Exercise for the Mind: Tips for training

By now we all know the important role a regular exercise routine can play in Parkinson ’s disease. Studies have shown time and again that consistent exercise can improve symptoms associated with Parkinson’s including balance, walking speed, as well as a decrease in rigidity and episodes of “freezing” or festination. We also know that exercise can really make a difference in overall quality of life, decrease rates of depression and give you more energy throughout the day. There has even been some research showing that Parkinson ’s disease progression can actually be slowed by exercise, prolonging a person’s ability to do the things that they love in life.

We are also learning more about what types of exercise can give us the most “bang for the buck”. Intensive cycling and walking studies have shown us that exercise programs that cause higher exertion levels can have a larger benefit than more conservative programs. Rhythmic exercise groups including dance, tai chi and boxing have been shown to improve walking and balance. Trunk rigidity and tightness can be improved by kayaking. Resistance training has shown to have benefit on overall strength and force production. Stretching and yoga programs can improve posture, blood flow and overall flexibility. The list goes on and on. With so many options, it can sometimes be a little daunting for a person living with Parkinson’s Disease, who may have never exercised in their life, to suddenly jump in head first. I hear people express this kind of nervousness often as a Physical Therapist and my advice to them: Start Simple. When it comes to getting your heart pumping, there is more than one right answer. The important thing to remember is the quicker you can get moving and make it a part of your everyday life, the better. And the exciting part is that we now know some of the essentials that will give you the best outcomes!

Make it intensive: If you are out for a walk, shooting for a pace of 90-100 steps per minute should be challenging and intensive. If you’re riding a bike, try to keep the revolutions per minute (RPMs) above 80 to give you the most benefit. If you can’t track your steps or RPMs, another way to ensure your exercise routine is stimulating your brain in addition to the body is by rating your exertion level. Using a simple scale with 0 (resting comfortably) to 10(extreme exertion) as a way to monitor your exertion level is very effective. You should try to keep your exertion level between a 6-7 for optimal intensity. Any activity that you enjoy and are comfortable performing can have benefit if you are maintaining your exertion level within this range.

Make your mind work: We are starting to realize that training the mind with the body is offers some really specific benefits for PWPs. Another term for this is cognitive dual tasking. When we are distracted by something we are thinking about, our movements get less precise. You may have noticed others mentioning you don’t walk as fast or shuffle more often when you are carrying on a conversation. The way to fight against this is by treating it head on. Whether it’s reciting important dates in your life (anniversaries, birthdays, etc) or making a point to carry on a conversation with your partner and still keep pace while on a walk or bike ride is important. You are literally teaching yourself to keep your body moving optimally while your mind is attending to other tasks, and that is important.

Make it LOUD and BIG: Using your voice with exercise is so important. Counting repetitions out loud is one way of maintaining proper voice volume and also offering a cognitive challenge as we discussed above. Making an effort to keep your size of movement as large as possible is also important. We know we have to move bigger than we think is necessary with PD, and putting this into practice during our exercise routines is a great way to reinforce this.

The moral of the story is that exercise, whether it be on your own or in a group setting, should be an integral part of the daily management of Parkinson ’s disease and should begin as early as possible after diagnosis. We have tried to incorporate all of the most important aspects of exercise for PD into our A.M.P. classes and Daily Dose online training in order to give you the most benefit. There is no better time than now to start giving your brain what it needs.

Nate Coomer, PT , DPT, NCS