Dan Keller (00:08)
Welcome to this episode of Substantial Matters: Life and Science of Parkinson's. I'm your host, Dan Keller at the Parkinson's Foundation. We want all people with Parkinson's and their families to get the care and support they need. Better care starts with better research and leads to better lives. In this podcast series, we highlight the fruits of that research, the treatments and techniques that can help you live a better life now, as well as research that can bring a better tomorrow. Exercise can make life better for people with Parkinson's by improving their physical functioning, mood, and quality of life. In fact, research from the Parkinson's Foundation's Parkinson's Outcomes Project, the largest-ever clinical study of Parkinson's, shows that people with PD who start exercising earlier and exercise at least two and a half hours per week experience a slower decline in quality of life compared to people who start exercising later. Exercise may even slow down progression of the disease, but judging by the kinds of questions that come into the Parkinson's Foundation helpline, many people don't know where or how to begin, how to get and stay motivated, and what kind of exercises can benefit them. So we turn to Jill McClure, an information specialist on the Parkinson's Foundation helpline, for answers.
Jill McClure (01:39)
One of the common questions we get is, what's the best exercise for Parkinson's? I don't think that there's a clear and simple answer for that, but getting people to think about Parkinson's and talk about Parkinson's exercise is tremendously helpful to start with.
Dan Keller (01:56)
And what are the kinds of exercise? Are they big muscle, aerobic sort of things, or fine motor, or what goes on?
Jill McClure (02:05)
So all exercise is great for people with Parkinson's, and certainly movement is preferable to immobility and a sedentary lifestyle, but very purposeful exercise can have profound benefits. With Parkinson's, we know that there's really something that happens in the brains and the bodies of people with Parkinson's who exercise. Sometimes getting started is hard for people, and perhaps beginning with a physical therapist who has experience in helping people with Parkinson's can really help you identify some of the deficiencies, some of the changes that may have crept in, and focus on some exercises that will target that. So there may be some exercises that are particularly good for balance or rigidity or some asymmetrical strength changes, and focusing on those, learning about those is perhaps an important foundation, but maybe the best exercise is really the exercise that you will do. So finding some things that are particularly good for you and then going off and finding more things that are fun and social and novel can really have tremendous benefits for people with Parkinson's.
Dan Keller (03:11)
Many people get scared when they hear the word exercise. They think it's going to be regimented and boring and things like that. I mean, what falls into the category of exercise—would dance be one thing, right?
Jill McClure (03:22)
There are many different options and many different types of exercise that have been sort of tailored to Parkinson's disease. So there is a wonderful dance program that's been developed, and then certainly other types of dance have been shown to be great and fun and beneficial for people with Parkinson's. People do yoga, water exercise classes. There's boxing programs that are popular. And finding something that is challenging enough and pushes you to do things differently, maybe something that's new to you, may be of particular help, and something you can really apply yourself to. We know that better benefits may come from a more intensive exercise experience. So finding opportunities to do something maybe a little bit longer, a little bit harder, or more intensely or a little bit faster over time, within the range of what's right for you, can really provide great benefits for people with Parkinson's.
Dan Keller (04:20)
How important is novelty? I mean, if somebody's been doing something all their life, is that the kind of exercise they should keep with, or should they pick up something different?
Jill McClure (04:29)
Well, certainly, we want to see people with Parkinson's staying engaged in things that they enjoy and that are fulfilling. But sometimes modifications can be helpful so that you can continue to do something you love, but definitely creating kind of a routine for yourself that does encourage you to try new things and do new things may help you harness more benefits in terms of your body, and maybe even changes that happen in the brain as a result of those new things that you're taking in and exploring and pursuing.
Dan Keller (05:01)
Is there evidence, either from animals or in people, that exercise can keep the brain functioning longer, better outcomes for people in the long term?
Jill McClure (05:11)
We have lots of information available in animal and people studies. We can say that exercise can push back disability. We can say that it keeps people functioning better, more fully, for longer. Whether it actually can change the course of the disease, this evidence is not entirely clear in humans. At this point, we have some very encouraging results about it in animal models, but in terms of humans and exercise, the benefits are evident, but long-term change in the course of the disease—I don't know that we're there yet with the information in humans.
Dan Keller (05:52)
So now it sounds like you will be better in the meantime, probably more functional, but you don't know whether the long-term event is going to be modified, right?
