Crafting Your Personal Exercise Routine
Posted on February 24, 2014 | By Larry Kahn | Leave a response
As one of the multitude of people with Parkinson’s who touts the therapeutic value of vigorous exercise, I am from time to time asked what exercises are best for Parkinson’s disease and how much exercise is enough. I’ve done a lot of reading on the subject, and today we’re adding a page to the site that provides some suggestions based on the latest clinical research and fitness guidelines. The science is still in process, so there’s no magic formula, but there’s enough promising results to justify the investment in our fitness, strength, flexibility and balance that may help us fight off PD’s various deficits for as long as possible. There’s not much else we can do to fight off the inevitable progression of our disease and, for me, exercise gives me the control, or appearance of control, over my body that keeps me sane.
Over the past two years, I’ve become more and more engaged in the science of PD and exercise and the reality of it. I have read scientific literature, signed up for clinical trials, participated in community-based group exercise programs for PD, and organized PD Gladiators, a nonprofit dedicated to spreading the word about the therapeutic effect of exercise and creating new exercise programs. Still only 3.5 years into my diagnosis, I am preparing my body for the fight of my life. I urge you to take a look at the much more detailed and objective “Crafting Your Personal Exercise Routine” page, but I also wanted to share a few subjective observations, and the blog seemed like a more appropriate venue.
I think advocates for a particular activity often miss the big picture. There’s a study that concluded that subjects who practiced tai chi scored better on certain measurements of PD progression than those who engaged in resistance training or stretching routines. Does that study suggest we should stop weight training and stretching and practice tai chi all day? Heck, no! I want to see the study that compares the guys who do it all–cardio, strength training, flexibility and neuromotor activities like tai chi–to those who limit themselves to one or two favored activities. The fitness guidelines recited in our full article say all Americans should choose activities from all four exercise groups, and I think it’s even more important for those of us with PD.
Stretching and other flexibility exercises like yoga help us fight off the rigidity that comes with PD. Weight training keeps our muscles strong, improving posture and balance. And the combination of cardio and neuromotor activities may actually lead to changes in our brains that compensate for the dying dopamine-producing neurons or even protect them from cell death. The literature linked on our PD Exercise Research page supports the conclusion that exercise paradigms combining goal-based exercise and aerobic training–vigorous and sustained activity–might work synergistically to promote neuroplasticity and improve motor learning. Take a look at the first three studies on that page–the Petzinger, Fisher et al study alone may motivate you to organize a boxing training or aerobic dance (like Zumba) program in your community because those activities make you sweat (and release certain neurotransmitters that may set the stage for brain change) and force you to learn new routines that actually burn new neural pathways that may compensate for some of the functions lost by our shrinking dopamine capacity.
Whether or not there’s sufficient “proof” of the neuroprotective value of exercise is a question I’ll leave for the neuroscientists. But the clinical trials and animal studies are pretty compelling. And we’ve all heard it anecdotally from so many of our fellow travelers how exercise changed their progression dramatically. Even Dr. Eric Ahlskog, a senior neurologist at the Mayo Clinic, believes that there is so much upside potential and so little downside to vigorous exercise that it should be prescribed as a primary therapy for PD immediately upon diagnosis. (See his article on the PD Exercise Research page–skip the neuroscience and go right to the conclusions!)
My final subjective observation is that there is value to community-based group exercise programs that goes beyond the vigorous activity. We share a common bond in our affliction, and the social connections, even friendships, that develop on the battlefield are a positive influence on so many levels. We become a mini-support group, sharing our stories and tricks and a few laughs. The desire to be with friends gets you to class even on days when you’d rather stay in bed. And when you’re in the gym and the gal next to you has got it worse than you but she’s kicking the living crap out of that punching bag, you don’t go through the motions. You get inspired. And when you’re short on dopamine you need all the inspiration you can get.