Benefits of Exercise in Parkinson's Patients: Maintaining Safety, Function, and Quality of Life
By Tyson Swigart

Parkinson's disease is a progressive neuromuscular disease that affects over a million people in the United States. Those affected with the disease tend to present with symptoms of bradykinesia (slowing of voluntary movement), resting tremor, rigidity during movement, poor balance, dysfunctional gait, and cognitive decline. These symptoms result from decreased production of the neurotransmitter dopamine in the basal ganglia. Although no cure has been found for Parkinson's disease, a myriad of research has been published regarding treatments used to slow the progression of this chronic disease. While pharmacological treatments merely treat the symptoms of Parkinson's disease, exercise programs have been shown to slow the progression of the disease as well as improve symptoms. Interestingly, those who workout regularly early in life seem to develop a "neuroprotective" quality that prevents their brains from being affected by Parkinson's later on.

Because patients with Parkinson's disease, as well as other neurodegenerative diseases, tend to have difficulty with balance and walking, they are at an increased risk for falls. Patients generally walk with a "Parkinsonian gait" which is characterized by a forward flexed posture, lack of arm swing, and small, shuffling steps. The patient may also have difficulty starting to walk and changing directions. They will appear as though they are about to fall forward during "normal" gait. In order to address these problems that are obviously a safety concern, exercise programs focusing on trunk strength and postural control are critically important. Incorporating these components into an exercise program will allow the Parkinson's patients to normalize their gait pattern for a longer period of time. With a normalized gait pattern as well as increased trunk control, patients are not as likely to fall.

In addition to decreasing the risk of falls, exercise has also been shown to improve cognition in patients with Parkinson's disease. Research has shown that Parkinson's patients who participate in an exercise program twice weekly over the course of twelve weeks exhibit improvements in frontal lobe based executive function activities including organization, problem solving, and memory. With the maintenance of executive function, Parkinson's patients can continue to excel in their careers despite the presence of pathology in their central nervous system.

By being proactive about preventing falls and maintaining brain function Parkinson's patients allow themselves to stay active without sacrificing quality of life. Before starting an exercise program, it is important that patients consult with their physician regarding exercise response and tolerance. Patients with Parkinson's disease should also consider a supervised training program as an option. In a research study published this year, exercise programs under the supervision of a physiotherapist were found to be more effective at improving activities of daily living, motor, mental, emotional functions and general health quality in patients with Parkinson's disease compared with a self-supervised home exercise program. A qualified exercise physiologist or other fitness professional can design a dynamic exercise program that is critical for combating the progression of Parkinson's disease. There is increasing support for engagement in activities that are both physically and mentally challenging. The martial arts, for example, incorporate strategy with physical activity. That being said, Parkinson's patients appear to benefiting greatly from utilizing movement-based treatments and should do in order to maintain safety, function, and quality of life throughout the lifespan.

Dr. Tyson Swigart is founder and owner of Southpointe Chiropractic and Fitness, 673 Morganza Road, Suite 105, Canonsburg, PA 15317. To make an appointment or for more information, you can reach Dr. Swigart at (724) 873-0700.

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