Study Finds Best Type of Exercise for Parkinson's

by Staff Writer
February 8, 2023 at 11:05 AM UTC

Almost any exercise will improve symptoms and quality of life in Parkinson's.

Clinical Relevance: Exercise should be a part of the clinical management for Parkinson’s Disease

  • A meta-analysis found that that most types of physical activity are safe and moderately effective in reducing the severity of motor symptoms and improving quality of life.
  • Dance, aqua exercise, endurance training, and functional exercise offered the most benefits, while mind body and flexibility programs seemed to offer the fewest.
  • Strength and voice training are the only types of physical movement in the review where the evidence remained inconclusive.

A new study suggests that physical activity for patients with Parkinson’s disease should be part of their prescription. And almost any kind of exercise will do. 

Parkinson’s disease (PD) is second only to Alzheimer’s disease as the most prevalent diagnosis for a neurodegenerative disease. An estimated one million Americans live with PD, and approximately six million worldwide. In PD, the progressive loss of dopamine-producing nerve cells in the brain leads to loss of motor control and overall physical coordination.

Parkinson’s Incidence Nearly 50% Higher than Previous Estimates

Recognition of OFF Episodes of Parkinson Disease

Effective Treatment Strategies for Symptoms of Parkinson’s 

This latest study was a meta-analysis of 156 randomized controlled trials with more than 7,900 participants. The goal was to come up with a meaningful way to rank different types of physical movement in terms of safety and benefits for adult PD patients, focusing on the severity of motor signs, quality of life, and the frequency of adverse events. 

Dance, water-based movement, and workouts that incorporated exercises for improving gait, balance, and function were all shown to be moderately effective for diminishing the severity of motor symptoms. Mind-body and endurance training had a small positive effect, while flexibility training seemed to offer a little-to-no benefit.

Aqua aerobics programs offered the most positives for quality of life while endurance programs like walking and biking also seemed to help. Ditto for workout programs that specifically centered on gait and balance. It was less clear if dance, mind body classes, or stretching made any difference on a PD patient’s daily living experience.

The good news is that all types of exercise are generally safe in Parkinson’s. The 85 studies that looked at adverse events found no significant increased risk of falls or pain. 

Strength training and voice training are the only types of physical activity where the benefits remain a question mark. None of the data in the review could draw meaningful conclusions about whether lifting weights or other types of resistance training either helped or hurt PD symptoms. The jury is also still out on systems designed to address movement deficiencies like the proprietary voice training program (LSVT BIG.) 

The big takeaway: type of exercise may not be as important as exercise itself for PD patients.  

“Our review highlights the importance of physical exercise regarding our primary outcomes, severity of motor signs and QoL, while the exact exercise type might be secondary,” the German scientists said in their Cochrane Review article.  “Notably, this conclusion is consistent with the possibility that specific motor symptoms may be treated most effectively by PD specific programs.”


A Welcome Focus on Psychotherapy

Learn more about JCP’s Focus on Psychotherapy section and meet the section editors.

John C. Markowitz and others

Brief Report

Camptocormia and Antipsychotic Medications

Camptocormia, or “bent spine syndrome,” is an often-overlooked adverse effect of antipsychotics; early diagnosis and treatment is essential to prevent severe consequences.

Rashmi Subhedar and others