Physical exercise and Parkinson’s disease: influence on symptoms, disease course and prevention

Abstract

Parkinson's disease (PD) is a common, disabling, neurodegenerative condition, and the disease prevalence is expected to increase worldwide in the next few decades. Symptomatic therapy remains unsatisfactory, and greatly needed neuroprotective therapies have not been successfully developed so far. Physical exercise (PE) has been associated with a lower risk of developing a neurodegenerative disease. The literature has been searched, and results have been systematized and interpreted with regard to the effects of PE in PD. Published data show the following: 1) PE has been associated with a lower risk of developing PD; 2) PE has been shown to improve disease symptoms, mobility, balance, gait and quality of life (in this regard, walking training, tai-chi and tango dancing have demonstrated the highest level of evidence of efficacy); and 3) neuroprotective effects from PE could be expected in PD, although this has been suggested in animal studies only. Further research on this topic should be encouraged. Multidisciplinary cooperation between neurologists, sports physicians and researchers is paramount.

Back to the basics: Regular exercise matters in Parkinson's disease: Results from the National Parkinson Foundation QII Registry study

“…Physical activity has been shown to improve the physical functioning of PD patients, including reducing falls [8], increasing muscle strength [9], improving gait [10] and mobility [11]. There is also data on improved quality of life (QOL) with physical activity [12]. Conversely, sedentary behavior in PD patients is associated with negative outcomes such as falls [13], worsening symptomatology of PD, comorbidities such as cardiovascular disease, and increased risk of mortality [14].…”

The potential of light therapy in Parkinson's disease

“…They are either presently at a very early phase of clinical trial, with no clear outcome or they have yielded mixed results after trial. 30 These treatments vary greatly in approach, for example, changing the phenotype of neurons (gene therapy, introduction of viral vectors), 31 introducing trophic factors that increase neuronal survival (eg, glial cell line-derived neurotrophic factor), 32 stimulating neurogenesis, 33 increasing patient exercise programs, 34 and finally, changing dietary intake, for instance, using antioxidants (eg, coenzyme Q10), fish oil, and vitamin E. 35 Light therapy, specifically low-level laser therapy of red to infrared light, is an emerging, putative neuroprotective treatment that, as with the aforementioned treatments, is showing promise at the basic science level. It awaits rigorous exploration at the clinical level for Parkinson's disease, but given its novel mode of application (see below; "What is light therapy and how does it offer neuroprotection"), we are very hopeful of positive outcomes for many patients.…”

Activity engagement and health quality of life in people with Parkinson’s disease

“…A growing body of literature provides evidence that engagement in physical leisure activities can be helpful to people with PD in reducing neuropsychiatric symptoms such as fatigue, depression and apathy, improving cognitive function, and enhancing motor performance [12][13][14][15]. In particular, dance has been found to improve balance and posture in people with PD.…”