Exercises for Parkinson’s Disease

Parkinson’s disease gradually impacts your brain and body over time. It can affect almost every aspect of movement, from walking and talking to digestion. Although there is no cure for Parkinson’s, combining exercise with other medical treatments can help slow the worsening of symptoms.

“I always tell my patients that Parkinson’s is a condition you manage indefinitely. The good news is that exercise has been shown in research to help delay, and even prevent, mobility problems,” says Kelly Hussey, PT, DPT, a Mass General Brigham physical therapist. Hussey is a board-certified neurologic clinical specialist and senior physical therapist in the Department of Physical Therapy and Occupational Therapy at Massachusetts General Hospital.

She works closely with providers in the Mass General Parkinson's Disease and Movement Disorder Center, recognized by the Parkinson's Foundation as a Center of Excellence for Parkinson’s research, clinical care, community education, and outreach. With the right treatment from an expert Parkinson’s disease care team, you can successfully manage symptoms for many years to come.

“Some things feel very out of control when you have Parkinson’s,” Hussey says. “Parkinson’s exercises can be one way to fight back against the disease.”

Management of Parkinson’s disease symptoms

People with Parkinson’s experience mobility-related symptoms, including:

• Tremors
• Misjudging movement, such as missing what you are reaching for or colliding with objects while walking
• Problems doing two things at once, like walking and talking
• Slow or small movements
• Sudden inability to move
• Tightness that makes it hard to turn the body
• Trouble moving from sitting to standing and other balance-related movements

The movement issues that come with Parkinson’s disease can lead to other problems, such as:

• Decreased flexibility and endurance
• Pain, weakness, and stiffness
• Poor posture
• Shuffling with shorter, smaller steps while walking
• Unsteadiness and risk of falling

“We know what the issues from Parkinson’s will lead to, and we try to prevent them before they start. We educate people about the importance of exercise as soon as they are diagnosed,” Hussey says. “For instance, stretching and using your full range of motion helps maintain flexibility and may help prevent stiffness or pain.”

Research shows improvement with Parkinson’s exercises

Changes in brain chemistry lead to Parkinson’s symptoms. But research shows regular exercise can improve brain function for Parkinson’s patients.

A study on exercise and Parkinson’s published in the Annals of Neurology in 2022 examined the effects of exercise on the brain. Researchers discovered that aerobic exercise improves how your brain controls your body, including a reduction in Parkinson’s movement problems.

“This study suggests aerobic exercise can improve how people with Parkinson’s think and feel,” Hussey says. “Exercise helps your muscles, heart, and lungs get stronger, and makes positive differences in your brain. The research is really exciting because it supports what we already see happening with patients.”

Work with a physical therapist for Parkinson’s exercises 

Whether you have never exercised or are picking it back up, Hussey suggests starting with a physical therapist who specializes in movement disorders.

“For some people it can be difficult to get started or know what is appropriate. Physical therapists understand Parkinson’s symptoms and create personal exercise programs,” Hussey says. “We test people to find out their current fitness level and then design a program to make exercise challenging and successful.”

The physical therapist recommends exercises for your symptoms and condition. The therapist also shows you safe ways to exercise if you have trouble with balance or you use a walker or cane. It’s also a good idea to return to a clinic once or twice a year to have a therapist reevaluate your exercise routine.

Hussey recommends finding a physical therapist who is a board-certified neurologic clinical specialist. Some therapists are additionally certified in LSVT Big. LSVT Big is a training method that teaches Parkinson’s patients how to use extra effort to produce bigger, more normal motions.

Simple exercises for Parkinson’s disease

Most people with Parkinson’s can do some simple exercises at home. “The best time to start exercising is right now. It’s never too early to start, even if you don’t have many symptoms. Also, it’s never too late,” Hussey says.

Always ask your doctor or physical therapist if it’s safe for you to exercise at home. When you get the green light, Hussey suggests making sure your workout has exercises in four categories:

Aerobic

High-intensity interval training (HIIT) increases your heart rate with short bursts of energy. It boosts metabolism and is good for your heart, lungs, and brain. Try walking at a normal pace for 2 minutes and alternating it with a faster pace for 1 minute. Aim for a total of 30 minutes a day, 3 to 5 times a week. You can get the same benefits on a stationary bike, elliptical machine, or exercising in the water.

Stretching

Daily stretching exercises help relieve stiffness from rigid muscles. There are lots of different stretching exercises. For instance, lay on your back with your feet flat on a bed or the floor. Bend your knees and let your knees gently fall from side to side. 

Balance and agility

Try standing on one foot for 10-30 seconds without using your hands to balance, then switch feet. Close your eyes or change the position of your feet for an extra challenge. Stand in the corner or next to a counter for safety.

Hussey recommends downloading a free booklet from the American Parkinson Disease Association, “Be Active & Beyond: A Guide to Exercise and Wellness for People with Parkinson’s Disease.” The booklet contains pictures of strengthening and stretching exercises with instructions that you can follow at home.

If you prefer group fitness classes, Hussey recommends tai chi, boxing, or dance, which all combine multiple benefits of exercise. “Look for local classes in your community. Some are specifically for people with Parkinson’s disease and older adults,” Hussey says.

Mass General Brigham offers a free virtual exercise class for people with Parkinson’s disease. You can join live using Zoom with your computer or mobile device. You can also exercise on your own time with recorded sessions. To request a Zoom link and more information about the virtual class, email parkinsons@partners.org.

Hussey suggests thinking of exercise as a prescribed part of Parkinson’s management. “Sometimes people struggle to fit exercise in, but the same people take medication regularly,” Hussey says. “You should think of exercise as a form of medicine for Parkinson’s disease. Try different exercises and change them up sometimes. Have something you do at home each day and find fun ways to keep exercising.”