Exercise for Parkinson’s

We all know that keeping active is important for staying well. For people with Parkinson’s, the stakes may be even higher. Research in animals strongly suggests that exercise could slow the progress of Parkinson’s. In human’s, we know that active lifestyles seem to be associated with better outcomes and quality of life. Here are some questions we often get asked about exercise for Parkinson’s.

Question 1: I have never seen definitive evidence in humans that shows that exercise, without a shadow of a doubt, can slow Parkinson’s. If I’m going to commit to slogging away at the gym/running track/football pitch, it would really help to know for sure that I’m making a difference to my future health.

We hear you! The problems with studying whether exercise can slow Parkinson’s are the same as the problems researchers face when studying whether a drug can slow Parkinson’s: Individual differences in disease progression and the use of more established treatments like levodopa tend to confound the outcomes. In addition, Parkinson’s progression is slow, and people need to be engaged in the exercise for long durations (think ‘lifestyle change’, rather than ‘quick jog around the block and call it quits’). Even if all this was solved, our current healthcare system does not have capacity to deliver exercise interventions long-term, and people with Parkinson’s often report they do not have opportunities to engage in exercise in their communities.

In short, the time frame we’re working with is too long, exercise is too hard to stick to, isn’t available to everyone equally, and the NHS wouldn’t have the resources to support it anyhow…

But, we’re not going to let any of that get in our way, right? The evidence we have is so compelling, and so full of promise. If we can think of new ways to deliver exercise interventions, and study the results, the outcomes could be game changing. Of course we’re not going to give up!

Researchers from Robert Gordon University in Aberdeen are working with people with Parkinson’s to design alternative models to deliver of exercise. Their PDConnect study aims to examine whether this collaborative approach to exercise delivery is feasible and effective. In the early papers describing the study, the researchers say:

“…this study aims to explore the feasibility and acceptability of an online collaborative approach to exercise, delivered by specially trained NHS physiotherapists and fitness instructors, which incorporates individualised exercise, education, and behaviour change techniques to support long-term exercise participation for people with Parkinson’s”.

We’re watching the study closely so we can understand how exercise interventions can be effectively added to our treatment arsenal for managing Parkinson’s.

Question 2: So you’re saying all that training I did for a 5K last year was pointless!!??

Not at all. Exercise you do for a short period is still helpful. This is particularly true when exercise helps people manage demanding periods of their lives.

For example, our North West Research Interest Group (which includes people with Parkinson’s, researchers and clinicians in the North West) are co-creating a mobility intervention that is targetted to people who have been, or are just about, to go into hospital. We know that recovery from hospital stays can take longer in people with Parkinson’s, and can increase the risk of falls and ongoing health issues, especially so if access to usual Parkinson’s medication is restricted at the hospital.

The mobility intervention combines virtual reality with physiotherapy exercises. It was designed by people with Parkinson’s and specialist physiotherapists from Manchester Metropolitan University. We are looking at ways to bring the intervention directly to the homes of the people who will benefit. We hope it will reduce the hospital stay-associated complications that can cause longer term mobility problems.

In short, exercise has an impact on your health and resilience even in the short term. Do what you can for now, and the long term might just get easier.