Exploring the Effectiveness of Different Exercises for Individuals with Parkinson's Disease
A recent analysis of various exercise regimens has revealed that physical activity can offer clinically significant improvements for adults living with Parkinson's disease. The findings, based on systematic reviews and meta-analyses, suggest a range of exercise modalities that can help alleviate motor symptoms and enhance quality of life.
Dr. Michael Okun, the national medical advisor for the Parkinson's Foundation, has welcomed the data, acknowledging that while more research is needed, the evidence supports the benefits of exercise for individuals with Parkinson's. The study, which included 156 randomised controlled trials with a total of 7,939 participants, primarily focused on individuals with mild to moderate Parkinson's and no major cognitive impairment.
The analysis found little evidence that one type of exercise works significantly better than another for treating Parkinson's. However, certain exercise modalities demonstrate meaningful improvements in motor symptoms and fall prevention. Group, individual, home-based activities such as dance, strength/resistance training, balance/functional training, endurance, and yoga were all found to be beneficial compared to usual care or self-directed activity.
Treadmill training, particularly weight-supported treadmill training, shows superior efficacy over conventional training for improving lower limb mobility, a key factor in gait rehabilitation. High-intensity aerobic and task-oriented training appear particularly beneficial, not only for motor symptoms but also for reducing non-motor symptoms like cognitive impairment and quality of life impact.
Emerging approaches like virtual reality (VR) training for motor-cognitive dual-task performance show promise, particularly in improving gait speed and dual-task abilities, which are relevant for real-world function and fall reduction. However, results vary, and more research is needed in this area.
In summary, aerobic exercise, strength and balance training, treadmill training (especially weight-supported), and potentially VR-based dual-task training represent the most effective exercise types for improving motor and some non-motor outcomes in adults with Parkinson’s disease. Exercise should be personalized, often emphasizing higher intensity and task-specific training to maximize benefits.
While the evidence is uncertain regarding the beneficial effects of mind-body training, gaming, strength-resistance training, dance, flexibility training, and LSVT BIG on quality of life, the Parkinson's Outcomes Project, a clinical study of over 13,000 individuals with Parkinson's disease from five countries, found that doing at least 2.5 hours of exercise per week can slow an individual's decline in quality of life from the disease.
It is crucial to note that the brains of individuals with Parkinson's often exhibit a loss of dopamine-synthesizing brain cells in the substantia nigra. Common symptoms include tremors, slow movement, limb stiffness, gait and balance problems. While the exact cause of Parkinson's remains unclear, many experts believe a combination of genetic and environmental factors may be to blame.
There is currently no cure for Parkinson's, but medications and surgeries can help manage the disease. Experts believe lifestyle modifications, including regular exercise, can also contribute to improving quality of life for individuals with Parkinson's.
The researchers looked at 85 of the selected studies that provided any kind of safety data. No adverse events occurred in 40 of the RCTs studied, while adverse events did occur in 28 studies.
In conclusion, exercise continues to be a promising form of treatment for individuals with Parkinson's disease, offering benefits that are comparable to medication effects. As research continues, personalized exercise regimens tailored to the individual's needs and preferences can help maximise the benefits and improve quality of life for those living with Parkinson's.
[1] Dr. Michael Okun, National Medical Advisor, Parkinson's Foundation [2] Cochrane Database of Systematic Reviews [3] Parkinson's Outcomes Project [4] Virtual Reality (VR) training for motor-cognitive dual-task performance in Parkinson's disease: A systematic review and meta-analysis. Frontiers in Neurology (2020) [5] Parkinson's disease: diagnosis and management. NICE Guidelines (2017) [6] The European Parkinson's Disease Association (EPDA) [7] The Michael J. Fox Foundation for Parkinson's Research.
- The findings support Dr. Michael Okun's views that exercise can significantly improve motor symptoms and quality of life for adults with Parkinson's, as reported by the Parkinson's Foundation's National Medical Advisor.
- The analysis of exercise regimens suggests that various exercise modalities, such as dance, strength/resistance training, balance/functional training, endurance, yoga, treadmill training, and virtual reality training, show meaningful improvements for individuals with Parkinson's, based on systematic reviews and meta-analyses.
- High-intensity aerobic and task-oriented training appear particularly beneficial, not only for motor symptoms but also for reducing non-motor symptoms like cognitive impairment and quality of life impact in individuals with Parkinson's.
- While some uncertainties remain regarding the beneficial effects of mind-body training, gaming, flexibility training, and LSVT BIG on quality of life, doing at least 2.5 hours of exercise per week can help slow an individual's decline in quality of life from Parkinson's, as found in the Parkinson's Outcomes Project, a clinical study of over 13,000 individuals with Parkinson's disease from five countries.
