Staying Active with Parkinson's
If you have Parkinson’s disease, staying active is particularly important. Regular physical activity like walking and performing balance or flexibility exercises helps maintain physical health and can improve mental well-being. In fact, the 2012 Canadian Guidelines of Parkinson’s Disease recommends physical and exercise therapies as part of the management of Parkinson’s disease.
Research has demonstrated the benefits of physical activity for those with Parkinson’s disease include:
- Improved walking speeds
- Reduced rigidity
- Easier to get up and go
- Improved balance and risk of falling
- Improved fitness for general health
Just as the type and severity of the physical symptoms of Parkinson’s vary considerably, the type of physical activity needs to be adapted to each individual. Ideally, the best type of physical activity programs should include some of the following:
- Walking and balance activities
- Flexibility, strength and posture activities
- Aerobic activities (e.g., treadmill, biking)
- Strategies to help initiate movement
Walking and Balance Exercises
People with Parkinson’s disease often have trouble with walking, balance and coordination due to trunk stiffness and difficulty initiating movement. Incorporating walking and balance activities can help improve walking speed, balance and prevent falls. Some examples of activities to maintain or improve walking or balance include:
- Tandem walking: this simply means practicing walking heel to toe as if walking on a line
- Standing on one leg: this involves balancing on one leg at a table or counter
- Walking sideways: practice walking sideways
- Walking on a treadmill: having to keep up with the movement may help improve walking speed
- Tai chi and dance: both have been shown to improve balance and walking speed
No matter what you’re are doing whether it is walking in your home, walking the dog, doing yoga or stretching, the important thing is to think about how you move. Parkinson's disease makes you take smaller movements than normal. The goal with any movement or activity is to overemphasize movements so they feel "bigger" than normal. Here are some quick tips:
- Take longer strides
- Pick up your feet higher than normal
- Swing your arms in an exaggerated manner
- Try walking briskly
Before commencing any new walking or balance exercises, consult with your health-care provider for expert advice on which activities are more suited to you personally.
Flexibility, Strength and Posture Exercises
Over time, people with Parkinson’s develop a stooped posture. This results from trunk rigidity, tight muscles, stiff joints and trunk weakness. The combination of a stooped posture and trunk rigidity impairs balance, mobility, breathing and swallowing. Incorporating posture, trunk flexibility and strengthening exercises can help maintain or improve posture, balance and mobility. Some examples of activities to help posture include:
- Chin tuck exercises: pulling you head back so your ears are over your shoulders (think of making a double chin)
- Stretching over the back of a chair: extending your trunk over the back of a chair
- Seated, standing or lying reach: in any position stretch your shoulders to reach as far overhead as you can
- Doorway stretch: if you are tall enough, reach overhead to the top of a doorway and gently lean forwards
- Trunk rotation: in a seat, hips facing forwards, turn your trunk as far as you’re able in both directions
Aerobic exercise is not just for healthy individuals, as it can also have significant health benefits for those with Parkinson’s disease. Aerobic exercises can improve breathing, overall physical function and mental well-being. Some experts suggest that exercises like treadmill walking or biking that requires keeping up to a certain pace may slow progression. Here are some tips when considering, selecting and starting an aerobic exercise program:
- Activities need to be performed for at least 30 minutes, three times per week for a minimum of 10 weeks.
- Speak to you family doctor before starting your exercise program to ensure its safe to do so. It’s also important to coordinate with your medications when you exercise.
- Pick aerobic exercises that you can do and most importantly that are fun. If needed, consult a health-care professional with expertise in prescribing exercise for a routine that suits you.
- Treadmill walking, brisk walking, biking, dancing and boxing have all been demonstrated to provide benefit for Parkinson’s patients.
Strategies to Help Initiate Movement
One of the major difficulties with Parkinson’s disease can be freezing, which creates difficulty when starting a movement. Taking a step, getting out of a chair or turning over in bed can become a challenge. Training that involves the use of rhythmical movements (e.g., marching) along with auditory rhythms (e.g., metronome) are strategies that can help initiate movement and reduce freezing. Some examples of rhythmical activities include:
- Marching on the spot: practicing military-style marching using arms and legs.
- Using visual cues while walking: practice while aiming for specific points on the floor (e.g., lines, footprints, dots).
- Walking over canes: helps to promote leg lift and reduce shuffling.
- Adding auditory cues: moving to the beat of music or a metronome can help initiate movement.
- Dance, tai chi, and music: any activity that requires moving or keeping up with a beat.
*Before commencing any new exercise consult with your health-care provider for expert advice on which activities are more suited to you personally.
A physiotherapist can be an excellent resource when seeking advice about which type of exercise program is suitable for you. Click here to find a physiotherapist.