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Parkinson’s & Exercise Research

Notes: Below is a list of studies and review articles regarding various forms of exercise and the benefits that they may provide to those with PD. Please note that due to various reasons, studies may be small and/or have important limitations, and therefore the results and conclusions should be taken with caution (as with any body of research!) However, these results can help give an idea of the benefits of physical activity for those with PD and the possible mechanisms through which this occurs.

All studies linked here are open access and peer reviewed.

General Benefits of Exercise:

Group-based exercise for Parkinson’s: a qualitative study of participants and partners’ perceptions of an exercise class delivered through a community-university collaboration (Ferrusola-Pastrana et al., 2024)

  • “Attending and supporting participation in community-university supported programmes for PwP appears to support self-management as well as foster an ethos of working together as a team”
  • “The class provides participants with a sense of companionship, meaningful social connections, fellowship and a perceived positive affective experience—psychosocial benefits that also extend to partners who come along to support their loved ones, and that are important for exercise adherence and achieving positive health outcomes”
  • “Our data reinforces previous work which suggests that, once involved with CBEPs [community-based exercise programmes], attendees perceive a sense of social belonging and feel less isolated and lonely”

Physical exercise for Parkinson’s disease: clinical and experimental evidence (Oliveira de Carvalho et al., 2018)

  • A review of research available regarding physical exercise and PD.
  • “Alberts et al. (2011) also demonstrated through magnetic functional resonance (fMRI) that aerobic exercise was able to promote increased activity in cortical and subcortical areas, with responses similar to those observed under the effect of antiparkinsonian medication”
  • “In general, the health benefits provided by strength training (increased strength and muscle mass, bone mineral density) are useful to the needs of patients with PD, especially with regard to functionality and independence related to daily life”
  • “Expression of neurotrophic substances, in particular, BDNF (Brain-Derived Neurotrophic Factor), growth factor promoting proliferation, survival, and maturation of new neurons, appear to be induced from one or more physical exercise sessions”

Exercise and Parkinson’s: benefits for cognition and quality of life (Cruise et al., 2011)

  • “Exercise was shown to exert a selective benefit for frontal lobe based executive function (EF) (i.e. spatial working memory and verbal fluency, both semantic and category)”
  • “Improvements in frontal lobe based EF may have important implications for people with PD, not only because EF deficits are frequently observed in PD, but because effective EF is important for activities of daily living”

Resistance Training:

A two year randomized controlled trial of progressive resistance exercise for Parkinson’s disease (Corcos et al., 2013)

  • “Our results are consistent with previous studies that have shown that resistance exercise can improve physical performance, and quality of life in Parkinson’s disease”
  • “At 12, 18, and 24 months the PRE [Progressive Resistance Exercise] elicited greater improvements than mFC [Modified Fitness Counts Exercise]”
  • “PRE has also been shown to reduce falls which are a major concern in the treatment of Parkinson’s disease”

Evidence of rehabilitative impact of progressive resistance training (PRT) programs in Parkinson disease: an umbrella review (Paolucci et al., 2020)

  • “The aim of this umbrella review was to provide evidence that PRT improves strength in PD, and the results favor the inclusion of strengthening exercises in the rehabilitation of PD patients through the improvement in muscle strength, and patients performed better in ADLs [Activities of Daily Living]”
  • “Improvements in muscle strength and power also have a significant impact on bradykinesia and could facilitate independence in the community, improve functional mobility, and reduce the risk of falls”
  • “Exercise improves the health of the brain […] ultimately improving motor, nonmotor, and cognitive behaviour in patients with PD”

Progressive resistance training improves bradykinesia, motor symptoms and functional performance in patients with Parkinson’s disease (Vieira de Moraes Filho et al., 2020)

  • “Improvements in functional performance were observed in common day-to-day locomotor activity, such as walking, turning, sitting, rising and walking speed”
  • “It can be established that moderate to high-intensity exercise can mediate neurobiological responses such as neurogenesis, angiogenesis, and synaptogenesis, affecting plasticity and promoting the better performance of neural centers affected by PD”

Effectiveness of aerobic and resistance training on the motor symptoms in Parkinson’s disease: Systematic review and network meta-analysis (Zhou et al., 2022)

  • “For patients with moderate to mild Parkinson’s symptoms, short period high intensity resistance training may provide complementary therapy for PD, and aerobic or resistance training of varying intensity and periodicity may be recommended as exercise prescription for PD patients”
  • “Several studies have confirmed that potential mechanisms for high intensity resistance training induced neuromuscular remodeling and improved moto function may be related to the up regulation of genes that enhance muscle development, and that central motor path-ways still exhibit altered neuroplasticity following resistance training despite the advanced age and neurological dysfunction of PD”

Dance:

Therapeutic dancing for Parkinson’s disease (Aguiar et al., 2016)

  • “The weight of the evidence suggests that therapeutic dancing can be beneficial for improving motor performance, mobility, and balance in people with PD”
  • “Dancing was associated with short-term improvements in freezing of gait, walking performance and wellbeing in some individuals”
  • “Music is a powerful determinant of motor performance in people with PD, especially when loud rhythmical tempos are used that provide external cueing to the defective basal ganglia pathways”

