Parkinson’s disease is a chronic and progressive disease. As the disease progresses, it may impact the quality of life for both people with Parkinson’s and their caregivers. There have been recent advances in terms of managing symptoms and improving quality of life through exercise.
Although everyone benefits from regular exercise, it’s particularly important for people with Parkinson’s disease. Regular physical activity can improve the stiffness, tremors and balance problems people with this degenerative disease experience, as well as an overall sense of well-being.
At the University of Guelph, Assistant Professor Philip Millar, a cardiovascular physiologist, is studying the benefits of high-intensity but shorter exercise periods for people with Parkinson’s. Current recommendations are for 150 minutes or more of aerobic exercise every week. That can be a tough regimen to follow.
Millar and his team measure improvements in blood pressure, motor symptoms, exercise capacity and balance in two groups of people with Parkinson’s. One group exercises at a moderate speed on stationary bicycles for 40 to 60 minutes at a time. The other group pedals furiously at one-minute intervals followed by low-intensity rests, during a 20-minute workout. That shorter workout requires 90 percent of the participant’s maximum capacity during those high-intensity intervals.
High-intensity exercise has already shown a benefit for people with cardiovascular problems. Millar believes people with Parkinson’s will get the same or greater benefits from the high-intensity workouts, and may not drop out.
“We know many of the benefits relate to the intensity of the exercise,” he explains.
In general, an individual’s capacity to exercise is one of the strongest predictors of mortality, says Millar. For people with Parkinson’s disease, exercise can improve stability, balance, and muscle strength, and improve motor symptoms.
In an earlier pilot study Millar conducted, the high-intensity Parkinson’s group showed the same or greater improvements than the moderate intensity group, Millar says. They also enjoyed their high-intensity workouts more. He hopes less muscle fatigue and fewer tremors will help people be more independent and do more activities of daily living, improving their quality of life.
One of the partners in Millar’s work is the Guelph YMCA. If the research succeeds in demonstrating the benefits of high-intensity training for people with Parkinson’s, Millar hopes the national YMCA will roll out a program incorporating the findings, and that his recommendations would also be incorporated into exercise guidelines for people with Parkinson’s disease.
Dr. Millar and one of his study participants, Quentin Lowe, recently put their practice into action as part of Parkinson’s Revolution in Oakville. The two took their efforts outside of the clinical setting alongside hundreds of other riders across three countries, raising more than $40,000 in Canada.
Steve Iseman, diagnosed with Young Onset Parkinson’s disease, knows about the benefits of exercise. From mountain climbing in Nepal to a steady diet of daily activity at home, Steve is encouraging others with Parkinson’s to exercise. Following on the heels of the popular fundraiser called Pedaling for Parkinson’s, pedalingforparkinsons.ca. he founded Rigid Riders, a group of hesitant cyclists who are sold on the benefits of exercise to improve their quality of life and the need to raise funds for research.
“Our riding team is for the reluctant cyclist, who has muscle rigidity and fear of falling—uncertainty we can work with,” says Steve. “It’s a lifestyle change for the better.”
Dr. David Grimes, a Parkinson’s disease expert and movement disorder neurologist at Ottawa Hospital, has treated individuals with Parkinson’s for over 20 years. He is the lead author of Canadian Guideline for Parkinson Disease, 2nd Edition, a comprehensive document that serves as a guide for health care providers based on the best published evidence with recommendations on communication, diagnosis and progression, treatment and non-motor features, and the new addition of palliative care.
“In the past we thought exercise was a ‘nice thing to do’ for our patients and for their general health. It’s become very clear to me with many randomized, controlled studies that exercise clearly improves Parkinson’s patients functioning as well as overall feeling well,” says Grimes. “I think a really key aspect to be promoted for all our patients is exercise—definitely an important treatment and part of their care.”
The Guideline offers practical clinical advice and is relevant to the Canadian health care system. Download your free copy here: www.parkinsonclinicalguidelines.ca/
Parkinson Canada provides resources for the Parkinson community in Canada—from educations materials and events, to support groups, webinars, podcasts and YouTube videos. To find out more about events in your area, including exercise classes through Dance for Parkinson, boxing, walking groups, spin classes—see more events on www.parkinson.ca.
Interview with Dr. David Grimes (Guidelines):
Interview with Steve Iseman (Rigid Riders):
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To share your journey with Parkinson’s and the importance of exercise to your quality of life, contact AnneMarie.Gabriel@parkinson.ca