New Exercise Recommendations for the Parkinson’s Community and Exercise Professionals
The Parkinson's Foundation, in collaboration with the American College of Sports Medicine, created new Parkinson’s disease (PD) exercise recommendations to ensure that people with Parkinson’s are receiving safe and effective exercise programs and instruction. The guidelines are the result of a convening including 34 exercise professionals and thought leaders who met in March 2020 to help develop the framework for these guidelines.
The new exercise guidelines include recommended frequency, intensity, time, type, volume and progression of exercises that are safe and effective for people with Parkinson’s across four domains: aerobic activity, strength training, balance, agility and multitasking and stretching. Each recommendation is paired with specific types of activity and special safety considerations for people with PD.
It is recommended that people with PD see a physical therapist specializing in Parkinson’s for full functional evaluation and recommends exercise during ‘on’ periods, when taking medication. The guidelines also recommend 150 minutes of moderate to vigorous exercise per week for people with Parkinson’s. Other key recommendations include:
Aerobic activity: 3 days a week for at least 30 minute per session of continuous or intermittent movement at moderate or vigorous intensity
Strength training: 2-3 non-consecutive days per week of at least 30 minutes per session for 10-15 repos for major muscle groups; resistance, speed, or power focus
Balance, agility and multitasking: 2-3 days per week with daily integration if possible
Stretching: 2-3 days per week with daily stretching being most effective
Research from the Parkinson’s Foundation Parkinson’s Outcomes Project, the largest-ever clinical study of Parkinson’s, suggests that people with PD do at least 2.5 hours of exercise a week for a better quality of life. The new Parkinson’s exercise guidelines aim to support the Parkinson’s community in staying active. The guidelines also provide an important framework for exercise professionals, who play a vital role in developing safe and effective programs to improve quality of life for the PD community.
17 Things Support Group Leaders Want Care Partners to Know
In the same way no two people with Parkinson’s disease (PD) experience identical symptoms, there is no one-size-fits-all approach to caregiving. Regardless of where you are in you care partner path with your loved one ― from newly diagnosed to advanced stages ― finding your support system is invaluable.
We asked caregiver support group leaders what advice they would give care partners:
“Take care of yourself first and get involved in a support group.”
– Jan B., Touchmark Caregiver Support Group Leader, Ridgefield, WA
"Seek out others who are walking this same journey; you are not alone and need to be able to share honestly and openly with someone who can really understand what you are experiencing.”
– Virginia D., care partner, Team Spark Support Group Leader, Grand Rapids, MI
“Learn as much as you can about the disease and know that you are not alone. There is help out there all around you.”
- Rae Marie E., care partner, Coaches Huddle Support Group Leader, Napa, CA
“Take care of yourself first so that you have energy to support your loved one. Take breaks, don't be too hard on yourself and don't feel guilty doing things that you enjoy.”
– Lynda E., care partner, Brainerd Lakes Area Parkinson's Support Group Leader, Baxter, MN
“I would encourage someone to PLAN ahead but to LIVE in the moment. Each day is so unique, and each moment can be joyous or difficult. ALL emotions are valid ― even the ones commonly viewed as negative. They are each allowed to feel exactly as they need to in the moment.”
– Celeste H., Houston Area Parkinson Society Caregiver Support Group Leader, Houston, TX
“I cared for my mother who had atypical PD. I would advise caregivers to be patient and make time for themselves. I would also encourage people to simply spend time with their loved ones. Spending time with them in the present moment is the greatest gift for them now, and something you will cherish after they are gone.”
– Nicole H., former care partner, Pioneer Memorial Rest Home Support Group Leader, Mullen, NE
“Understand grief in children and how it can manifest itself. You aren't only caring for the person with Parkinson’s, but the people who surround that person as well, including yourself.”
– Michelle F., young-onset care partner, KCPWP: Kids and Caregivers of People With Parkinson’s Support Group Leader, Mapleton, UT
“Join a support group.”
– Pat F., care partner, Whine & Dine Caregivers Support Group Leader, Knoxville, TN
“Be involved in your partner’s doctor visits and medication. Take care of yourself!”
– Elizabeth H., care partner, Fearington Parkinson Support Group Leader, Pittsboro, NC
“We have PD. You are in this together. Learn all you can about the disease. Take the LSVT BIG program as soon as possible. Learn about all the specific programs for PD for your partner to participate: Rock Steady Boxing, PWR, Let’s Ride, Dance for PD, other exercise.”
– Paula H., care partner, Central Bucks Parkinson's Support Group Leader, Colmar, PA
“Keep active and be happy with what you are able to do rather than looking at what you can’t do.”
