Clinical Manifestations

Parkinson’s Disease (PD) is the second highest neurodegenerative condition by prevalence and the most common major movement disorder, affecting over 80,000 people in Australia. Prevalence increases three-fold after the age of 65, and with Australia’s aging population there has been a significant increase in total economic cost and burden of disease.

The cardinal signs of PD include bradykinesia, rest tremor, rigidity and loss of postural reflexes. However it is a very subjective disease and those diagnosed can exhibit a multitude of other symptoms including secondary motor and non-motor issues.

Benefits of Exercise

Numerous studies have assessed the benefit of regular physical activity in the long term treatment of people living with PD. Evidence suggests exercise has significant benefits with regards to physical functioning, strength, balance, gait mechanics and health-related quality of life (Goodwin et al., 2008). The release of dopamine from the remaining dopaminergic cells stimulated through exercise reduces PD symptoms, and enhances neuroplasticity through maximising synpatic plasticity and promoting greater structural adaptation (Fox et al., 2006).

Exercise treatment for PD

Due to the subjective nature of the disease, exercise prescription needs to be specific to the individual’s symptoms. An exercise program for PD needs to focus on improving strength and endurance in functional movements, overall mobility and static and dynamic balance for falls prevention.

Including ADLs such as sit to stands, balance drills such as hurdle steps and LSVT-Big movements within the program is important for building endurance to maintain independence. Postural correction is also commonly required to counteract the forward lean associated with PD, through strengthening the upper back and core muscles.

Studies have shown that dopaminergic neurones are highly responsive to exercise, and the combination of greater cerebral oxygenation and release of neurotrophic factors promote new cell growth and cell survival (Dishman et al., 2006).

FORGE PD Program

Here at Forge we run classes specifically for individuals with PD or PD-like symptoms. Our clients love exercising in these groups because it allows them to create connections and share experiences with people facing the same condition.  Forge’s integrated approach caters for all levels of symptom severity; our physiotherapists run gentle, clinical pilates-based sessions for those with severe movement deficits and our exercise physiologists cater for individuals with a higher level of function in weights-based sessions.

References:

• Goodwin, V.A., Richards, S.H., Taylor, R.S., Taylor, A.H., & Campbell, J.L. (2008). The Effectiveness of Exercise Interventions for People with Parkinson’s Disease: A Systematic Review and Meta-Analysis. Movement Disorders, 23(5), 631-640.
• Fox, C.M., Ramig, L.O., Ciucci, M.R., Sapir, S., McFarland, D.H., & Farley, B.G. (2006). The science and practice of LSVT/LOUD: neural plasticity-principled approach to treating individuals with Parkinson’s disease and other neurological disorders. Semin Speech Lang, (27), 283-299.
• Dishman, R.K., Berthoud, H.R., Booth, F.W., et al. (2006). Neurobiology of exercise. Obesity, (14), 345-356.

Ebony Blackstone (AEP, AES, ESSAM)

Clinical Exercise Physiologist and Sports Scientist