11 Ways to Stay Sharp With Parkinson’s
A new Parkinson’s disease diagnosis and the onset of its hallmark symptoms—tremor, slow movement, stiffness, loss of balance—can be really discouraging. There’s no cure for the progressive neurodegenerative disease, but medications that boost dopamine in the brain can help to minimize symptoms. What’s more, you hold the key to slowing down symptom progression and maintaining your quality of life. How? Exercise—both physical and mental. Let’s dive into how working both the body and brain can help you stay sharp with Parkinson’s.
How Movement Helps Your Mind
Exercise is important for maintaining strength, range-of-motion (ROM), and balance—all things that decline as Parkinson’s progresses. “If you don’t use it, you lose it,” says Julie Safer, L.C.S.W. at the Mount Sinai Parkinson’s Disease and Movement Disorders Center in New York City. Exercise has been shown to slow down the progression of Parkinson’s symptoms, says La’Tai Jenkins, a physical therapist at Johns Hopkins Hospital in Lutherville, Maryland. Exercise not only strengthens and stretches your muscles, but also creates neurological connections between your brain and body, and it may promote more efficient dopamine use.
Start by Asking Yourself a Few Questions
Finding the best types of exercise for people with Parkinson’s depends on many different factors. Age, fitness level prior to diagnosis, and current symptoms all factor into what activities are appropriate and safe, Jenkins says. It also matters what functional goals a person wants to achieve—do you want to be able to get on the floor and play with your grandkids? Go play tennis with your friends? Working with a physical therapist and occupational therapist can help you figure out your goals and what activities are best for you.
Get Moving Now
“We see the best results with a newly diagnosed patient early on in their Parkinson’s journey,” Jenkins says. It’s more feasible to prescribe a daily exercise program when someone has minimal symptoms. Research suggests that people who establish a regular exercise habit early are able to stave off the decline in quality of life for longer. “That’s not to say we don't see improvement in someone who has had Parkinson’s for a long time or older patients,” she adds. They just might have more limitations and need to scale back on frequency and intensity to avoid getting hurt.
Focus on Large Movements
Because of the way Parkinson’s impacts the brain, physical movements become both smaller and slower, Jenkins says. “That is why their movement becomes slow, fine motor control is slow, even the voice becomes lower.” To combat that, physical therapists work with people to make movements bigger and bolder. “We really encourage them to overshoot. With the neural drive slowing everything down, the goal is to meet somewhere in the middle and produce something that looks like normal movement.” Large movements could mean swinging your arms as you walk or taking very high steps.
Make Time to Stretch
Madeline Williamson, a licensed occupational therapist and leader of the occupational therapy neurology team at University of Pittsburgh Medical Center in Pittsburgh, recommends doing a short stretching routine every morning, and ideally, a few times throughout the day. “I can’t emphasize enough how important the stretching is because that is going to help you maintain the ROM you do have so you can reach up to the cabinet, into the fridge, or down to tie your shoes,” she says. At the end of the day, it’s all about maintaining the ability to function and do daily activities without assistance.
Get in Some Cardio Every Day
“Exercise is good for anyone regardless of if they have a degenerative disorder,” Williamson says. “It helps with blood flow, brain function, strength, and ROM.” A repetitive cardio workout, like biking or walking, is also a good time to throw in some extra mental challenges if it’s safe, Williamson says. For example, naming different countries while you’re walking, or focusing on the route you’re tracking on a bike (if you’re able to bike outside). Other great forms of cardio include dancing, boxing, and running. It all just depends on a person’s physical fitness and ability to do activities safely.
Constantly Challenge Yourself
Continuing to challenge yourself is a great way to keep your brain building new connections. “We all need to challenge ourselves; that’s how we maintain or enhance what we can do,” Williamson says. This is especially relevant to training a person’s balance and coordination. You can challenge yourself during sports and workouts (just make sure a challenge is safe and not going to cause you to fall or get hurt). “As soon as tasks become easy for people, we want to bump it up and make it harder. That’s what the brain needs to produce functional change,” Jenkins says.
Fresh air and nature can be a boon to mental well-being, and something that people in the early stages of Parkinson’s should do as much as they can, Williamson says. Even watching and hearing the sounds of nature digitally can help—and may be the only option in later stages of the disease. “When you reach later stages, it can be difficult if not impossible to get out of bed. We’ll bring mental imagery to them via the computer or phone, and use noise machines to stimulate natural sounds, like ocean waves,” Williamson says.
Develop a Routine
Getting into a good daily routine can be beneficial to people with Parkinson’s, Williamson says. This doesn’t mean doing the exact same exercises every day; rather, reserving certain times throughout the day for exercise and any other therapies or activities you want to do. Following a schedule can make it easier for people to remember to do these tasks, and having some structure can also help keep people moving. Frequency and repetition of physical movements is also key for the brain. “That frequency and repetition is what the brain needs to create neural plasticity,” Jenkins explains.
Play Brain Games
“There is a level of cognitive disorder that happens with Parkinson’s and can be a side effect of the medications as well,” Safer says. Doing activities to keep your brain working—whether it’s watching Jeopardy, doing crossword puzzles, or reading—can help stave off mental decline, she says. Technology makes these tools even more accessible, especially for people with Parkinson’s who may have trouble writing with a pen or pencil, Williamson adds. “We’re so lucky to have as much technology as we do, and so many apps people can try.” Ideas? Wordscapes, Sudoku, and the New York Times Crossword.
Crank Up the Music
A research review published in the Journal of the American Medical Directors Association found that music therapy can be beneficial for treating motor and nonmotor symptoms and have a positive impact on quality of life of people with Parkinson’s. Williamson likes to incorporate music into her sessions with people with Parkinson’s. “Some research demonstrates that if someone is engaged with music and following the beat of something, it can help enhance the movement,” she says. It works by essentially activating a part of the brain that’s connected to movement, she adds.
Take Advantage of Community Wellness Programs
It can be difficult to get motivated to do physical therapy exercises on your own at home, which is why Jenkins encourages people with Parkinson’s to get involved in the active aging community in their areas. Many community wellness programs offer everything from boxing classes to chorus groups to run clubs, all for the aging community. Being involved in a community helps many people get moving and get excited about doing physical activities. It also makes for a social experience—another important way to keep the brain well-oiled—and lets you connect with other people who have similar health conditions.
Neurological Impact of Exercise: Parkinson’s Foundation. (n.d.) “Neuroprotective Benefits of Exercise.” https://www.parkinson.org/Understanding-Parkinsons/Treatment/Exercise/Neuroprotective-Benefits-of-Exercise
Benefits of Exercise: Parkinson’s Foundation. (n.d.) “Exercise.” https://www.parkinson.org/Understanding-Parkinsons/Treatment/Exercise
Benefits of Getting Outside: American Psychological Association. (2020.) “Nurtured by nature.” https://www.apa.org/monitor/2020/04/nurtured-nature
Music Therapy: Journal of the American Medical Directors Association. (2018.) “Music Therapy in Parkinson's Disease.” https://www.jamda.com/article/S1525-8610(18)30540-1/fulltext