– Myra H., former care partner, Cherry Hill Parkinson’s Support Group Leader, Willingboro, NJ
“Be patient, read all you can, talk to as many people as you can, share info.”
- Mary Ellen P., care partner, Partners with Parkinsons Support Group Leader, Richmond, VA
“Be sure to open your mind up to joining support groups and sharing your journey. You will find you are not alone and can learn so much from hearing others story, find much needed support and your story will be relatable and helpful to others.”
– Dawn R., Aloha Carepartner PD Support Group Leader, Marietta, GA
“Take it day by day and make sure you are carving out time for yourself on a regular basis or you will not have the energy/health for the long run.”
– Kristen S., care partner, Northwest Ohio Caregiver Support Group Leader, Waterville, OH
“Live each moment. Not everyone's walk with PD is the same, but meaningful information, encouragement and strength can be found at support group meetings.”
– Darla D., care partner, Western Oklahoma PD Support Group Leader, Weatherford, OK
“Attend as many doctors appointments with their partner as possible to learn about the disease, expectations for the future and care plans. Do not to Google anything!”
– Kelly W., person with Parkinson’s and care partner to her father with PD, NorthShore Active Life PD Support Group Leader, Chicago, IL
“Patience, patience and a bit more patience .... with yourself and your person with Parkinson’s. This was told to me someone living with PD for 20+ years. It has served my wife when she was living and myself very well.”
– Jarrig V., former care partner, St Albans Parkinson's Outreach Program Leader, Swanton, VT
It’s summertime! After a particularly challenging 2020, taking care of yourself and managing your Parkinson’s disease (PD) has never been more important. Whether you’re eager to resume in-person social activity or you feel more comfortable at home, read on for five ways to make the most of summer 2021.
1. Move your body
The sun is shining, the weather is warm — get outside and move! Exercise not only feels great, but it can also improve your physical PD symptoms and slow the progression of the disease. Here are ways you can get started right now:
Sign up for a non-contact boxing class at your local gym or use our chapter resources to find a PD-tailored class near you.
Sign up for a Moving Day event in your area to raise awareness for Parkinson’s and connect with other members of the PD community.
2. Join a Parkinson’s support group
Summer is a great time to make new friends! Support groups give people living with PD and their care partners the opportunity to learn from peers and share their experiences in an understanding environment. Let us help you with this process:
Listen to our podcast to better understand what PD support groups offer and how participating in one can benefit you.
Join a local in-person support group or attend a virtual support group from home.
Looking for a new support group? Check out PD Conversations to join our online network of support.
3. Get creative in the kitchen
Switch up your everyday dinner routine and try out a new summer recipe! Practicing good nutrition can help alleviate PD symptoms and offer other health benefits as well. Follow these tips to get cooking:
Take a cooking class. Bring a friend and learn to cook together – or go solo and surprise everyone with your new skills.
Challenge yourself to cook one new recipe every week. Our Foodie Friday video series demonstrates how to make quick, delicious meals at home!
4. Take a meditation class
Mental wellness is equally as important as physical wellness. Incorporating mindfulness into your weekly routine will keep you relaxed and ready for more summer fun! These ideas will keep you calm:
Go to a meditation or yoga class at your local wellness center to relax your mind and body.
Register for an upcoming Mindfulness Monday virtual event to learn guided relaxation techniques and start your week with calmness.
Meditate using an app in nature – find a quiet space in your backyard, at a local park or the beach.
5. Learn more about Parkinson’s
Part of living well means understanding how Parkinson’s disease plays a role in your life. Gaining more knowledge about PD now can benefit you and your family in the future! Start learning with our online resources:
Participate in our PD GENEration study, which offers genetic testing and counseling at no cost for people with Parkinson’s disease. In-person testing is available at participating Centers of Excellence, or you can register for an at-home appointment.
Listen to our podcast for information on PD-related topics like exercise, clinical trials and nutrition.
No matter where your summer plans take you, the Parkinson’s Foundation is here for you. Call our Helpline at 1-800-4PD-INFO (1-800-473-4636) to find resources in your community. Stay healthy and safe!
Updates From the Field: Parkinson's Outcomes Project
For more than a decade, the Parkinson’s Outcomes Project has captured the experiences of people with Parkinson’s disease (PD) and care partners on topics such as medications, treatment, exercise and lifestyle. How has this essential data helped make life better for people with Parkinson’s?
When researchers analyze the experiences of more than 13,000 people living with PD who seek treatment within the Parkinson’s Foundation global Centers of Excellence network, they can identify new and better ways to provide care and manage Parkinson’s. The goal of this study is to improve health outcomes and quality of life for people with Parkinson’s and care partners.
