Fitness for People with Parkinson’s

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by Lisa Snow

For many with Parkinson’s, just managing day to day activities and keeping track of medications can be a challenge, so adding a structured exercise program can seem overwhelming.  Even those who do exercise regularly are often doing a single activity, such as a stationary bicycle, because they’re unaware that customized corrective exercise can help them with more than just burning calories.

If you or a loved one have Parkinson’s, how can exercise help?  Outside of medication, exercise is the only thing that can actually raise dopamine levels.  In addition, a carefully designed exercise program can help you with balance, posture, flexibility, walking and stair climbing ability, and more.   Once you complete physical therapy, a post-rehab personal trainer can help you regain full body fitness and your ability to perform everyday activities.

When and Where to Exercise

Your daily medication schedule can have a dramatic effect on your ability to exercise.   Most people need to experiment with several different times of day to find when the medication is allowing them to be at their best.  It’s important to choose a trainer with a flexible schedule.  On days when you aren’t working with a trainer, find a friend to do your workout with you.  You will be more motivated, have more fun, and reduce your fall risk.

Many personal trainers can come right to your home, brining all their own equipment.  This saves you time spent commuting to a gym, as well as eliminating the cost of a gym membership.  If you prefer going to a gym and feel that meeting other gym members is part of the fun, many independently owned gyms allow clients to bring their own trainer.  (Chain gyms like New York Sports Club or Crunch don’t allow outside trainers.)  This way you can choose a trainer who specializes in post-rehab rather than working with whichever trainer happens to be at the gym the day you show up.  A randomly selected trainer may only work with weight loss clients and have no experience with Parkinson’s.

Balance

Most healthy older adults assume that loss of balance is a result of aging.  For able bodied people, the primary cause of loss of balance is that they don’t practice balance regularly.  Age has much less to do with balance problems than simple disuse.  At EFT Personal Training, we regularly see healthy clients in their 60s, 70s, and 80s regain their balancing skills, including being able to stand on one foot without holding on, being able to stand up from a chair without pushing on the chair handles, walking in a straight line, standing on unstable surfaces like balance boards when appropriate, and doing exercises like walking lunges that require you to balance on one foot during part of each stride.  For our Parkinson’s clients, it’s more complicated.  Parkinson’s affects many aspects of balance, and it takes longer for people with Parkinson’s to regain some of their balance abilities.  However, people with Parkinson’s can and do relearn to balance!  This has a positive effect on being able to walk without a cane, and being able to go up and down stairs.

While many creative balance exercises are beneficial, starting simple is always the best plan.  Try standing on one foot and compare your balance on the right and left side.  Be sure to stand near a grab bar or the doorknob of a locked door you can hold onto for balance in case you need it.

Posture

Parkinson’s and aging both contribute to loss of good posture, but corrective exercises can help you stand tall again.  To see where you’re at with posture today, recruit a friend or family member with a camera.  Stand with your back to a blank wall, and stand as tall as you can.  Then have your friend get face on photos, as well as profile photos from both sides.  If when standing relaxed, you can’t have your hips, upper back, and back of your head all touching the wall at the same time, you could benefit from working with a physical therapist, chiropractor, or post-rehab personal trainer to regain your upright posture.

Flexibility

People of all ages with Parkinson’s can markedly improve their flexibility.  While post-rehab personal training provides the most customized approach to improving flexibility, gentle yoga classes can also be helpful.   Although there aren’t yet many group classes for Parkinson’s, many Parkinson’s patients do well in yoga or group exercise classes geared toward arthritis patients or older adults in general.   To get a “Before” snapshot of your flexibility, try touching your toes.  If you know you don’t have the balance to stand and touch your toes, try it sitting down.  (If you can’t touch your toes even while sitting, it’s typically a flexibility problem that can be remedied by a good stretching program.  However, if you can easily touch your toes sitting, but can’t reach that low while standing, it’s typically core stability, not flexibility, that needs to be addressed.)  While you have your friend with the camera doing the posture test, also get another set of photos standing with your back to the wall, but this time with your hands reaching over your head.  If you can’t reach overhead, or if reaching all the way up makes your hips leave the wall, you need to work with a physical therapist or post-rehab personal trainer to regain your shoulder mobility.

Standing Up from the Floor

If you can still stand up from the floor, it’s important to practice daily to retain this ability.  If it has been several years since you have attempted standing up by yourself, recruit a friend to be there during your first attempt.  If you know for sure that you can’t stand up from the floor, a physical therapist or post-rehab personal trainer can help you regain this important ability!

Learn More and Start Moving

An affordable way to get started is with an illustrated book on exercise and Parkinson’s, such as

Delay the Disease: Exercise and Parkinson’s Disease by David Zid

Even if you are anxious to get started with an exercise program, I always recommend people with Parkinson’s stay in physical therapy as long as their insurance will allow.  You can always exercise on your own between physical therapy appointments.  It’s important to get written do’s and don’ts (often called recommendations and contraindications) from your physical therapist, so you can share them with a personal trainer or any other wellness professionals you plan to see after you are discharged from therapy.  Post-rehab personal training is not covered by insurance; however, it may be tax deducted as an unreimbursed medical expense if you get a doctor’s note saying the training is medically necessary.  (Be sure to talk to your accountant about whether or not you qualify for this deduction.)  In addition to one-on-one personal training, some post-rehab personal trainers also offer small group training at a lower cost per session.  Both private and small group training usually work well for people with Parkinson’s.  Large group classes tend to cover too many new exercises to learn all at once, and don’t offer the individualized attention most people with Parkinson’s need.

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Missed last month’s column? Read it now:

Customized Exercises for People with Back Pain
What Should People Look for When Hiring a Personal Trainer?
How do trainers know what program is right for their clients?
Who Benefits the Most from a Personal Trainer?
Motivate Yourself to Better Health
Three Dimensional Fitness