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For Parkinson’s: Everyday activity better than strenuous exercise

Woman doing laundryHere’s my latest prescription for Parkinson’s: Do the dishes, fold laundry, work in your garden and walk around your neighborhood.

Patients with Parkinson’s disease are often told to engage in (vigorous) exercise, but when my colleagues and I studied 48 individuals with Parkinson’s we found that everyday activities were much more effective than occasional strenuous exercise. We discovered that it is not so much the exercise but the routine activities from daily living that protect motor skills.

Exercise is fine, but there are many barriers to exercising. These include transportation, expense and time commitment. Furthermore, people typically exercise for only a short time and a few times per week. 

Fortunately, the type of physical activity we found most effective is really just the “movements of daily life.”

Our methods for this Parkinson’s study

We explored the relationship between the duration of both non-exercise and exercise physical activity and the severity of motor symptoms over a 4-week period. We performed PET brain imaging to measure dopamine levels and used a questionnaire to learn about how physically active the patients were. We included both exercise and non-exercise activity such as household tasks.

Dopamine is a neurotransmitter or chemical messenger in the brain. It plays a part in many important functions in the brain such as voluntary movement, cognition, motivation, attention, mood and learning.

Although loss of dopamine is a key brain change for Parkinson’s patients—and has been thought to be the main reason Parkinson’s patients become more sedentary—we found that non-exercise physical activity protected motor skills even among patients with different levels of dopamine.

It may seem that the level of physical activity is more a function of the severity of the disease rather than individual behavior. However, this was not the case because we controlled our analyses for the severity of the disease based on the levels of brain dopamine determined by a PET scan.

The Catch-22 of being inactive

Sedentariness, or the tendency to be inactive, is associated with increased death and disease in older adults. People with Parkinson’s disease have an even greater tendency to be inactive if they experience motor complications like freezing of gait or falls. Such patients may develop fear of falling and as a consequence move even less. This will result in a downward spiral because with increasingly less physical activity they will decline even more.

It’s a Catch-22 situation: You’re afraid of hurting yourself, so you move less. But in actuality, moving every day is very important to maintain the mobility you have.

The message

If you have Parkinson’s and you are able to move, move. And move every day—even if you’re engaging in what you think are small tasks. You’ll feel better and keep up your mobility, too.

Next steps

Nico BohnenNicolaas I. Bohnen, M.D., Ph.D., is Director of the Functional Neuroimaging, Cognitive and Mobility Laboratory and Professor of Radiology and Neurology at the University of Michigan; staff physician in the VA Ann Arbor Healthcare System; and research investigator at U-M’s Udall Center for Excellence in Parkinson’s Disease Research.

 

 

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