Parkinson’s Outcomes Project research has led to several findings that have already improved care within the PD community. Four primary landmark findings include:
Exercise and Physical Therapy
Increasing physical activity to at least 2.5 hours a week can slow the decline in quality of life and help people with Parkinson’s live fuller lives. At the same time, referrals to physical therapy during the early stage of disease can help prevent hospitalization and falls. These findings led to the establishment of the Exercise Initiative, partnering with physical therapists and exercise professionals nationally.
Mental Health
Depression and anxiety are the top factors impacting the overall health of people with Parkinson’s. This understanding has led to greater supports across Parkinson’s Foundation Centers of Excellence as well as a dedicated sub-study looking at mental health.
Hospital Care
People with Parkinson’s are hospitalized 1.5 times more often than their peers without Parkinson’s, and these visits bring with them a host of complications. These findings resulted in the Foundation’s Hospitalization Initiative to drive culture and policy change at the hospital administration level. Learn more about the Parkinson’s Foundation hospitalization kit now.
Caregiving
The cost of caregiving increases 180% from early to advanced stages of Parkinson’s, with female care partners predominantly (72%) carrying the weight of care. Acknowledging these factors and how to best provide day-to-day care will help improve the quality of life for those with Parkinson’s and their care partners.
The Next Generation of Parkinson’s Research
The impact of the Parkinson’s Outcomes Project continues to direct the work of the Parkinson’s Foundation. Next, the study will next focus on recruiting more participants who are part of traditionally underrepresented populations in clinical research. The study will work to better understand the PD experiences of people with Young-Onset Parkinson’s, newly diagnosed, early and late-stage disease progression and broader ethnic and racial diversity.
The Foundation is underway with the next phase of the study, genetic testing offered through PD GENEration: Mapping the Future of Parkinson’s Disease. Genetic testing is a powerful tool that can help people learn more about their own disease, uncover biological pathways that cause Parkinson’s and can accelerate the development of improved treatments and care for all people with Parkinson’s.
“Together, the Parkinson’s Outcomes Project and PD GENEration will help researchers understand why and how Parkinson’s develops,” said James Beck, PhD, Parkinson’s Foundation Chief Scientific Officer. “These initiatives may also answer questions that researchers may never have asked, providing hope and a vision towards a cure for PD.”
For the full update from the field, read Parkinson’s Outcome Project: Improving the lives of people living with Parkinson’s through research. In this publication, we highlight landmark findings, how this research guides Foundation priorities, what’s next for the study and more. Read it now.
Pandemic Fast-Tracks Future of Digital Therapies for Parkinson’s Community
In the context of the COVID-19 pandemic, telehealth medicine has emerged as an essential tool for accessing healthcare. This trend has led to increased demand for evidence-based digital treatments, known as digital therapeutics. In response to the demand, the development of digital therapeutics is being fast-tracked in the scientific research community and utilized among people with Parkinson’s disease (PD). Although anyone can create and offer downloadable wellness apps, digital therapeutics require they be based upon rigorous, evidence-based studies that clinically demonstrate their effectiveness.
Since digital therapeutics is an evolving, new technology, still lacking extensive data, it is essential that potential real-word benefits and shortfalls be investigated. A recently published study in the Journal of Parkinson’s Disease, titled, “Digital Therapeutics in Parkinson’s Disease: Practical Applications and Future Potential,” (Ellis & Earhart, 2021), explored recent and emerging evidence for using digital therapeutics to facilitate lifestyle changes and motor (e.g., walking) and non-motor (e.g., sleep, anxiety) Parkinson’s symptoms, with the goal of determining whether participant outcomes might be improved.
As part of this research, researchers reviewed multiple studies. Information provided concerning the length of studies, types of studies, study design, study demographics, number of participants and statistical significance varied greatly. Additionally, most studies were not PD population-specific.
Researchers analyzed the following studies:
Results
Digital Therapeutics to Improve Walking
A one-year, single-blinded randomized controlled trial of people with mild to moderate PD in which participants were given a video-taped custom-tailored exercise program designed to help with walking. After uploading the video as a mobile app for their personal use, participants were required to enter personal data related to their adherence to the program, pain, and level of difficulty. This data was monitored remotely by a physiotherapist with whom the participants could message, ask for help, receive encouragement, etc. The physiotherapist would also adapt the exercises based on the progress achieved.
An increase in daily steps and moderate intensity minutes was experienced by both groups, with clinically meaningful improvement achieved by the less active group.
