Exercise

Exercise is an important part of managing Parkinson's disease. It can help improve balance, coordination, mobility, and reduce symptoms. 

Types of Exercise:

Aerobic exercise: Walking, biking, swimming, dancing

Strength training: Exercises with weights, resistance bands, or body weight

Balance and coordination exercises: Tai chi, yoga, Pilates, boxing

Cognitive exercises: Marching, tapping, counting, cross-body movements

In the last decade, research studies and clinical experience have upgraded the importance of exercise for people with Parkinson’s from a “nice to have” activity to an essential way to help manage symptoms and maintain quality of life. Exercise helps or even improves everything from your mood to your fatigue to muscle stiffness to tremor and constipation.

You can find local PD specific classes here: https://www.cdparkinsons.org/classes

Dance? Why should people with Parkinson's dance?

Dancing Your Way to a Better Quality of Life with Parkinson'shttps://parkinsonsdisease.net/living/dance-therapy

Dancing Helps People With Parkinson's Diseasehttps://www.forbes.com/sites/evaamsen/2019/04/30/dancing-helps-movement-for-people-with-parkinsons-disease/

“You get a sense of your body and are pushing your body to do things you con’t think you can accomplish,” says Brown, who was diagnosed in 2008 with the neuro­degenerative disease. “There is something about the music and movement together that seems to help at a different level. … I come out of the class feeling energized and relaxed, all at the same time, and ready to move.”https://stanmed.stanford.edu/2017winter/dance-for-parkinsons-disease-at-the-stanford-neuroscience-health-center.html

Evidence from more than 40 peer-reviewed scientific studies serves to underpin the effectiveness and benefits of the Dance for PD teaching approach. The program has been featured in such media channels as The New York Times, USA Today, NBC, CNN, NPR, and The Guardian and has received multiple awards for its groundbreaking work.

https://danceforparkinsons.org/

Boxing

Boxing has emerged as a popular and feasible exercise intervention for people with Parkinson’s disease. Clinical research indicates that boxing, often performed in group settings with PD-specific modifications, can improve balance, physical fitness, and quality of life - although the improvements may be modest and vary by individual. Adding techniques like kicking does not significantly enhance benefits but can increase exercise variety and motivation. Safety is generally good, with few adverse events reported in supervised programs.

1. Boxing with and without Kicking Techniques for People with Parkinson's Disease: A Randomized Controlled Trial

2. Boxing with and without Kicking Techniques for People with … - PMC

3. Effects of boxing interventions on physical fitness and health-related quality of life in older people with Parkinson's disease: a systematic review with meta-analysis.

4. Neuropsychological Effects of Rock Steady Boxing in Patients with Parkinson's Disease: A Comprehensive Analysis

Ping Pong

Come play with us at the Guilderland, Glenville, Clifton Park or Bethlehem Y and at the Parkinson's Center YMCA.

Local Ping Pong

https://www.cdparkinsons.org/exercise

Navin P. Kumar - Table Tennis Champion with Parkinson's

https://youtu.be/XLZO5kRHsL4?si=m_m3Zyd5Nb0E21H1

Ping Pong serves up therapy for mind and body among people with Parkinson's disease [CBS Mornings Health Watch]

https://youtu.be/JivSzx88f3g?si=wZOZRo2R5VPToJ9k

Can Ping Pong Help Parkinson’s? | Inside Penn Medicine’s Community Program

https://www.youtube.com/watch?v=T1xVW1Bog8g

Nenod Bach starts PPP

https://youtu.be/MvdK90m9dZQ?si=o7xRLX1AgE6OSgT5

https://www.brainandlife.org/articles/benefits-of-ping-pong-for-parkinsons-disease

Rock Climbing for PD

Up Ending Parkinson’s (UEP): Climbing for PD Therapy

Up Ending Parkinson’s (UEP) started in 2012 with the goal of providing accessible and beneficial therapeutic activities for people living with Parkinson's Disease (PD). We have worked with individuals from their mid-thirties to their early 90s and are passionate about using our experience to help others better understand and manage this multifaceted disease.

Website: https://www.upendingparkinsons.org/

Why Climbing?

UEP is dedicated to helping people with PD by raising awareness and making rock climbing an accessible therapy.1 We have seen firsthand its positive impact and recently published a study in the Archives of Physiotherapy (available in the attachment) validating its benefits.