Jill McClure (06:02)
Another encouraging thing we can say is that it definitely has been shown in human studies that quality of life for people with Parkinson's is better, and that's a tremendous value, I think, for individuals to consider and a good motivator.
Dan Keller (06:18)
What about the aspect of getting up off the couch? Are there benefits to doing something social, seeing other people? Or how do you motivate yourself, is what I'm asking.
Jill McClure (06:27)
It can be particularly difficult, especially within the context of Parkinson's, where we know people with Parkinson's, alongside all of these motor symptoms, can experience a lot of other challenges like depression, anxiety, apathy. It's particularly hard for people with Parkinson's to get going and do what we know can be so helpful. Sometimes making an appointment with a physical therapist or a trainer, or signing up for a class, can lure you into actually doing something that you know you should do. Sometimes partnering up with a friend so that you know you can't leave your friend waiting on the corner for you—that brisk walk is going to happen one way or the other. You wouldn't let your friend down. And different people have different levels of motivation, but getting encouragement from doctors and health professionals—a clear and consistent message—can be helpful. Family and friends can help. It's hard to get going, but it's so worthwhile, and we have such compelling evidence from studies and great videos out there that really show you, wow, exercise can help control symptoms. It can help improve quality of life, and if you choose to do it in a social setting, you're also getting that benefit of connecting with people and sharing your experience and sharing the joy of moving.
Dan Keller (07:47)
As someone said, if you want a friend, get a dog. Does just walking your pet count?
Jill McClure (07:53)
Absolutely. Walking is better than not walking, and walking your pet and your dog—having that connection—can be a wonderful thing for people with Parkinson's. I will say that walking briskly is better than a dog who wants to sniff all the time, so keeping it going—walks with your dog and walks without—so that you can kind of get a little interval training and go for some intensity and some good benefits would be ideal.
Dan Keller (08:19)
What's important or interesting to add—anything?
Jill McClure (08:23)
I think that sometimes people do get a little hung up with the idea of what's best for me, or I'm going to get an exercise bike or machine or sign up for something, and what exactly should I do? And I think on the helpline, our role is partly to help people know what the possibilities are, but getting too hung up on whether you're doing exactly the right thing can be something that does keep you on the sofa. So go out, try something. If you don't find a physical therapist or a trainer who seems particularly adept or helpful or just a good fit for you, try somebody else. Explore the options, and contacting the helpline and other resources can help you learn about what is out there. We do try to make a point of really trying to help individuals connect with programs in their community. Beginning something is the way to go, and it's different from one person to the next in terms of what your interests are and what you'll like to get involved in, and what's available to you as well. And you can find exercise curriculums you can do at home on your own if you have that motivation. So there shouldn't be barriers to getting active and exercising at any stage. It can mean different things to different people with different abilities, but moving and exercising and exploiting the benefits that can come from exercise should be available to everybody with Parkinson's.
Dan Keller (09:48)
Great, thank you.
Dan Keller (09:59)
Jill and other Information Specialists on our helpline are ready to answer your questions about exercise and to help you find an exercise program or facility near you. You can reach them toll-free at 1-800-4PD-INFO. As Jill mentioned, the best exercise is one that you enjoy and will do. There is something for everyone, regardless of your current fitness level or stage of Parkinson's. So let our Information Specialists help you find something that will work for you. You can start with our free publication, Fitness Counts. It includes sample stretching, aerobic, and strengthening exercises, along with information on physical and occupational therapy, posture and balance, and more. If you have any questions about the topics discussed today, or if you want to leave feedback on this podcast or any other subject, you can do it at parkinson.org/feedback. At the Parkinson's Foundation, our mission is to help every person diagnosed with Parkinson's live the best possible life today. To that end, we'll be bringing you a new episode in this podcast series every other week. Next time, we'll hear more about exercise in the context of overall Parkinson's wellness. If you can't wait till then, for more exercise information, listen to one of our earlier podcast episodes, The Benefits of Exercise for People with Parkinson's. In it, Dr. Bas Bleum talks about exercise research and overcoming barriers to getting enough exercise. For more information and resources, visit parkinson.org or call our toll-free helpline at 1-800-4PD-INFO—that's 1-800-473-4636. Thank you for listening.