Digital Therapeutics to Improve Non-Motor Outcomes
A six-session, single-blinded randomized controlled study of 1,711 adults compared digital cognitive behavioral therapy (CBT), delivered via web or mobile, with standard sleep education hygiene, for insomnia on health, psychological well-being, and sleep-related quality-of-life. Treatment consisted of a behavioral component (e.g., relaxation), a cognitive component (e.g., mindfulness) and an educational component (e.g., sleep hygiene). Participants could view their progress, treatment strategies, sleep schedule and educational materials via the platform at their convenience. An interactive, animated virtual therapist provided support and advice based upon the goals set by the patients at the beginning of the study. Participants also uploaded daily data in the form of a sleep diary.
The CBT approach resulted in a small improvement in functional health and psychological well-being. It also resulted in a large improvement in sleep-related quality-of-life compared with sleep hygiene education — after four weeks and 24 weeks. This study was not conducted among people with PD but suggests potential benefits for people with Parkinson’s.
Digital Therapeutics for Virtual Coaching & Healthy Lifestyle Promotion
A 12-week study used an artificial intelligence virtual coach to provide instant messaging (to personal devices) focused upon fostering a Mediterranean-style diet and an increase in physical activity. Eighty-one inactive (mostly overweight or obese) adults, ranging in age from 45 to 75 participated in a proof of concept study (testing whether the concept could realistically work). Weekly check-ins concerning participants’ step counts and dietary choices were recorded.
Physical activity was increased by an average of 109 minutes per week. There was also an overall average weight loss of about 2.8 pounds. Thus, practicality was excellent in terms of recruitment, retention (90% at 12 weeks) and safety. Limitations of this study include a lack of a control condition and a relatively short follow- up period.
What Does This Mean?
The COVID-19 pandemic put the need for remote healthcare in fast-forward. Digital therapeutics — which combines sophisticated technology with evidence-based medicine — shows great promise. It is a meaningful step forward towards more personalized medicine, and could enhance the preferred, more holistic, interdisciplinary approach for managing PD.
However, there is much work to be done. Digital therapeutics remain underdeveloped and underutilized. In addition, while proof-of-concept studies in the general population are valuable, more studies specific to the PD population are needed.
Learn More
The Parkinson’s Foundation believes in empowering the Parkinson’s community through education. Learn more about telehealth, COVID-19 and its impact on the PD population by visiting the below Parkinson’s Foundation resources, or by calling our Helpline at 1-800-4PD-INFO (1-800-473-4636) for answers to your Parkinson’s questions.
Ellis, T. D., & Earhart, G. M. (2021). Digital Therapeutics in Parkinson's Disease: Practical Applications and Future Potential. J Parkinsons Dis, 11(s1), S95-S101. doi:10.3233/JPD-202407
Schneider, R. B., Omberg, L., Macklin, E. A., Daeschler, M., Bataille, L., Anthwal, S., . . . Parkinson Study Group, A. T. H. P. D. I. (2021). Design of a virtual longitudinal observational study in Parkinson's disease (AT-HOME PD). Ann Clin Transl Neurol, 8(2), 308-320. doi:10.1002/acn3.51236
Being a care partner for a loved one can be meaningful, but the stress of this role can be exhausting as well. Finding the time and energy to take care of yourself while being a care partner is difficult, but it is important to be intentional with your own physical and mental health.
During the Parkinson’s Foundation Care Partner Program: Staying Healthy as a Care Partner, Amy Goyer, AARP’s Family and Caregiving Expert, answered the most common questions about staying healthy while also being a care partner to a person with Parkinson’s disease (PD).
Why is it important for care partners to stay healthy?
It can be easy to ignore your needs while being a care partner, but your needs are just as important as your loved one’s needs. Care partners often prioritize those who need care over themselves. This can result in caregiver burnout.
Like a car, we cannot run on empty. You have to keep putting gas in your car, it is not a one-time thing. The same is true for yourself — you are going to run out of energy if you do not make time to care for yourself. Self-care is necessary to caring for your loved one and staying healthy. Remember that healthy habits sustain us.
You and your loved one are on the same team. As a team you are taking care of them and taking care of you. Be honest and discuss your needs, together.
What role can support groups play in helping care partners share their feelings?
A support group is a safe place for care partners and loved ones. This is a great opportunity to express your feelings and process through your journey. You should look for a support group that fits your needs and personality. Tips to find a support group:
Call the Parkinson’s Foundation Helpline at 1-800-4PD-INFO (1-800-473-4636) to find a support group in your area.
Ask your loved one’s neurologist or specialists for support group recommendations.
Utilize the Parkinson’s Foundation In Your Area search.
Once you have found a potential support group, reach out to the support group leader to discuss what to expect within the group.
