Which Exercise Is The Best Time Investment?
The question is no longer whether to exercise - the question is which exercise should an individual spend their time doing? And the ever-challenging question of how to stay motivated to exercise.
When I was in physical therapy school, we joked that our professors would always answer “it depends.” Now that I study and teach physical therapy, I know how true that answer is.
The best exercise for you … depends …
… It depends on your abilities, your goals, your preferences, and your community resources.
Let’s start with preferences and resources. Find exercises that are enjoyable and convenient in both location and cost. If you need help finding local resources, ask your neurology center coordinator, physical therapist, or in the absence of a local care team, the Parkinson’s Foundation helpline can you find local resources – you can call 1-800-4PD-INFO (473-4636) or email helpline@parkinson.org.
How can physical therapy help?
Next, let’s think about which exercise is best based on your abilities and goals. This can be the trickier piece which is part of the reason most people with Parkinson’s, even those who are early after diagnosis, can benefit from physical therapy.
Physical therapy can be just one session for an evaluation and an exercise consultation. Sometimes it’s best to follow-up on these every 6-12 months in the dental model.
Physical therapy could be 1-2 sessions a month to help you monitor and modify your exercise and mobility program over time.
Physical therapy can be 2-3 times per week for a couple months to treat a movement problem then transition to more independent exercise.
Physical therapists, especially those with expertise in Parkinson’s disease, will evaluate balance, walking, mobility, and exercise. They will then prescribe a personalized exercise program. Different countries have different reimbursement policies for physical therapy, which is important to consider. However, if a Parkinson’s-trained physical therapist is accessible to you (location, cost, possibly telehealth), they can help you find the best exercise for you based on your abilities and goals, as well as your preferences and community resources.
Where to start if you don’t have a physical therapist yet?
Unfortunately, not everyone has access to physical therapists. And even if you do, reimbursement policies (to my knowledge) never support physical therapists to be the go-person to help a person with their day-to-day exercise routine. Community exercise professionals, including certified personal trainers and group exercise instructors can also develop expertise in Parkinson’s disease. They can become a great addition to your care team. If you know an exercise professional who wants to learn more about Parkinson’s disease, the Parkinson’s Foundation has resources for them.
The Parkinson’s Foundation worked with expert researchers and exercise professionals to develop Parkinson’s Foundation’s Parkinson’s Exercise Recommendations. The recommendations say that individuals with Parkinson’s should try to get about 150 minutes of at least moderate intensity aerobic exercise, with at least 2 days a week of strengthening exercise. The recommendations also include two additional types of exercise: stretching and balance, agility, and multi-tasking. Ideally, people should try activities that blend these four types of exercise. The guidelines themselves can be overwhelming and feel like a full-time job of exercise! Creating a comprehensive but manageable weekly program is where skilled exercise professionals or Parkinson’s-specific group exercise programming can help.
Miriam Rafferty, DPT, PhD Director of Implementation Research, Research Scientist II, Shirley Ryan AbilityLab, Assistant Professor, Department of Physical Medicine and Rehabilitation, Northwestern University. She will be speaking at the WPC 2023 Congress in Barcelona on the topic of “Exercise for Life”. View the full Scientific Program here.
Ideas and opinions expressed in this post reflect that of the author solely. They do not reflect the opinions or positions of the World Parkinson Coalition®