too!

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Parkinson’s Exercise Principles

1. Build stamina through aerobic activity.

  • Research suggests aerobic activity supports positive changes in the brain.
  • Aerobic activity can include high intensity walking or biking followed by other higher intensity activities, like lunges.

2. Target specific areas for better flexibility.

  • Rigidity along the spine causes “stooped” posture and pain among people with Parkinson’s. Some of this rigidity comes from increased muscle tone in flexor muscles.
  • Stretching, especially the flexor muscles, is especially important. This includes the chest, shoulders, abdominals, hip flexors, gluteals, hamstrings, hip adductors, and calves.
  • Activities that rotate the spine, such as kayaking, are also helpful for improving rigidity.

3. Improve and maintain flexibility with dynamic stretching.

  • Improving flexibility can facilitate better posture and better movement. A whole body stretching routine, like those done in yoga, can be particularly beneficial.

4. Strengthen extensor muscle groups to improve posture.

  • Extensor muscles unfurl a person from a fetal position until they can reach for the sky. That reaching upright posture is great for Parkinson’s.
  • Extension exercises strengthen backs and hips, facilitate upright posture and may relieve back pain.
  • Strengthen especially the back, hips, and triceps.

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

  • Slow, small movements are a common symptom of Parkinson’s. People with Parkinson’s tend to think a move looks big, but it will actually be undersized.
  • Thinking BIG helps you move BIG. If you think to exaggerate the movement, it will be more full size.
  • Use the whole body. For example, you could do rows, standing tall with squats, so the work is more whole body.
  • Move in all directions, practice turning and emphasize weight shifting

6. Practice dual tasks and cognitive challenges.

  • People with Parkinson’s can have difficulty performing more than one task at a time or shifting from one task to another. Practicing dual physical tasks (combining two physical activities, such as walking while doing triceps extension) can help improve this symptom.
  • People with Parkinson’s will eventually experience cognitive challenges. Adding counting or singing and other more complex cognitive challenges to a movement can help improve this.

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

  • People with Parkinson’s can also experience problems initiating movement, which can lead to abruptly halting or “freezing.”
  • Keeping up a pace can also be a real challenge.
  • Practice self-initiated and self-paced movements. Counting can help keep a pace, and imagining yourself doing a movement before you perform it can help initiate movement.

8. Develop reciprocal motions.

  • Uneven or non-swinging arms are common symptoms of Parkinson’s and can lead to balance problems.
  • Practicing reciprocal, coordinated arm and leg movements may help address this problem. Using very light wrist weights can help increase arm swings, too.
  • Twisting the trunk, like kayaking, can also help improve arm swings.

9. Develop erect postural alignment.

  • Stooped posture is a common symptom of Parkinson’s that can affect balance and movement.
  • Think tall posture while doing physical activity:
  • Chest is lifted upwards, spine is straight, braced by abdominals.
  • Shoulders are back and down, head is back, chin parallel to floor.
  • Eliminate or reduce activities that foster spinal and hip flexion (biceps curls and bent over biking positions are two examples of what to avoid).

10. Use loud, strong voices.

  • Soft and slow speech is a common symptom of Parkinson’s, which can make it difficult to communicate with people.
  • Practicing loud and strong voices while performing exercises can help with both voice quality and movement.
  • Be careful not to yell, which can strain the voice and throat..

11. Improve sensory-motor integration for balance.

  • Sensory-motor integration refers to the communication between our senses and our muscles. In people with Parkinson’s, sensory-motor integration can become impaired.
  • Balance pads or mats, dyna discs, varying surfaces and inclines may help you adapt to changing conditions in the environment.
  • Reducing visual input may also help improve sensory-motor integration. Darken the room, close one eye or put on sunglasses to reduce dependence on sight.

12. Encourage speed and quickness.

  • Parkinson’s can cause slowness of movement. Practicing fast movements, like quick footwork in boxing, can help.
  • Shuttle runs, agility ladders and boxing sequences are a few techniques that can help improve speed.

13. Build mind/body connections.

  • Building mind/body connections can help promote awareness of our own movement, which can become impaired in Parkinson’s.
  • Mind/body connections can promote relaxation and self-awareness, both of which can positively affect anxiety and depression.
  • Doing activities that require planning or sequencing can help build mind/body connections.
  • Connecting breathing patterns to movement or relaxation such as in tai chi or yoga is also helpful

14. 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 health care provider before engaging in new exercise programs.

Boot Camp for Parkinson’s Program

The goal of the Boot Camp is to incorporate a variety of activities into each class to combat some of the mobility limitations associated with Parkinson’s. The table below gives a basic outline of what a sample class would include. The format can also be adapted to include different types of activities.
Activity Goals Time
Warm Up Gentle warm up and dynamic stretches 5 mins
Aerobic Activity Use high intensity and/or interval training to build stamina 15 mins
Agility Course Functional and fun with obstacles to negotiate
  • Shuffles, skips, high knees
  • Quick, wide, and big steps
  • Multiple and changing directions, turns
  • Big arms, rotating trunks
10 mins
Lunges BIG whole-body steps in multiple directions with reciprocal arm swings 5-10 mins
Boxing Sequencing and cognitive training with powerful, big movements and quick feet 5-10 mins
Tai Chi Balance, sequencing, relaxation and meditation 5-10 mins
Pilates & Yoga Transitions for every day skills and flexibility 5-10 mins
Total Time 60 mins