What can care partners do on a daily basis to ensure their loved one’s ongoing needs are met, without derailing their day?
There needs to be an expectation for interruptions. As a care partner, you have to prepare for change. is vital to nurture your own ability to be flexible and expect the unexpected. Flexibility will mean these interruptions do not feel as unsettling, but rather every interruption is an obstacle that can be worked out. You should also get more help as your loved one’s needs increase, so you can continue to live your life.
Your self-care routine and time are important. Many care partners view their self-care routine as not necessary, but self-care is key to having a healthy lifestyle. Everyone’s self-care routine and timing are unique, but just because your loved one’s needs may be increasing, does not mean your needs are decreasing. There will be times when your routine is interrupted, but it is important to return to your self-care routine and prioritize your needs.
How can care partners regularly assess their mental health to ensure they are getting the support that they need?
It is important to regularly assess your mental health. Oftentimes care partners can experience guilt when taking time for themselves. Guilt is a natural emotion, but it is not something you have to carry on your own. Here are some ways to check-in on your mental health and find support:
Reach out to friends and family.
Meet with a mental health professional on a consistent basis.
Journal to process your experiences.
Practice mindfulness to ease stress and expand your perspective.
It can be difficult to maintain a healthy lifestyle as a care partner, but you are not alone in this journey. The Parkinson’s Foundation has many resources to help you as a care partner, and we want to help you find what works best for you.
As we enter 2025, we're here to help you thrive! Setting New Year's Resolutions is the perfect way to kickstart intentional goals and positive habits. These resolutions can change your behavior throughout the rest of the year.
New Year’s resolutions can often mean having goals that last for a short time. It is important to create resolutions that are personal to you and what you want this year to look like. Resolutions are not supposed to be impossible or cause guilt; they should be goals that bring excitement and hope. We have fun tips and suggestions on what kinds of resolutions you can make!
Exercise
It is important to find an exercise plan you enjoy and that fits well into your schedule. Exercise helps people with Parkinson’s disease (PD) manage movement and non-movement symptoms. There are many options for what kinds of exercises you can try. Participating in a fun workout can help you enjoy your time and strengthen your body.
Resources for You!
Try new exercises from the comfort of home with Fitness Fridays
Use our In Your Area search to find exercise classes near you
Nutrition is an important part of your physical and mental health. Good nutrition can help manage Parkinson’s and promote overall well-being. It is also fun to try out new recipes and change up what you eat.
Practicing self-care can be a challenge to incorporate in your daily life but creating a self-care plan is a great way to start. A self-care plan looks like a personalized schedule to enjoy what brings you rest. Self-care can promote mindfulness and resiliency throughout the year.
There are many ways to get plugged into your community. It can be helpful to have people around you for support through the year. In times of stress, a community can remind you that you are not alone. The Parkinson’s Foundation has many resources for you to connect with a strong support system.
There are also many opportunities to serve your community. Find your local Parkinson’s Foundation chapter and the events coming up. Volunteering and fundraising can create a positive impact on your community while helping you feel connected to those around you.
Resources for You!
Get connected to your local chapter to find support groups and events
Sometimes resolutions can feel overwhelming and impossible. It can be easy to feel guilt and frustration when things do not go as planned. Follow these tips to make your New Year’s resolutions fun:
Find goals that excite you
Create goals that are achievable. It is good to challenge yourself, but resolutions should not be impossible.
Talk to a loved one about your resolutions so that you have someone to support you
Remember it is never too late to create or adjust goals
Throughout 2025, use your resolutions to try new things and develop personal growth. The Parkinson’s Foundation is happy to support your goals with our many resources.
The Parkinson's Foundation is here for you. Our Helpline can not only answer your Parkinson’s questions but can help you find local exercise classes and support groups. Call our Helpline at 1-800-4PD-INFO (1-800-473-4636).
Just as physical health is affected by lifestyle and exercise, so is your mental health. Cognition, mood and sleep all play integral roles when it comes to maintaining proper mental health.
Most people living with Parkinson’s disease (PD) experience changes and symptoms that impact cognition, mood and sleep as time goes on. Some people even experience cognition, mood and sleep symptoms as early PD signs. Below we highlight tips for how to support your mental health with changes in your cognition, mood and sleep.
Cognition Tips
Cognition is the act of mental processing. While tremors are a recognizable PD symptom, Parkinson’s may also impact cognition. Cognitive changes can include shifts in your thinking and behavior, along with slowness in memory. This non-movement symptom can impact quality of life. It can be scary to experience cognitive changes, but there are ways to support your mental health:
Create coping strategies like developing a routine and staying engaged with fun hobbies.
