Exercise and Parkinson's

We all know the barriers we face when trying to maintain a healthy lifestyle. Combine these with the complex symptoms of Parkinson's, and exercise becomes even more challenging.

Here, expert physiotherapists Bhanu Ramaswamy and Beccy Oliver explain how the professional community can make a difference.

Imagine that you enjoy hiking with a walking group. Suddenly you find yourself needing the toilet more, so get anxious about being close to toilet facilities. You can't get around as easily so you find it hard to even get to the walking route in the first place. And when you do, you feel you can't keep up with the pace of the other group members, or feel like you're slowing them down. Chances are, you'd probably just stop going.

For many people with Parkinson's, these are the realities they describe to health professionals. Physical (and non-physical) symptoms, such as slow movement, rigidity, pain, anxiety and fatigue, can make exercise seem difficult, off-putting or even impossible. It can mean that many people simply give up exercising altogether.

How can exercise help people with Parkinson's?

Exercise good for people with Parkinson's and their general wellbeing. But we now know that the right type and intensity of exercise can actually slow the progression of Parkinson's symptoms.

The right exercise can help people remain physically active, and reduce discomfort from pain and other symptoms affecting mobility. Exercise done in a group setting can contribute to a sociable and active lifestyle.

Exercise also improves sleep. It can even help with issues that many people don't talk openly about, such as constipation or problems with mood. 

Many people with Parkinson's also talk of exercise as a way of taking back some control in order to manage their symptoms, with some going as far as to say it helps them "fight back" against the condition.

What is the Parkinson's exercise framework?

Even though the message from research and the experience of people with Parkinson's is that exercise is good for you, not all professionals have been able to keep up to date about what people with Parkinson's should be doing and when. A worrying trend is that some professionals can even be a barrier to a person's progress. 

The Parkinson's exercise framework was developed to help answer questions about what the right type of exercise is for people with Parkinson's at different stages of the condition.

A group of expert physiotherapists (part of an Exercise Hub for professionals that Bhanu and Beccy co-chair in the UK Parkinson's Excellence Network) came together to develop the framework based on research and speaking to people with Parkinson's and professionals. The aim is to provide information on how people with Parkinson's should be engaging in exercise safely and effectively.  

What is the best type of exercise for Parkinson's?

As Parkinson's affects everyone differently, there is no ideal solution or exercise for everyone. So the exercise framework suggests a blend of styles and intensity that will help people with Parkinson's do what they can at different times over the course of their condition.

Some people should be participating in more vigorous (higher-intensity) exercise at the gym, or out cycling and running with friends. Others are best doing chair-based exercises at home.

Exercise might be done individually or in a class, and can be targeted to specific symptoms, like balance, or at improving general health and wellbeing, like walking. 

So, to answer this question, we say that the best type of exercise should help people with Parkinson's to feel and remain as fit and well as possible to manage everyday life. 

When it comes to exercise, how can I support someone with Parkinson's? 

Exercise can be as important as medication and should be 'prescribed' in a similar way. Because of this you can use the exercise framework to promote exercise as an important part of everyday life for people with Parkinson's.

You can direct professionals to the UK Parkinson's Excellence Network resources and learning hub, and we also want you to share the Parkinson's exercise framework with your networks.

Any professional working in neurology or with older people should be conveying the message that exercise is important for everyone, as it helps keep the body as fit and well as possible, both physically and mentally.

Essentially, promoting and providing education on exercise should be central to the role of health and exercise professionals.

What is one key message to take away about Parkinson's?

It's really important that people with Parkinson's understand that exercise is something to be embraced – it's as important as medication, plus a great way to take control of their symptoms and their lives.