Exercise and PD

EXERCISE AND PARKINSON'S DISEASE

by Cheryl Suvic, PT

In my work as a therapist, I am more and more convinced of how important exercise is—not only to those with Parkinson's disease (PD) but to all of us, including caregivers. I can almost see some of you grimacing and thinking, "Oh no, not this lecture again." But if your doctor offered you a pill that could give you more energy, make your muscles stronger and more flexible, help you control your blood pressure, lift your mood and fight depression, reduce your risk of heart attack and improve your balance without harmful side effects, would you take it? I'll bet you would and pay top dollar for it! These are all benefits of a regular exercise program for individuals with PD and caregivers alike. You should check with your physician before beginning any exercise program. A physical therapist can be helpful in designing your own personal exercise program to address your needs. Some of the specific impairments associated with PD that an exercise program can address are rigidity-tightness and resistance to movement in muscles and joints, bradykinesia or slowness of movement and impaired postural reactions causing increased loss of balance and falls. A good exercise program has three basic components: stretching, strengthening, and aerobic conditioning. Each component is important and all are necessary to allow you to remain as active as possible.

STRETCHING helps with rigidity and keeps your muscles and joints more flexible. Stretching also helps with posture, relaxation, circulation, and protects against muscle sprains or strains. It should be done at least twice a day and always before other exercises.

STRENGTHENING is another important part of an exercise program. You can do strength training by lifting weights, using elastic resistance bands (i.e. TheraBand), or household items such as soup cans or plastic bottles filled with water or sand. Some exercises such as squats or prone on elbows don't need added weight, just your own body weight can be used as resistance. You should avoid pain, perform the movement slowly, and breathe in while performing the movement and breathe out while relaxing the movement. Begin with weight you can perform 10 repetitions with and gradually increase to performing 3 sets of 10 repetitions. Then increase the weight gradually. Strengthening exercises should not be done two days in a row, so skip a day or perform arm strengthening one day and work your legs the next. The benefits you receive from strengthening are stronger muscles which can help you stand up straighter and get out of a chair more easily. It also decreases joint pain and helps to strengthen bones, so if you fall you will be less likely to break a bone.

AEROBIC CONDITIONING is the third component of a good exercise program. This does not mean only running or fast moving aerobic classes. It can mean anything you enjoy doing in which you are performing sustained movement with arms, legs or both for at least 15-20 minutes at least 3 times per week. Examples would be walking, biking, water aerobics, dancing, swimming or household chores such as vacuuming, gardening, or yard work. Again, start slow and gradually work up to at least 20 minutes. The benefits of conditioning are impressive. It will help strengthen your heart and lungs, improve your stamina, reduce stress, elevate your mood and aid in controlling your blood pressure and cholesterol. How do you get started? Come up with a plan and try it for at least 3 months regularly. Results take time but see if you don't feel better. Exercise at a time when you are well rested and your medication level is at its peak. Wear loose comfortable clothing and good supportive shoe wear. Remember, the improvements will not happen overnight. Your muscles may be tired and slightly painful. If your fatigue lasts more than one hour afterward or muscle soreness lasts through the next day, your intensity needs to be decreased. However, don't stop, maybe miss a session but get back to it. Expect good days and bad days but stick it out. The benefits are well worth it!

Cheryl Suvic is a physical therapist with Iowa Health System in Des Moines, Iowa.

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