Beginning an Exercise Program When You Have Parkinson's Disease

The 3 components of a total fitness routine.

Regular exercise is important for those with PD to help you stay strong and mobile and maintain your independence and reduce the risk of falls. A complete exercise program should consist of the following 3 components:

Aerobic/Cardiovascular Exercise.

The purpose of aerobic exercise is to strengthen the heart and lungs and it also helps you maintain a healthy weight and blood pressure. Examples of aerobic exercise include walking, biking, swimming and aerobic dance classes. Aerobic exercise involves sustaining the exercise for 15-30 minutes to a level where you are slightly out of breath and breaking a light sweat. A common technique to judge your level of exertion is the Rating of Perceived Exertion. On a scale of 1-10 (with 1 being no exertion/asleep and 10 being completely exhausted) you should perceive that you are exercising at a level of 4-6. This means that you know you are working out but you are not exhausting yourself. As your cardiovascular system becomes stronger you will find that you do not get out of breath as quickly when walking or climbing stairs and as your lung capacity improves so will your ability to project your voice.

For those with PD there is a tendency to walk on the toes with a shuffling step and to hold the arms stiff when walking. Try to focus on stepping out with the heel first, toes flexed, and swing the opposite arm to leg.

Strength Training/Resistance Training/Weight Training

This type of activity aims to strengthen the muscles of the body. Strength training involves moving your muscles against some kind of resistance such as machines, free weights, tubing or even your own body weight. Unlike aerobic exercise, these exercises should always be done slowly and with control. Stronger muscles help you get in out of a chair or car, climb stairs, and lift/carry items such as groceries more easily. Stronger muscles will also help you lessen your risk for a fall.

Stretching/Flexibility/Range of Motion Exercises

These exercises are designed to increase the flexibility and range of motion in the muscles and joints. These exercises should be done after the body has "warmed-up" such as after aerobic exercise. Stretches should be held for 20-30 seconds each. Never bounce while in a stretch as this can lead to injury! Increased flexibility and range of motion makes everyday tasks such as turning your head to back up the car, grooming, putting on shoes, and reaching items in high and low places easier.

Tips to make exercise safe

Know any contraindications for any medical conditions you have.

This information should be provided to you by your doctor or a licensed physical or occupational therapist. Situations such as joint replacements, osteoporosis, heart disease and diabetes, etc. all have specific considerations in regards to exercise. Do your research before starting to exercise as this will keep you safe and provide a more enjoyable and efficient workout. If you are having trouble with your balance look for programs that provide chairs or railings to hold onto.

Use common sense and listen to your body.

Exercise should not hurt, it should help! Feeling a bit achy or stiff after exercise is normal, but pain is a signal that something is wrong. Never exercise to the point of pain and discontinue any exercise that makes your symptoms worse. You should never "feel" the exercise in your joints including the neck and back. Your body knows best. Use the feedback from your body to judge whether or not the exercise is right to do.

Suggestions to help prevent freezing.

Issues with freezing can make exercise challenging for those with PD. Some tips that may help include:

Try to quickly lift up the toes of both feet or swing both arms up to shoulder height. This may jolt the body into moving.

Count or speak out loud, saying '1, 2, 3, 4' or "step, step, step." Speaking out loud creates a rhythm that sometimes gets the body going again.

Sing or hum an easy song you know well. This also creates a rhythm for the body to follow.

Carry a small metronome to provide a constant source of rhythm.

A word about posture.

Having PD can mean that you have a tendency to lean forward at the hips and stand with your shoulders rounded forward. This postural habit can be corrected. Look for programs that emphasize movements that open the chest and pull the shoulders back. Try to limit participation in classes that involve movements that make you round your back and shoulders forward.

Lori Newell is an ACSM certified personal trainer and certified yoga teacher with a Master's degree in Health Promotion. She has been teaching fitness and yoga programs for over 20 years and specializes in programs for those with chronic illness. Lori is the author of The Book of Exercise and Yoga for Those with Parkinson?s Disease. It is available through Living Well Yoga and Fitness. Mention your favorite PD organization when placing your order and a portion of your purchase will be donated to them.