Physical activity and Parkinson’s: what do we know?
Research has shown that physical activity comes with many benefits for people with Parkinson’s, from reducing movement symptoms, to improving overall mental and physical wellbeing. But why is this and what are the best ways to stay active?
Keeping active is good for everyone. A regular exercise routine can help to maintain and build strength and power in your muscles, improve flexibility in your joints, and keep you generally fit and mobile. It can also keep your mind healthy, improve your mood and help you sleep. All of these benefits can help to better cope with the challenges that living with Parkinson’s may bring.
The impact of physical activity on Parkinson’s has been studied for many years and there is plenty of research evidence to support the importance of keeping active. Let’s take a look at the highlights.
What’s the evidence that physical activity is beneficial for Parkinson’s?
In 2023, a review was published that analysed over 150 research studies that investigated the impact of different types of physical activity on people with Parkinson’s. The review aimed to understand how different types of physical activity can be used to manage Parkinson’s symptoms. Overall, the researchers found that taking part in physical activity, which included dance, aqua-training and weight training, had benefits for people with Parkinson’s in terms of movement or improved quality of life, when compared with people who had not been active. Read a summary of the 2023 physical activity review on the Parkinson’s UK website.
Another study, published in 2024, explored the long term effects of tai chi, a martial art that involves gentle movements, on Parkinson’s. The study followed 330 people with Parkinson’s who had and hadn’t engaged in regular tai chi training over 3 and a half years. The results showed that tai chi training had a long-term beneficial effect on Parkinson’s, improving both movement and non-movement symptoms. Symptoms also appeared to deteriorate more slowly in people who practised tai chi, suggesting that physical activity could slow the progression of Parkinson’s. Read the published paper exploring Parkinson’s and tai chi in the Journal of Neurology, Neurosurgery and Psychiatry.
Dance has also been investigated for Parkinson’s. The PD Ballet study explored how engaging in a ballet class once a week for 12 weeks could impact people with Parkinson’s. 53 people took part in the classes, which were led by English National Ballet dancers. The results showed improvements to movement symptoms, pain, and other non-movement symptoms. Read the published PD-Ballet paper in the journal Neurology.
"The benefits of physical activity extend beyond the physical benefits that many people are familiar with such as improved fitness or increased muscle strength. Participation in physical activity also has many social benefits including developing a sense of community and providing opportunity for shared experience or shared learning. Above all, physical activity provides people with Parkinson’s to do something positive to help themselves."
Dr Julie Jones, Physiotherapist and researcher at Robert Gordon University, Aberdeen
In 2021, Laurel took part in a study investigating the benefits of mini trampolining exercises for people with neurological conditions. After the study, participants reported improvements in confidence, muscle strength, balance and coordination.
Laurel shared: “Taking part was most enjoyable, fun even. A weekly free one to one exercise class with a physiotherapist who is engaged in research to try to help people with Parkinson’s. It challenged me and helped me to work harder than I'd thought I'd be capable of. I felt it definitely improved my strength, balance and confidence. What's not to like? I'd do it again in a shot!'
How is physical activity and exercise changing what’s happening in the brain in Parkinson’s?
Whilst studies show that keeping active is good for people with Parkinson’s, our understanding of why is quite limited.
We know that aerobic exercise, which is high-impact and more vigorous, makes the heart work harder than normal to deliver oxygen to working muscles. This increases both the heart rate and breathing rate and means the brain receives a greater supply of blood and therefore more oxygen and nutrients to keep the tissue healthy and functioning well.
There is also growing evidence to show that types of exercise that raise the heart rate, like swimming or brisk walking, can stimulate the body to produce growth factors. Growth factors are sometimes described as fertilisers for the brain because they encourage new growth and help to keep brain cells healthy. One growth factor thought to increase after exercise is called brain derived neurotrophic factor, BDNF, which helps improve memory and thinking, among other roles.
Research, published in 2016, analysed a number of different studies involving a total of 1,111 participants, and found that exercise caused large amounts of BDNF to be delivered to the brain, and that regular exercise increased this effect. Read the 2016 published paper about BDNF in the Journal of Psychiatric Research. Similarly, a review, published in 2024, analysed 16 different studies and concluded that physical activity improved levels of BDNF. Levels of BDNF increased as the intensity and amount of exercise increased, but didn’t differ between different types of physical activity. Read the 2024 review of exercise and BDNF in the Frontiers in Physiology Journal.
Researchers have also suggested that regular exercise may improve symptoms of Parkinson’s by creating more connections between areas of the brain affected by the condition. One research study, published in 2021, compared cycling on a stationary bike (the exercise group) to stretching (less active group) 3 times a week over a 6 month period. 130 people with Parkinson’s took part in the study. After 6 months, they reported that people in the exercise group had developed more connections between important brain areas and performed better on thinking and memory tests. Read a summary of the 2021 cycling study in a news article on the Parkinson’s UK website.
"Depending on what type of exercise you do and how long you do it for, the brain can be pushed to levels where new pathways and connections to different areas of the brain are created. New blood vessels form, bringing in a fresh supply of nutrition whilst clearing away unneeded waste, keeping the brain clean and efficient. Hormones that help with healing and learning can also be produced by more vigorous types of exercise."
Dr Bhanu Ramaswamy OBE, Independent Physiotherapy Consultant
Which type of physical activity is best for Parkinson’s?
Research has explored many different types of physical activity, from dance and swimming, to yoga and boxing. But, we don’t yet know which types of physical activity may help with specific symptoms, such as tremor. Future research is needed to understand this.
Dr Julie Jones shared: “Research into physical activity is really important as Parkinson’s affects people differently. Therefore, research is needed to determine or inform the optimum physical activity prescription for each person with Parkinson’s.”
Different activities will naturally work better for different people depending on their symptoms and experience of the condition. A good tip is to do something that you enjoy. If you want to get active but you’re not sure where to start, Parkinson’s UK can point you in the right direction. Visit the physical activity resources page on our website.
Dr Bhanu Ramaswamy OBE shared: “I would say there is no ‘best’. Most people with Parkinson’s need to do a combination of types of physical activity, and most will benefit from exercising in company. It is about doing something regularly, even if your choice of activity alters over time because of differing fashions in sport or because you need to improve a specific fitness component of your body.”
What research is ongoing in this area?
More research is needed to better understand whether keeping active can slow the progression of the condition, whether different types of physical activity can help to manage different symptoms and how people with Parkinson’s can be better supported to keep active.
Professor Bastiaan Bloem is currently leading a research study called SLOW-SPEED. The study is exploring if it’s possible to use physical activity to slow the development of Parkinson’s in people who have early symptoms or a high risk of developing the condition. Participants are asked to take part in an exercise programme, which is delivered remotely to a smartphone, for a period of 3 years. The study hopes to provide insights into the success of remote exercise programmes and whether physical activity could become a preventative measure to slow the development of the condition. This research is part funded by Parkinson’s UK and is due to conclude in June 2027.
A number of studies are also exploring different programmes to help people stay active. Dr Gill Barry is leading a study at Northumbria University exploring whether an NHS approved digital health programme can help people with Parkinson’s stay active. The programme, called Keep On and Keep Up, is designed to engage older people in safe and effective balance, strength and fall prevention exercises, but has not yet been tested on people with Parkinson’s. The study is due to finish in June 2025.
Research continues to tell us more about physical activity and Parkinson’s. We know that there are benefits to staying active, and Parkinson’s UK can support you on your journey. Find out more by requesting a free copy of our Being Active with Parkinson’s guide or contact the Physical Activity team at [email protected].