Climbing is a full-body activity performed in a controlled, safe environment.2 It directly challenges and improves skills often affected by PD, including balance, coordination, movement speed, and planning skills.

Our local UEP chapter, started in June 2025, meets every Tuesday from 3:00 PM to 4:30 PM at:

• Hudson Boulders
  195 Troy-Schenectady Rd, Latham, NY 12110

How to Sign Up

The cost is a $20 day pass, which covers the climbing harness, chalk, and shoe rental.

Trained volunteers are provided for assistance and support.

• Registration: Walk-ins are welcome, or you can call ahead to the gym at (838) 221-7673 or use the online registration link https://hudsonboulders.com/

For more insights, you can view the recent feature on WNYT 13: https://wnyt.com/top-stories/tamara-tries-rock-climbing-for-strength-balance-at-hudson-boulders/

Remember, it’s only UP from here!

Jeremy Wood

Lead Volunteer, Up Ending Parkinson’s - Hudson Boulders, Latham NY

518-791-7362

Swimming

If you have not gone swimming for some time, and you want to add swimming to your exercise routine, start with a short s[[ession in shallow water. Even if you are (or were) a strong swimmer, PD-related motor impairments—such as bradykinesia, rigidity, and impaired coordination—can make swimming challenging and even pose safety risks like near-drowning.

I know, it happened to me. After more than 10 year as a life guard, water safety instructor and waterfront director, and able to handle myself in any water conditions, I lost my sence of "up" after swimming for about 20 minutes. I was able to stop and find the top of the water, but I have found other types of exercise that don't cause that knd of worry.

Swimming is a beneficial form of aerobic and resistance exercise for people with Parkinson’s Disease. It offers support to joints due to buoyancy, improves cardiovascular health, and can aid in muscle strengthening and flexibility. However,  Dopaminergic medications, compensation strategies (like using swim fins or internal cueing), and supervision significantly improve safety and swimming ability. Consulting a healthcare provider and incorporating swimming thoughtfully into an exercise regimen can enhance physical and emotional wellbeing in PD

Benefits of Swimming in Parkinson's Disease

Swimming is an excellent low-impact aerobic exercise, which is especially valuable for individuals with PD who may suffer from joint pain or muscle stiffness. The water's buoyancy reduces stress on weight-bearing joints, providing a supportive environment for exercise. Swimming can:

• Increase cardiovascular and respiratory fitness.

• Improve muscular strength and flexibility.

• Aid balance and coordination through resistance from water.

• Enhance mood and reduce fatigue through physical activity.

This can lead to improvements in stamina, mobility, and quality of life.

Challenges and Risks Specific to PD

Despite its benefits, swimming poses unique challenges to people with PD due to:

• Bradykinesia (slowness of movement): This can impair limb coordination and reduce swimming speed.

• Muscle rigidity and stiffness: May cause difficulty in stroke fluidity.

• Impaired interlimb coordination: Increases the risk of difficulty maintaining balance and propulsion in the water.

• Postural instability: May cause difficulty floating or maintaining horizontal position.

• Fear of falling or drowning: Real concerns as near-drowning events are reported.

A survey of 309 people with PD showed that nearly 88% noticed swimming capacity decline, and about half experienced near-drowning events, highlighting safety concerns [ https://pmc.ncbi.nlm.nih.gov/articles/PMC7328419/ ].

Medication and Compensation Strategies

Dopaminergic therapy (like levodopa) improves bradykinesia, which can enhance swimming ability but usually does not fully restore coordination. Nonpharmacological compensation strategies are valuable:

• Using swim fins to increase leg propulsion and water displacement.

• Internal cueing techniques, such as counting strokes to improve rhythm.

• Using a floatation aid or focusing on leg-only strokes to bypass impaired arm-leg coordination.

• Having supervision or swimming with a buddy for safety.

Practical Considerations for Swimming with PD

• Consult healthcare professionals before starting swimming; physiotherapists can provide personalized advice.

• Warm-up and stretching before swimming reduce stiffness and aid posture.

• Swimming aids: Floats, noodles, or fins can help maintain safety and improve movement.

• Swimming environment: Pools with ramps, non-slip tiles, less crowded times, and warm water are preferable.

• Start slowly and increase duration from 10-15 minutes to longer as tolerated.

• Adapt to outdoor swimming cautiously, with safety measures such as swimming with others and using wetsuits if needed.