Find a counselor to help you adjust to these changes. You can see a counselor individually or with your care partner.
Everyone experiences mood changes; however, Parkinson’s can influence mood as a non-motor symptom. Mood changes may negatively affect your social life and emotional well-being. They may include depression, anxiety and other mood-related changes. Your mood may be affected by major life changes or medication. It is important to evaluate your mood and mental health. We have tips to help support you through these mood changes:
Create an exercise plan to support your emotional and physical health.
Connect with those around you to provide social support. Attend a support group and build your community — try attending a local PD event by using our In Your Area search tool.
Talk to a mental health professional who can help you process mood changes.
Focus on your nutrition. Eating healthy is important for helping manage Parkinson’s symptoms and optimizing PD medications.
Talk to a doctor about a treatment plan, especially if your mood changes are associated with pain.
Sleep is a vital part of mental health; our bodies and minds need rest. Parkinson’s can often affect your ability to sleep and daytime alertness. Sleeping problems may be the result of sleeping disorders like insomnia and sleep apnea. Your mental health may be affected by unhealthy sleeping patterns. Here are five tips that can help with sleep and Parkinson’s:
Set a schedule around sleep: avoid naps and try to set a consistent sleep pattern.
Practice exercise to get your body moving and ready for rest.
Avoid using electronic devices right before sleep.
Set aside time to relax intentionally as you get ready for bed. Avoid doing things that cause stress.
Discuss sleep issues with your doctor and healthcare team.
Although changes in your cognition, mood and sleep may feel overwhelming, you are not alone. It is very important to care for your mental health. The Parkinson’s Foundation has many resources to support you through these changes.
5 Care Partner Tips for Managing Mid-Stride Parkinson’s Symptoms
In the first few years of treatment following a diagnosis, your loved one’s Parkinson’s disease (PD) symptoms probably improved. Medications most likely helped your loved one go about their life, continue their hobbies and social activities as they did before PD. They may have even experienced near complete control of symptoms with minimal side effects.
Parkinson’s, however, is a progressive disease. After several years of taking levodopa, many people with Parkinson’s notice that controlling symptoms becomes more difficult. This stage of Parkinson’s disease is known as mid-stride, where new symptoms may begin to emerge at any time and can require treatment modifications. Although these changes bring adjustments to how PD is managed, your loved one can still experience good to great quality of life with your support.
Here are five tips for navigating Parkinson’s mid-stride as a care partner:
1. Manage medications.
As Parkinson’s progresses, levodopa stays effective for shorter periods of time. When levodopa begins to lose its effect, your loved one may have periods in which symptoms are much more noticeable and movement becomes more difficult. Known as “off” time, these motor fluctuations often result in the need for more frequent doses of medication.
Download our Medications and Schedule worksheet to keep an updated list of medications and dosage information. You may also want to set regular timers on your phone or tablet to remember when it’s time for the next dose.
2. Encourage exercise.
Because of how Parkinson’s impacts movement, it is natural to move less as the disease progresses. However, exercise is still essential for people in the mid-stride stage of PD. Findings from the Parkinson’s Foundation Parkinson’s Outcomes Project show that increasing physical activity to at least 2.5 hours a week may help manage Parkinson’s symptoms.
Encourage your loved one to stay active. Help them sign up for exercise classes that benefit people with PD, like Tai Chi, yoga or boxing. Our Fitness Friday series also offers at-home workouts that feature a different focus every week. Find a PD-tailored exercise class near you at Parkinson.org/InYourArea.
3. Stay social.
As symptoms progress, it is common for people with Parkinson’s to socialize less often. Sometimes the person with Parkinson’s and care partner isolate, withdrawing gradually from participation in the community and prior social life.
Finding a comfortable environment to share your thoughts and feelings about PD can make a big difference. Join a support group in your area to connect with local members of the PD community. In addition to groups for people living with Parkinson’s, there are also support groups available for care partners. Visit our Chapter pages or contact our Helpline at 1-800-4PD-INFO (1-800-473-4636) for help finding a support group.
4. Work alongside the care team.
Keeping in touch with your loved one’s PD care team is especially important throughout the mid-stride stage of Parkinson’s, as symptoms may begin to progress during this time.
Our Global Care Network is widely recognized as the best-in-class treatment centers for Parkinson's. These designated centers offer team-based, interdisciplinary treatment and care to people with Parkinson’s. Find expert care near you.
5. Take time for yourself.
Remember that after several years of caring for someone with Parkinson’s, experiencing some degree of care partner burnout is normal. Addressing these feelings as they appear is important, before they result in compassion fatigue.
Make time outside of your caregiving duties for yourself. Whether reading a book, going for a run or painting, working self-care into your care partner routine can help you keep yourself and your loved one healthy.
