Unpacking Parkinson’s

Senior standing with toddler

What comes to mind when you read the words active aging? Do you immediately envision someone working out? Or playing golf? Whatever image came to mind for you, I am willing to bet that it involved sParkinson’s disease (PD) is a neurodegenerative disorder that is most commonly recognized for its motor symptoms. It is a progressive disease and as it progresses, further symptoms present themselves. While Parkinson’s is most commonly recognized for its movement related symptoms, there are many other symptoms of Parkinson’s that highly impact quality of life and disease progression that are not movement related like fatigue and depression. While there is no cure for Parkinson’s there are key factors and habits in one’s lifestyle that can be changed to promote better management of the disease. One of those factors, and perhaps the most important one aside from medication compliance, is exercise.

Parkinson’s and Movement

Exercise can positively impact symptoms of PD in many ways. It can help improve both motor related symptoms and non-motor related symptoms, also. There are 4 main areas of exercise that should be included in your workout routine, and they include: strength training, aerobic training, stretching and balance/ dynamic training. Each offers its own benefits. For example, stretching which is often overlooked, skipped, and brushed off as optional, can actually help with muscle rigidity. Muscle rigidity or stiffness contributes to decreased range of motion (ROM) which further contributes to a cascade of symptoms like limited mobility, pain, and joint health issues. Exercise can also:

  1. Improve balance and help prevent falls
  2. Improve posture and help prevent stooped posture 
  3. Improve sleep and decrease fatigue

Standing Tall Against Falls

Balance impairments and falls are a common concern among adults as they age. Falls become increasingly important for individuals with PD and for good reason. Falls are twice as likely if you have PD compared to those who don’t have PD. This is the result of multiple factors and alterations that one experiences due to the disease progression. Hallmark motor symptoms, rigidity and bradykinesia, paired with changes in posture are major contributors to risk of falling.  Not only does exercise improve balance itself, but it also improves each of the three symptoms mentioned above that all contribute to an increased risk of falling. 

Group exercise classes designed specifically for falls prevention are a great resource to utilize if you have one offered near you. The great thing about balance training is it can come in many forms! Try challenging your balance with dance. Dance is great because it challenges the body to move in all planes of motion and often includes multi-directional stepping. Multi-tasking is another way to challenge the brain. Try adding a cognitive challenge to a simple movement. For example, challenge yourself to recite the alphabet backwards while seated marching. It’s not as easy as you might think!

Stronger Muscles for Better Posture

Another common symptom of PD is stooped posture or rounded shoulders. Stooped posture, similar to falls, is impacted by multiple factors one of the biggest factors being muscle rigidity. When you have stooped posture, your upper body muscles, your chest and shoulder muscles, become tight and less flexible, which further contributes to and reinforces stooped posture and ultimately, falls. We learned a moment ago that a stretching routine can help combat rigidity or stiffness of muscles. This is a great example of how exercise benefits multiple symptoms and how one symptom can play into or exacerbate or help another symptom. Stretching the upper body muscles can also help prevent stooped posture and improve balance. 

Your posture can also benefit from strength training. You just read that muscle rigidity effects the muscles on the front of our upper body but what about our backs? When an individual has stooped posture, their chest muscles tend to be tight and their back muscles are weak and unable to help maintain an upright posture. Strength training will strengthen the muscles of your back and help you maintain an upright position or reduce your forward hunch. It is so important to get ahead of stooped posture or address it immediately once signs begin to appear. Stooped posture can lead to further complications and impact things you might not think of like your breathing and communication skills.

Fighting Fatigue

Fatigue is bothersome and unfortunately, very common among individuals with Parkinson’s. Fatigue effects nearly half of people with PD and is recognized as one of the most disabling symptoms of PD. Fighting fatigue can be cumbersome. The mental and physical fatigue felt on a daily basis is already challenging enough. Identifying a source and a modality for managing fatigue requires additional effort but left unaddressed can decrease overall quality of life. Exercise is recognized as the “best known therapy” for fatigue.

One cause of fatigue is a lack of sleep and poor sleep quality. There are many factors that contribute to a poor night’s rest, but exercise can help. Exercise can be a powerful sleep aid by helping to regulate our internal sleep-wake cycle or our circadian rhythm. Exercise done outdoors, with exposure to natural sunlight, in the morning, preferably before 10am, can help regulate our natural sleep-wake cycle. Light is an important component here. Light also helps regulate your sleep-wake cycle, especially exposure to natural sunlight. The combination of the natural sunlight in the morning and physical movement works wonders for our sleep. But remember, you must be consistent. This isn’t a do it once, or even occasionally or even once or twice a week, solution. This is a habit that you develop and maintain on a daily basis. Overtime you should reap the benefits of shorter sleep onset and better overall sleep quality. Sleep is just one component of fatigue though. Looking at other possible causes of fatigue, like depression are important and should be discussed with your care team. Also, it’s important to make clear that fatigue and sleepiness or tired are two different things. When you’re tired, sleep is the remedy. Fatigue can be present without sleepiness. Fatigue can also persist even after ample sleep. These are just a couple of ways that exercise can positively impact an individual’s disease course. If you or someone you know need some guidance on exercise and movement for Parkinson’s, we got you covered! Join us for one of our live workshops this month where we take a deeper look common symptoms of Parkinson’s disease and how movement and exercise can help!