The Why and How �of Parkinsons Exercise ?

Beccy Oliver Parkinsons Specialist Physio

Thorpes Physiotherapy Eversley �beccy.oliver@thorpesphysiotherapy.com

Exercise is perceived as the most positive avenue towards disease modification (Mak et al, 2017, Lauze et al, 2016).

Session Learning Outcomes

By the end of this session you should be able to:

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• Understand WHY we need to exercise
• Understand the especial benefits of exercise for Pwp
• Find out more about what types and styles of exercise are � important for you.

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Try some out today!

Benefits of Exercise

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Exercise is as important as taking your medicine

Parkinson’s can cause Deconditioning …

• 70% of people with Parkinson's classed as sedentary� (Lord et al, 2013)

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• Physical activity levels and intensity of exercise tends to decline from diagnosis (Cavanagh et al, 2012)�
• Mean daily step count: Pwp 4,765 5,444 average UK (Benka Wallen et al, 2015 -)�
• Prospective studies report between 45% - 68% of PwP fall each year (Bloem et al, 2001, Paul et al, 2014)�
• 50–86% experience recurrent falls (Allen et al, 2013)

What STOPS you exercising?

Motor symptoms

Non-motor symptoms

Secondary symptoms

Normal ageing process

Co-morbidities

Covid

Slowness- Bradykinesia, Stiffness & Tightness- Dystonia�Tremor�Freezing of gait (FOG)

Low Mood (decrease in Dopamine), Urinary symptoms, Constipation, Cognitive compromise �Cardiac changes (difficulty in inc heart rate)�

Muscle pain, joint pain, side leaning causing loss of balance, weakness in muscles

MSK conditions, confusion, tiredness

Cardiac conditions, osteoporosis, respiratory conditions

Reconditioning of the population, services being lost

It can be tough…. So why bother??

Why is exercise beneficial for Parkinson’s?

Improved health and well-being and sense of community, taking control of own health

Why is exercise beneficial for Parkinson’s?

Reduce the risk of

• developing type 2 diabetes by 30-40%
• of cancer,
• of dementia
• of stroke
• of heart disease by 35%
• of depression.
• Improves quality of sleep,
• increases energy levels,
• is an effective pain manager
• improves quality of life in ageing�

Find out more https://www.sportengland.org/why-were-here/physical-wellbeing

Why is exercise beneficial for Parkinson’s?

Muscles working harder increase your efficiency, speed & strength supporting daily life.

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Moving more improves your balance feedback loop key in Parkinsons.

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Exercise reduces stiffness in your body and increases vital range of movement in joints including your spine and neck.

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Dual Tasking (Hand/eye/feet/mind/ speech co-ordination) is key in Parkinsons and can be trained effectively though exercise.

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Why is exercise beneficial for Parkinson’s?

Exercise can encourage you to leave your house and therefore reduces isolation.

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Group Exercise has been shown to be beneficial in increasing ‘happy hormones’- serotonin as you interact with others verses exercising alone.

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Increasing your fitness in a group class is easier when there are others encouraging you to do more than you would alone.

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Why is exercise beneficial for Parkinson’s?

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A More Efficient Brain

Neuro-Protection- When we exercise our brains produce a chemical known as Brain Derived Neurotrophic Factor (BDNF) into the exercising circuits, this acts like a ‘body guard’ to the dopamine and ensures that it stays in the area for as long as possible.

Neuro-Restoration- Extra dopamine is produced by the body for the exercising circuits, and the receptors on the neurones become more efficient at attracting the dopamine. The nerve cell is therefore becomes more efficient.

Neuro-Plasticity BDNF is also the brains fertiliser, when its around the brain can adapt and form new connections, both to aid improvement in movement and in our thinking (cognition).

Why is exercise beneficial for Parkinson’s?

BUT research has shown that BDNF is produced only when we exercise hard, making our heart work towards its maximum for short periods

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• 3 x a week for 45-60min sessions
• Medium intensity vs High intensity training (HiiT, >85%mHR)
• 45 secs work and 15 seconds rest
• Significant improvement in BDNF in HiiT Group
• 46.2% v 82.4% increase in BDNF between groups

So working HARD is good for our brains and bodies…..but how do we know how hard is hard without expensive gadgets??

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Its all in your PUFF!

Exercise is Good!

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But what exercise is best for me and my Parkinsons?

A reminder..What are we targeting?

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• Slowness
• Small movements
• Balance dysfunction
• Reduced range of joints inc flexed posture
• Difficulty dual tasking (motor and cognitive task)

https://www.parkinsons.org.uk/information-and-support/parkinsons-exercise-framework

Let’s try

an exercise

https://youtube.com/shorts/_CSEt8BrfpQ?feature=share

https://youtu.be/cDC1wd493Gc

https://youtube.com/shorts/KfF1JPkg5Wk?feature=share

https://youtu.be/J8YFw5NRjXE

https://youtu.be/nawOPZjUMU0

Sit to Stand LSVT Style!

https://youtu.be/v-Ct4znTbhQ

https://www.clockyourself.com.au/

Online Exercise

https://briangrant.org/exercise/

https://www.youtube.com/channel/UC9QTes9SMZKbSzDS-nvhr3g

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https://www.parkinsons.org.uk/information-and-support/exercise

PD Specific Exercise

https://www.reachyourpeakonline.com/

https://www.lsvtglobal.com/LSVTBIG

https://pdwarrior.com/10wc-online/

https://www.pwr4life.org/virtual-pwr/

https://foundationsphysio.co.uk/specialist-classes/

https://www.neuroheroes.co.uk/classes#/events

In Person Classes

Monday

Mapledurham Low & High intensity

Reading Hydrotherapy

Sunningdale High Intensity

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Tuesday

Wokingham Medium Intensity

Bracknell Leisure Centre Hydrotherapy

Bracknell Nordic Walking

Eversley High Intensity

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Wednesday

Reading Dancing

Reading Pilates

Mapledurham High intensity

Bracknell Low & Medium & High Intensity

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Thursday

Wokingham, Medium Intensity

Online Low intensity

Reading Hydrotherapy

Reading Nordic Walking

https://thorpesphysiotherapy.com/neurological-physiotherapy�https://bracknellparkinsons.org/exercise�https://parkinsonsreading.org.uk

Key Messages

• Exercise is increasingly being shown to slow down the rate of decline, especially in early stages of PD
• Exercise has potential to modify the underlying pathophysiological process
• Exercise has a positive impact on motor and non-motor symptoms
• Frequency and intensity of exercise are key
• Exercise choices should be varied in line with the Exercise Wheel
• EVERYONE CAN DO IT at any stage of their PD

Do you now…..

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• Understand WHY we need to exercise
• Understand the especial benefits of exercise for Pwp
• Understand more about what types and styles of � exercise are important for you.��Whats your next step?

Any Questions?

Beccy Oliver Parkinsons Specialist Physio

Thorpes Physiotherapy Eversley �beccy.oliver@thorpesphysiotherapy.com

07920444979