Top Takeaways About Complementary Therapies and PD
People with Parkinson’s disease (PD) seeking to ease symptoms sometimes explore complementary therapies to support traditional treatments. Whether employing mindfulness to help manage pain or incorporating food as medicine, broad-ranging supplemental wellness strategies can boost well-being. Learn what to consider when exploring these therapies and how to work with your care provider for peak outcomes.
This article is based on Conversations About Complementary Therapies and PD, a Parkinson’s Foundation Expert Briefings webinar exploring treatments sometimes used together with medicine, presented by Natalie Diaz, MD, Neurology, Pacific Movement Disorders Center, Pacific Neuroscience Institute.
Up to 40% of people with Parkinson's in the U.S. incorporate complementary therapies into their self-care.
Advances in Integrative Medicine
Up to 40% of people with Parkinson's in the U.S. incorporate complementary therapies into their self-care.
There are more than 20 available prescription medications available today to treat Parkinson's symptoms. Complementary therapies are supplemental wellness products or strategies sometimes used alongside conventional medicine to alleviate the non-motor symptoms of Parkinson's, such as stress, nausea or constipation, or to improve sleep or well-being. Research shows up to 40 percent of people with Parkinson's in the U.S. incorporate complementary therapies into their self-care.
Integrative medicine — where medical providers combine traditional medicines and complementary therapies in a person's care — is also thriving. Doctors and healthcare experts can now receive board-certified integrative medicine fellowship training. A 2020 study found more than 50 percent of primary care physicians have recommended complementary therapies.
Data shows geographic differences in the use of complementary therapies. Americans tend to incorporate vitamins, dietary supplements and herbs and botanicals. Europeans and Scandinavians rely more on body-based practices, such as yoga and massage. Traditional medical systems in Asian and African countries incorporate a combination of all these practices.
There is also a socioeconomic gap in complementary therapy adoption – with people of greater incomes tending to use them. Many such treatments can be costly and are rarely covered by insurance.
Types of Complementary Therapies
Exercises, like Tai Chi and yoga
Vitamins and Supplements
Acupuncture
Meditation
Healthy Foods
Medical Cannabis
And more!
Benefits of Mind-body Wellness Practices
Types of Complementary Therapies
Exercises, like Tai Chi and yoga
Vitamins and Supplements
Acupuncture
Meditation
Healthy Foods
Medical Cannabis
And more!
Studies show mindfulness practice has physical and mental benefits. People with PD use mindfulness meditation to ease pain, minimize stress, increase focus and boost mood.
Other mind-body wellness practices proven to reduce stress and ease many symptoms of Parkinson's include exercises such as yoga and Tai Chi. These can lessen stiffness, increase flexibility and awareness of movement, and improve alignment, posture and core strength.
Acupuncture, where thin needles are placed at specific body points, is also sometimes used to alleviate PD pain. It's important to work with a qualified, skilled practitioner. Practitioners of reflexology, another mind-body technique, manipulate areas of a person's body to ease stress and aid digestion. As with exercise, effectiveness of these complementary therapies requires regular practice.
Making Sense of Supplements: Proceed with Caution
Despite the eagerness to incorporate supplemental strategies to live well, research shows more than half of Americans using complementary therapies don't consult their doctors before or during use. Open discussion with your care provider can uncover potentially serious side effects, prevent prescription medication interactions and ensure optimal outcomes.
Prescription medications go through rigorous U.S. Food and Drug Administration (FDA) approval processes to monitor and log potential adverse effects. However, alternative therapies such as nutritional supplements are instead regulated by the FDA as food, rather than medication. Although some companies use third-party verification to vet the supplements they sell, ingredients and dosages in over-the-counter vitamin, herb and dietary supplements can vary greatly. Be sure to seek a quality source.
Much of the science around nutritional supplements, herbs and botanicals is limited and inconclusive. Though some substances hold promise, more studies are needed.
Vitamins and supplements studied for complementary therapy by people with PD include:
Vitamin C – antioxidants that may protect brain cells.
Coenzyme Q10 – dosages of up to 2,400 mg daily are shown to be safe and well-tolerated, but there's currently no evidence of clinical benefits. This supplement interacts with blood thinners and aspirin. It can promote blood clotting and lower blood pressure.
Creatine – while studies currently show no effect on PD progression or symptoms, this supplement might possibly boost mood.
Vitamin E – one study shows this vitamin failed to stop Parkinson's progress. It can increase bleeding risk and interact with blood thinners and aspirin.
Glutathione – studied in oral, injected and intranasal formulations to show no PD benefit.
