Individuals living with Parkinson’s Disease (PD) greatly benefit from regular exercise but often become discouraged because of the challenges they face as a result from their disease. While PD affects each individual differently, there are some common symptoms that can make exercise more difficult. PD produces physical limitations including tremors, muscle rigidity (stiffness caused by problems in the nervous system), changes in posture, decline in balance, smaller size of movements, reduced strength and decreased flexibility. These factors need to be considered when choosing appropriate exercises for an individual with PD to ensure safety and reduce a risk of injury or falling. The autonomic nervous system is also affected by PD. This can cause drops in blood pressure and changes in heart rate that can make a person feel dizzy or lightheaded with movement and changes in posture. Finally, there is a mental toll that PD takes on an individual both because of the changes occurring in the brain and due to the struggle of living with a chronic condition. It is not uncommon for people with PD to face depression, anxiety, and changes in memory. This can reduce an individual’s ability to properly comply with an exercise program or be motivated to participate in exercise. Combined, these physical and mental limitations can make exercise seem like a daunting task.
While it may seem overwhelming to take on an exercise routine, maintaining mobility and fitness is crucial to ensure as much safety, independence and ability to actively participate in life as possible. It is a common misconception that individuals who have PD can not progress or improve with exercise because the disease is chronic and progressive in nature. However, this is not true. Exercise, especially when it includes large amplitude movements, can help people with PD improve their strength, balance, cardiovascular endurance, mood and mobility. Prior to beginning an exercise program, individuals with PD should consider their goals for exercise, access to equipment, and ability to be safe with whichever program they choose. It is often beneficial for some individuals with PD to begin working with a physical therapist or an experienced personal trainer who has extensive training and experience in working with the unique challenges that people with PD face with exercise. From there, some people are able to maintain their exercise program independently while others require occasional “tune-ups” to modify and adapt exercise programs intermittently.
Here are 5 simple exercises that individuals with PD can try (and use this link to see a video demonstration of these exercises: https://youtu.be/QtgW7ajEtrE:
1. Sit to Stands
How to Perform: Sit upright with your best posture on the edge of a sturdy chair. Reach forward with your arms and rise up to a standing position. Bring arms back towards your side and stand as tall as possible. Next, reach forward and return to sitting using a controlled movement. Sit up tall. Repeat.
Why This Exercise Is Beneficial: Sit to stands will help with trunk and leg strength, along with increasing an upright posture instead of a forward flexed posture.
Frequency: Perform 8-10 repetitions twice per day
Precautions: If you feel unstable, do this exercise with a table next to you or your walker in front of you to place your hands on for support as you come up to standing
2. Forward Stepping
How to Perform: Place a series of small objects on the floor in front of you. Take large steps to walk over the objects on the floor. When you get to the end, turn around and return back to the beginning.
Why This Exercise Is Beneficial: Taking large steps will help to improve leg strength, standing balance, and ability to walk with larger steps.
Frequency: Perform for 1-2 minutes, twice per day
Precautions: If you feel unstable, do this exercise with a table or countertop next to you to hold on for support as needed. This exercise could also be performed while holding onto a walker. If it is too difficult to step over an object, using a flat obstacle on the floor (such as lines made with tape) can be substituted.
3. Wall Angels
How to Perform: Start in standing position with back and head against a wall (as best as you can). Have arms against the wall with palms facing outward. Move arms up the wall as far as you can without leaning forward or having arms come up off of the wall. Return back down to starting position.
Why This Exercise Is Beneficial: This exercise will help work on shoulder mobility and postural strength. Individuals with PD often begin to stand in a forward flexed position, so this exercise helps to counteract that.
Frequency: Perform 10 repetitions, twice per day.
Precautions: This exercise should be performed in a pain-free range of motion to avoid injury to the shoulders. It is important to ensure you are keeping your very best posture while performing this exercise.
4. Crossbody Punches
How to Perform: Stand with your feet staggered (take a step forward with right foot) and tall posture. Start with left elbow bent, hand in front of shoulder. With your left arm, punch forward and across your body so that your trunk also turns slightly to the right. Bring arm back to starting position. Repeat. Perform 10 repetitions. Then, switch feet around and repeat with right arm.
Why This Exercise Is Beneficial: This exercise works on standing balance, shoulder strength, core stability, and spine mobility which will help with daily reaching activities.
Frequency: Perform 10 repetitions on each side, twice per day
Precautions: If you feel unstable, you can do this with your feet in a normal standing position or while sitting down with good posture on a firm chair.
5. Backward Walking
How to Perform: Stand up tall. While maintaining good posture, walk backwards taking nice big steps. Repeat.
Why This Exercise Is Beneficial: Backwards walking will help with maintaining dynamic standing balance and proper weight shift while walking. We do not always move in a forwards direction, so it is important to move in all planes of mobility.
Frequency: Perform for 1-2 minutes, twice per day
Precautions: If you feel unstable, do this exercise with a table or countertop next to you to hold on for support as needed. This exercise could also be performed while holding onto a walker.
When beginning any exercise program, it is important to make sure that an individual has medical clearance from their physician to exercise. Individuals with PD can have other health conditions that could impact their ability to safely exercise, so these must be considered when designing an exercise program. It is beneficial for people with PD to exercise daily and use a variety of exercise methods that include balance, strength, flexibility and cardiovascular techniques.