Aging Well: Exercise improves Parkinson’s symptoms

There are many unanswered questions about Parkinson’s disease.

Some, such as what causes the condition in the first place, are troubling. Others, such as why exercise improves lives of people coping with the disease, are more optimistic.

Take, for instance, the European man with severe Parkinson’s disease who cannot walk more than a few steps but regularly rides his bike for miles and miles. His doctor, whose observations are described in the April 1 issue of the New England Journal of Medicine, found that other patients in later stages of Parkinson’s disease also were able to ride bicycles.

More research is needed to understand why cycling may be possible for individuals with Parkinson’s disease when other activities are not and whether this might be true for other types of exercise.

The case does, however, add more hope to a string of studies suggesting consistent exercise loosens Parkinson’s grip, helping ease, and possibly even delay symptoms, and extend a person’s independence.

Parkinson’s and exercise

Parkinson’s disease is a movement disorder characterized by tremors in hands, arms, legs or jaw; rigid or stiff limbs and trunk; slow movement; and impaired balance and coordination.

These symptoms, which grow worse throughout time, happen when cells producing dopamine, a chemical messenger involved in movement control and coordination, die.

Although Parkinson’s is not considered terminal, an individual’s quality of life can decrease significantly as they have more difficulty walking and performing daily tasks such as driving, working, bathing and getting out of bed.

Balance and walking problems make people with Parkinson’s disease susceptible to falls and fractures, while loss of independence can cause depression.

Medications widely are used to help patients manage symptoms. As with many chronic conditions, a healthy lifestyle that includes a nutritious diet, physical activity and social interaction seems to further help individuals with Parkinson’s maintain their quality of life.

Based on studies of mice, scientists think exercise actually may change the structure and function of the brain to help it use dopamine more efficiently. This, in addition to factors such as increased muscle mass, can lead to better balance, flexibility, strength, motor coordination and walking ability.

Social and meditative components of some types of exercise, in addition to a person’s improved mobility and independence, also help ward off stress, anxiety and depression.

Exercise tips

Any exercise is good exercise for a person with Parkinson’s disease, but experts recommend a varied program that addresses strength, balance, coordination, flexibility and endurance.

Depending on a person’s stage of Parkinson’s and capabilities, an exercise routine might include activities such walking, running, biking, Pilates or weight training.

Alternative exercise, such as yoga, tai chi and qigong also can help improve balance, coordination, flexibility and strength while promoting a positive state of mind.

Once a person establishes an exercise program, it’s important they stick to it and challenge themselves as much as possible. The most significant gains appear in people who exercise regularly with greater intensity.

Experts suggest people with Parkinson’s, particularly young onset or those in early stages, exercise with intensity for about one hour, three to four times per week.

Physical therapists trained to help patients with Parkinson’s disease can assist individuals, particularly those new to exercise or those with more severe symptoms, in developing a safe exercise regimen to fit their needs.

Studies suggest that a person with Parkinson’s receives the most benefits from consistent exercise started in early stages of the disease though a patient’s age or stage of disease should not be a deterrent to exercise.

For that reason, experts recommend people see a physical therapist as soon as possible after diagnosis for evaluation and help developing an exercise program to get on the right track toward maintaining their quality of life.

It’s important for individuals to get a referral for physical therapy from their physician in order to receive coverage from insurance or Medicare.

Appropriate exercise classes can offer a secure environment with ongoing guidance as well as a social element that can help motivate individuals to continue exercising.

The Aging Well program of the Northwest Colorado Visiting Nurse Association offers fitness classes targeting older individuals coping with symptoms of Parkinson’s disease and other chronic conditions and other age-related physical challenges.

Classes such as Arthritis Foundation Fitness and Aquatics, Tai Chi and N’Balance provide a range of opportunities from gentle to challenging exercise.

Aging Well also offers Healthier Living Colorado workshops, which provide participants with chronic conditions goal-setting tools to make healthier choices.

A person might utilize workout tapes, Nintendo Wii or books to help them develop a workout routine at home.

“Delay the Disease — Exercise and Parkinson’s Disease,” by David Zid and Jackie Russell (www.delaythe

disease.com), helps people develop a Parkinson’s-specific exercise program that can be adjusted to their abilities.

This article includes information from the Parkinson’s Disease Foundation, the National Parkinson Foundation and “Cycling Provides a Break for Some with Parkinson’s,” an article by Gina Kolata, The New York Times.

— Tamera Manzanares writes for the Aging Well program and can be reached at tmanzanares@nwcovna.org. Aging Well, a division of Northwest Colorado Visiting Nurse Association, is a community-based program of healthy aging for adults 50 and older. For more information, log onto www.agingwelltoday.com or call 871-7676.

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