Move Well With Parkinson’s

By Professor Meg Morris, PhD
Physiotherapist at The Victorian Rehabilitation Centre, Healthscope

One of the most valuable tips for people living with Parkinson’s disease is to think of exercise as medicine.  Exercises and physical activities are one of the most beneficial things that a person with Parkinson’s can do, to live long and live strong. The exact cause of Parkinson’s is still not known and there is currently no cure. Yet the characteristic signs are easy to recognise. Movements become progressively slower and movement size diminishes. This is typically seen as short, slow or shuffling steps when walking, a forward stooped posture, micrographic handwriting or reduced facial expression. There can be rigidity of the muscles and some people find that they have a tremor, especially of the hands at rest. Falls can become a problem because balance is often affected after a number of years. 

There are a range of very helpful medications to treat the symptoms of Parkinson’s disease and Deep Brain Stimulation is an option for a small proportion of people. But for everyone, exercise and structured physical activities are an important part of the comprehensive management of Parkinson’s over the course of the disease.

When to seek help?

• The sooner you start your tailored exercise and physical activity program the better
• For all of us its important to build a physical activity program into our daily routine; we often aim for at least 30 minutes each day
• When you meet with your medical practitioner its good to ask about physical therapy options, to complement your own medical management
• A consultation with a physiotherapist or exercise scientist can be an excellent way to select the therapy program that best meets your exercise needs
• Its good to check in with your health professional from time to time, to adjust the exercise programs to your changing needs

What are the exercise choices?

There are lots of different modes of exercise and physical activity. Your health professional will help to select the best combination to meet your own unique needs. They will advise you on how many repetitions and for how long to do the different exercises:

• Physiotherapy rehabilitation program
• Gym exercise program
• Walking
• Progressive resistance strength training
• Aerobic exercises, such as cycling, treadmill, skipping, running, rowing
• Aquatic therapy
• Upper limb training
• Dance therapy / movement to music
• Boxing for Parkinson’s
• Tai Chi, Yoga, Pilates and other complementary therapies
• Balance and falls prevention programs

Tips

• Always get medical clearance first
• Let your health professional know about your medications and any co-morbidities as these need to be taken into account when designing therapy
• Try and exercise at peak dose of your Parkinson’s medication cycle and not too late in the day
• Check that you have a safe environment for exercising, free from trip hazards and obstacles
• Keep well hydrated and take regular breaks
• You might try exercising to your favourite music or even singing
• Enjoy yourself!

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References

1. Morris ME et al. A Randomized Controlled Trial to Reduce Falls and Improve Mobility in People with Parkinson’s disease. Neurorehabilitation and Neural Repair 2015;29(8) 777-785. JCR Impact Factor 4.617.
2. Tamplin, J., Morris, M.E., et al. (2020). ParkinSong: outcomes of a 12-month controlled trial of Therapeutic Singing Groups in Parkinson’s disease. Journal of Parkinson's Disease, 10(3), 1217-1230. 
3. Carroll, L. M., Morris, M.E., et al. (2020). Is aquatic therapy optimally prescribed for Parkinson’s disease? A systematic review and meta-analysis. Journal of Parkinson's Disease, 10(1), 59-76. 
4. Morris, M. E., Ellis, T. D., Jazayeri, D., Heng, H., Thomson, A., Balasundaram, A. P., & Slade, S. C. (2019). Boxing for Parkinson's Disease: has implementation accelerated beyond current evidence?. Frontiers in Neurology, 10, 10 pages