Author: Dr. Jory Davis, PT, DPT
There were countless times while working in an outpatient physical therapy clinic where I would meet someone newly diagnosed with Parkinson’s Disease (PD). In fact, PD is the second most common neurodegenerative disease with a prevalence rate of 1–2 per 1000 of the population worldwide. There is an overwhelmingly large amount of people with PD who wonder how exercise will fit into their lives. In some cases, a diagnosis of PD is life changing, scary and comes with an unpredictable prognosis. PD is truly a “boutique disease” meaning that presentation of symptoms and progression of the disease is not homogeneous. For this reason, it is salient for someone to approach the diagnosis with an emphasis on their unique presentation.
Currently, Pharmacological management and physical exercise (PE) is the mainstay of treatment. So what does that mean? It means that we should treat physical exercise as a form of “ medication” for our body. It is a way to slow down progression and improve quality of life. It has been shown that exercises that incorporates goal-based training and aerobic components can improve cognition and drive neuroplastic changes. From a cellular level, vigorous exercise limits the alteration in dopaminergic neurons which provides for improvement in motor commands and control. In some cases, after a diagnosis of PD, people may be fearful to exercise at an intense level. They may believe that low intensity is best, however, this contradicts current evidence. It is crucial to encourage people with PD to perform beyond self-perceived capability. Additionally, PE activates the release of neurotrophic factors and promotes angiogenesis which improves memory and cognitive factors. People who engage in increased amounts of PE have a decreased risk of developing PD. This is crucial because it tells us that exercise can be preventative! To all the die-hard PIT members out there, all your hard work not only makes you feel great but it has overall health benefits and can decrease your risk of developing PD. Evidence also supports that exercise has preventative measures against developing Alzheimer’s disease. So basically, keep exercising!
Rock Steady Boxing is a non-contact boxing program for people with PD. It is a prime example of moderate-high intensity exercise that may not only improve quality of life but may slow the progression of the disease. One longitudinal study by Horbinski et al. (2021) found that boxing therapy decreased participants average number of falls by 87%. This is a staggering figure and illustrates the importance of exercise to improve function in someone with PD. I distinctly remember working with someone with PD who was afraid of falling so much that they barely engaged in exercise. This became a viscous cycle of decreased PE resulting in decreased mobility, function and motor control which all resulted in increased falls. The take home message here is that PE is truly a form of “medication” for people with PD. It may slow down the progression and improve current symptoms. If you don’t have PD then you should still exercise since exercise is preventative and has neural protective qualities. It’s time to protect your brain, get in the game and exercise for a better you!