Physical activity based on dance movements as complementary therapy for Parkinson’s disease: effects on movement, executive functions, depressive symptoms, and quality of life (Duarte et al., 2023)

  • Small study with important limitations but suggests the outcomes that could be improved with dance.
  • “Physical activity based on dance movements contributed to significant improvements in movement (balance and gait), executive functions, especially in cognitive flexibility and inhibitory control, and the quality of life too”

Parkinson’s disease motor symptom progression slowed with multisensory dance learning over 3-years: a preliminary longitudinal investigation (Bearss & DeSouza, 2021)

  • Study conducted in Toronto. It is a pilot study, with a small number of participants and other limitations. Findings are interesting, but should be approached with caution.
  • “This study is the first to show that neither the motor nor the non-motor PD symptoms progress in this disease with participation in longitudinal neurorehabilitation training over three years”
  • “Our data further showed that training in dance will slow the rate of PD motor impairment progression, as measured by the UPDRS III”
  • “A review of studies that incorporated music and dance indicated the beneficial aspects of using this tool as a form of rehabilitation for people with PD as it improves cadence, speed, gait, balance, and stability while stimulating improvements in both the motor and cognitive symptoms in PD”

Tai Chi:

Effect of long-term Tai Chi training on Parkinson’s disease: a 3.5-year follow-up cohort study (Li et al., 2024)

  • The first study to show the long-term effects of Tai Chi training. Participants were observed for an average of 4.3 years.
  • “Delayed progression in motor function and continuous improvement in quality of life, sleep and cognition were found”
  • “The prevalence of complications (dyskinesia, wearing-off phenomenon, dystonia) and several non-motor symptoms (hallucinations, PD-MCI and restless legs syndrome were lower”
  • “Our results show that Tai Chi can prolong the improvements in motor and non-motor symptoms comprehensively, and those patients with PD who persevere with Tai Chi training could gain more benefits from exercise, indicating that continuing to exercise helps the control of symptoms”

Mechanisms of motor symptom improvement by long-term Tai Chi training in Parkinson’s disease patients (Li et al., 2022)

  • This study observed early-stage PD patients for one year.
  • “In this study, we found long-term beneficial effects of Tai Chi in improving balance and other motor symptoms in PD. Tai Chi improved BBS [Berg Balance Scale], UPDRS [Unified PD rating scale], TUG [Time Up and Go test] and step width, indicating its beneficial effects on motor symptoms (including gait and balance)”
  • “Proinflammatory cytokines were downregulated after Tai Chi training […] Inflammation plays an important role in the pathogenesis and disease progression of PD”
  • “fMRI and blood biomarker evidence suggest enhanced brain network function, reduced inflammation, improved amino acid metabolism, energy metabolism and neurotransmitter metabolism, as well as decreased vulnerability to dopaminergic degeneration in PD after Tai Chi training”

Effects of Tai Chi exercise on reducing falls and improving balance performance in Parkinson’s Disease: a meta-analysis (Liu et al., 2019)

  • “This meta-analysis provides moderate- to high-quality evidence from five RCTs [randomized control trials] that Tai Chi could be a good physical training strategy for preventing falls and improving balance and functional mobility in people with PD”
  • “These beneficial effects may be related to certain characteristics of Tai Chi exercise.
    • “First, Tai Chi includes many movements with slow weight shifting, body rotation, and single-leg standing in different positions, requiring delicate joint control with muscle coordination […]
    • “Second, Tai Chi exercise may provide more proprioceptive stimulation and lower extremity muscle strengthening, which are important for movement control in daily life. Additionally, flexibility and coordination of the whole body can be improved after Tai Chi exercise.
    • “Finally, recent studies also found that Tai Chi practitioners showed better cognitive functions, such as motor learning, memory, and executive function. Overall, the positive effects on balance, motor function, coordination, muscle strength, flexibility, and cognitive function after Tai Chi exercise may prevent PD patients from falling”

Effects of a 12-week online Tai Chi intervention on gait and postural stability in individuals with Parkinson’s disease (Law & Li, 2023)

  • “A 12-week biomechanical-based online TC [Tai Chi] training was effective towards improvement of gait and postural stability among people in the early-stage of PD”
  • “Those who practice TC regularly crossed a 15-cm and 23-cm high obstacle with significantly faster and longer step length and significant higher toe clearance than the age- and exercise volume-matched older adults, suggest that they have better movement and postural control capacities”

 

Studies Currently Underway:

Study in Parkinson’s disease of exercise phase 3 (SPARX3): study protocol for a randomized controlled trial (Patterson et al., 2022)

  • “SPARX3 will be the first Phase 3 clinical trial of exercise dose in PD”

Effectiveness of a long-term, home-based aerobic exercise intervention on slowing the progression of Parkinson disease: design of the cyclical lower extremity exercise for Parkinson disease II (CYCLE-II) study (Alberts et al., 2021)

  • “Should long-term aerobic exercise demonstrate disease-modifying capability, this study will provide evidence that “Exercise is Medicine” for PwPD”