Omega-3 fatty acids – 1,000 mg of flaxseed oil and 400 IU vitamin E may decrease inflammatory markers and improve motor function. However, it can cause gastrointestinal and neurological side effects.
CDP-choline(cytidine diphosphate) studies show taking 400 mg three times daily may lower levodopa dose.
Phosphatidylcholine studies show using 100 mg three times daily can improve mood and motor function but can interact with other medications.
Resveratrol caninteract with aspirin, blood thinners and anticoagulants. It can also cause mild estrogenic activity.
Beta carotene can cause skin pigmentation.
Vitamin A might create nausea, dizziness and headaches.
Vitamin B3/Niacin can bring on facial flushing and tingling.
Vitamin D3 can lower the effect of statins and elevate blood calcium level when taken with certain diuretics.
Herbs and botanicals investigated for effectiveness in PD are:
Gallic acid
Ginseng
Gingko biloba – shown to cause headache, stomach upset, palpitations and constipation, and can interact with many medications, including blood thinners.
Curcumin, which might cause nausea or diarrhea.
Green, black and oolong teas (camellia sinensis) cancause weight loss, nausea, rash, jitteriness or liver toxicity.
Epigallocatechine-3-gallate (EGCG),can create dizziness and low blood sugar.
Lion’s mane (Hericium erinaceus) can increase bleeding and interact with blood thinners.
Milk thistle can cause abdominal bloating, diarrhea and loss of appetite. It also may lower blood sugar in people with diabetes.
Quercetin can cause headache and nausea.
Vincamine can cause low blood pressure, sedation and irregular heartbeat.
Red clover can cause headache, nausea or muscle aches or estrogen-like effects including bloating, weight gain or tender breasts.
Nutritional supplements potentially useful for Parkinson's include:
Melatonin, which may ease sleep-onset insomnia and dream enactment.
Chamomile or passionflower – to promote sleep and ease anxiety.
Valerian root might also promote sleep, but some people can experience headache, stomach upset and mental fog.
Ginger may help with indigestion, but can cause heartburn and diarrhea.
Peppermint oil might also help with indigestion.
Flaxseed or flaxseed oil might ease constipation.
Cranberry extract – may reduce the risk of recurrent urinary tract infections.
Mucuna Pruriens (velvet bean)
Seeds of mucuna pruriens, a legume found in tropical and subtropical areas, contain levodopa — the most powerful treatment for PD. Mucuna has been used in traditional medicine for millennia for a number of medical conditions. It's thought to have anti-inflammatory properties and may benefit diabetes.
It also might work as an antidepressant and has been documented in ancient texts to help what sounds like Parkinson's. A few studies compare this legume to traditional levodopa, however, more research is needed to explore its safety and long-term side-effects.
Cannabinoids
Cannabinoids are one group of hundreds of substances found in the cannabis sativa plant, known when dried as marijuana. There are more than 100 known cannabinoids.
Tetrahydrocannabinol (THC) is known for its psychoactive euphoric effects. Cannabidiol (CBD), another psychoactive, is associated with calming effects.
Medical marijuana is now legalized in more than 30 states, while recreational marijuana is legal in 15 states. Small studies have shown cannabis might have potential to ease some PD symptoms — such as anxiety, sleep disturbances, pain or gastrointestinal issues — but more research is needed to determine if there is any medical benefit.
Safety issues from use include potential medication interactions, delayed absorption and effects from edibles, and dangers of lung injuries from vaping. Side effects can also include low blood pressure, fatigue, dizziness, mood or cognitive changes, changes in balance, hallucinations and changes in weight.
The lack of quality control across products also has its dangers. No governing body regulates cannabinoid quality or labelling accuracy. Products can be contaminated with microorganisms, pesticides or other substances. Like nutritional supplements, studies show cannabinoid content differs between manufacturers and deviates from the label.
The Takeaway
Complementary therapies often focus on treating the whole person, rather than symptoms alone. They can inspire a sense of wellness or empowerment. Some therapies have even shown promise in Parkinson's studies, but research is still in the initial stages.
Discuss the pros and cons of any complementary therapy with your care team before beginning. When incorporating complementary therapies, only change one thing at a time. Monitor your progress. Noticeable changes can take time — give it anywhere from a few weeks to a month.
Explore the nonprofit U.S. Pharmacopeia (USP) scientific organization to discover supplement manufacturers who participate in USP's dietary supplement verification program. ConsumerLab.com also independently tests vitamins and nutritional supplements for quality and labelling accuracy.
Looking to amplify your wellness from home? The Parkinson's Foundation has everything you need to live better today. Join us weekly for PD Health @ Home.
