Intense Exercise Could Slow Parkinson’s Symptoms
Date: December 21, 2017
Researchers put people with Parkinson’s on a high-intensity exercise routine. They say they noticed a slowdown in the patients’ decline in motor skills.
If you want to slow the symptoms of Parkinson’s disease, you might want to get on the move.
And be intense about it.
That’s the conclusion from researchers at Northwestern University and the University of Denver.
In a new study, the researchers said people with Parkinson’s can stall the decline in their motor skills by engaging in high-intensity exercise three times a week.
Exercise that gets the heart working at 80 to 85 percent of its maximum capacity was found to provide health benefits that didn’t show up in people with Parkinson’s who got no or moderate-intensity exercise.
“We are stopping people from getting worse, which is significant, particularly if we catch them early in the disease,” said Daniel Corcos, PhD, a study co-lead author and a professor of physical therapy and human movement sciences at Northwestern University’s Feinberg School of Medicine. “We gave them a proper workout. This is not mild stretching. This is high intensity. It’s part of the idea that exercise is medicine.”
“There has been no study in the literature showing that high-intensity exercise slowed the progress of the disease, until now,” Corcos told Healthline.
What the study revealed
The multisite, phase II study involved 128 participants ages 40 to 80 years old.
Researchers said the trial showed that people with Parkinson’s can safely engage in high-intensity activity — in this case, running on a treadmill.
Symptoms of Parkinson’s disease include progressive loss of muscle control, trembling, stiffness, slow movement, and impaired balance.
Participants in the Study in Parkinson Disease of Exercise (SPARX) were at an early stage of the disease and not currently taking medication.
The age group was representative of people with Parkinson’s, as the disease typically develops in people age 60 and older.
The researchers said they found that participants who got triweekly, high-intensity exercise maintained their baseline scores on an assessment tool called the Unified Parkinson’s Disease Rating Scale.
That scale rates symptoms with a 0 to 108 score — the higher the score, the worse the symptoms. Study participants all had initial scores of about 20.
By comparison, a control group that didn’t exercise saw their scores worsen by 3 points. Those who engaged in a moderate exercise regimen got worse by 1.5 points, on average.
“We’re not saying you should not go to the gym and get other kinds of exercise, but it’s quite clear that if patients want to reduce or delay the progress of this disease, high-intensity exercise has the best evidence,” said Corcos.
Experts said the size of the study group made the research especially significant, as was the use of the standard rating scale to measure outcomes.
Researchers now want to see whether the effect of intense exercise can be sustained beyond six months.
That will be the subject of a planned phase III clinical trial, said Corcos.
What is it about exercise?
Research from the University of Alabama at Birmingham has found similar relationships between high-intensity exercise (albeit strength training, not treadmill running) and benefits to Parkinson’s patients’ cognitive skills and muscular strength, according to neurologist Amy Amara, MD.
Why does exercise seem to help people with Parkinson’s?
“Probably the same reasons that apply in the general population,” Amara, who is involved with the Parkinson’s treatment collaboration between the school’s neurology department and its Center for Exercise Medicine, told Healthline.
She also noted that some animal studies have shown that high-intensity exercise can affect the level of toxic chemicals in the body, including those that can be used to induce Parkinson’s in lab animals.
Corcos added that past research also has shown that exercise can ease Parkinson’s symptoms in animals with Parkinson’s-like lesions and damage to the basal ganglia in the brain.
“Blood flow to the brain increases with exercise, providing nutrients and oxygenating neurons, so that’s one possibility,” he said.
The fact that many people simply dislike exercising — especially as they get older — could be a barrier to putting the study’s findings into practice, said Corcos.
However, therapists have used a variety of exercise-oriented interventions to help mitigate the symptoms of Parkinson’s disease, even with patients of advanced age.
Alysa Stanford, administrator of AES Therapy and Fitness of California, tells Healthline that for her Parkinson’s patients — whose average age is 95 — 80 percent of maximum heart capacity could be achieved by standing and marching in place, cycling, or even working with an exercise peddler while seated in a wheelchair.
Eastern wellness techniques and controlled movement exercises have also found a place in treating Parkinson’s.
New York-based health counselor Claudia Matles, for example, uses Hatha and Ashtanga yoga and Pilates to help a client with the disease.
“These restorative sessions go deep beyond the surface of the body, mind, and spirit,” Matles told Healthline. “These restorative sessions relax the nervous system and body while creating a deep detoxification in all the organs, cells, muscles, and tissues.”
“I’ve found that anecdotally Pilates-based physical therapy interventions have significantly improved functional status in people with Parkinson’s disease, specifically relating to balance,” added Kelsey Garcia, DPT, of Pilates in the Grove in Florida. “My clients with Parkinson’s have reported less falls and improvement on dynamic balance tasks, including forward reaching to their limits of stability. Clients also have reported improved quality of life and improved endurance with daily living tasks.”
“Intensity and emphasizing large amplitude movements are key in ensuring success in the client with Parkinson’s disease,” Garcia told Healthline.