If you are considering swimming as part of your PD management plan, discussing with your healthcare team is essential.

Swimming Safety Checklist

Swimming Safety Checklist: For People with Parkinson’s & their care partners

1. Pre-Swim Preparation

• [ ] Physician Clearance: Has the swimmer discussed aquatic exercise with their neurologist?

• [ ] DBS Review: If the swimmer has Deep Brain Stimulation, have they been warned that "land success" does not always equal "water safety"?

• [ ] The "Buddy" Rule: Is there a dedicated person in the water or on the deck specifically watching this swimmer? (Never swim alone).

2. Entry & Environment

• [ ] Safe Access: Use a ramp or stairs with a handrail. Avoid ladders or diving.

• [ ] Depth Check: Ensure the swimmer stays in "chest-deep" water or remains close to the pool edge.

• [ ] Lifeguard Brief: Has the on-duty lifeguard been notified about the swimmer’s condition?

3. Mobility & Coordination Assessment

• [ ] Horizontal Stability: Can the swimmer maintain a flat position without their legs sinking?

• [ ] Stroke Sync: Are the arms and legs moving in a coordinated rhythm?

• [ ] Treading Water: Can the swimmer keep their head above water for 30 seconds without assistance?

• [ ] Breathing: Is the swimmer able to time their breaths without gasping or swallowing water?

4. Warning Signs (Stop Immediately if:)

• [ ] Swimmer is struggling to stay horizontal.

• [ ] Movements become excessively "small" or "frozen."

• [ ] Sudden loss of coordination (common with DBS settings).

• [ ] Increased tremors or visible fatigue.

💡 Why This Matters

• The Benefit: Water reduces fall risk and builds strength/posture.

• The Risk: Nearly 50% of Parkinson’s swimmers in a major study reported near-drowning experiences due to sudden coordination loss.

• The DBS Factor: Deep Brain Stimulation can improve walking but may "short-circuit" the complex coordination needed for swimming. Always re-test skills after a DBS adjustment.

What is Parkinson’s disease?

Parkinson’s disease (PD) is a progressive neurodegenerative disorder primarily affecting movement but also causing non-motor symptoms such as sleep disturbances, mood changes, and cognitive challenges. Diagnosis relies on clinical evaluation, and while there is no cure, a variety of medications, therapies, and lifestyle approaches can help manage symptoms. Many trusted organizations provide regularly updated FAQ resources for patients and caregivers to aid understanding and day-to-day management

Myths around Parkinson’s Disease

Myths around Parkinson’s Disease are common but can hinder early diagnosis and effective treatment. Understanding and sharing accurate information helps improve outcomes and reduce stigma for those affected. Continued education for patients, families, and providers is vital.

Myth: Everyone with PD has tremor

Everyone with PD has tremor

About 80% of patients experience tremor, but many do not, especially early on. Some have primarily stiffness or gait problems.

Tremor is common and recognizable but not universal. PD symptoms vary greatly among individuals.

Myth: Levodopa stops working after 5 years

Levodopa stops working after 5 years

Levodopa remains effective for decades; reduced duration of benefit is due to disease progression, not drug toxicity.

Early fears of "levodopa phobia" led patients to delay treatment unnecessarily. Dyskinesias and wearing off are related to disease progression, not levodopa itsel

Myth: PD is a death sentence

PD is a death sentence

PD itself is not fatal; it is a progressive disease but with proper care, many live many years. Complications like falls or pneumonia can be serious.

Quality of care, exercise, and symptom management significantly affect longevity and quality of life[1], [2].

Myth: PD is always genetic

PD is always genetic

Only about 15% of cases report a family history; most cases are sporadic influenced by environmental toxins and aging.

While some genes have been identified, genetics account for a minority of PD cases[3].

Myth: PD only affects movement

PD only affects movement

PD causes many non-motor symptoms including sleep issues, anxiety, depression, cognitive changes, constipation, and fatigue. These often precede or are more disabling than movement symptoms.

Most focus is on motor signs like tremor or stiffness, but non-motor symptoms significantly affect quality of life and require treatment attention.

How is Parkinson’s diagnosed?

How is Parkinson’s diagnosed?

Diagnosis is clinical, based on history and physical examination by a neurologist, preferably a movement disorder specialist. Imaging and tests are primarily used to exclude other conditions.