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Parkinson Disease and Exercise

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Parkinson disease (PD) is a progressive, neurodegenerative movement disorder. PD was originally attributed to neuronal loss within the substantia nigra pars compacta, and a concomitant loss of dopamine. PD is now thought to be a multisystem disorder that involves not only the dopaminergic system, but other neurotransmitter systems whose role may become more prominent as the disease progresses (). PD is characterized by four cardinal symptoms, resting tremor, rigidity, bradykinesia, and postural instability, all of which are motor. However, PD also may include any combination of a myriad of nonmotor symptoms (). Both motor and nonmotor symptoms may impact the ability of those with PD to participate in exercise and/or impact the effects of that exercise on those with PD. This article provides a comprehensive overview of PD, its symptoms and progression, and current treatments for PD. Among these treatments, exercise is currently at the forefront. People with PD retain the ability to participate in many forms of exercise and generally respond to exercise interventions similarly to age‐matched subjects without PD. As such, exercise is currently an area receiving substantial research attention as investigators seek interventions that may modify the progression of the disease, perhaps through neuroprotective mechanisms. © 2013 American Physiological Society. Compr Physiol 3:833‐848, 2013.

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Figure 1. Figure 1.

Hypothetical “disease‐modifying” effects of vigorous physical exercise in individuals with PD. Adapted from the “Milestone Model” of Parkinson's disease progression (). Disease burden is represented by the color bar with brighter colors representing worsening of symptoms and greater disease burden. We suggest that physical exercise may attenuate or delay the progression of symptoms of PD and thereby reduce disease burden as a function of time.

Figure 1.

Hypothetical “disease‐modifying” effects of vigorous physical exercise in individuals with PD. Adapted from the “Milestone Model” of Parkinson's disease progression (). Disease burden is represented by the color bar with brighter colors representing worsening of symptoms and greater disease burden. We suggest that physical exercise may attenuate or delay the progression of symptoms of PD and thereby reduce disease burden as a function of time.

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Gammon M. Earhart, Michael J. Falvo. Parkinson Disease and Exercise. Compr Physiol 2013, 3: 833-848. doi: 10.1002/cphy.c100047