Exercise as Medicine: Don't Forget Your Daily Dose!

Exercise is a powerful tool that has been shown in numerous studies to delay the progression of Parkinson’s disease and to even improve existing symptoms. As more research is performed and more sophisticated tools are used to analyze the effects of exercise, it is becoming more and more evident that everyone with PD should be exercising!  

In an attempt to help spread the word on the benefits of exercise, we will be presenting a series of blogs that go into detail on this topic. In this initial discussion, we will introduce the top 10 reasons why individuals with Parkinson’s disease should exercise and elaborate on the #1 REASON for individuals to exercise.  Stay tuned to the upcoming blogs as we will be going into more detail and presenting the latest research regarding these 10 benefits of exercise!

Here are the TOP 10 reasons why everyone with PD should get moving…

10. Exercise helps your muscles and joints loosen up so you can Move Better

9. Exercise helps your brain use dopamine better – both the dopamine you are naturally producing and the dopamine in your medication - so you may have a Better Response to Medication

8. Exercise has been shown to Decrease Tremor

7. Exercise improves your Balance, which prevents falls

6. Exercise improves your Mood, which can prevent depression

5. Exercise improves Digestion, which helps prevent constipation

4.  Exercise helps you Sleep Better

3. Exercise gives you More Energy to last through the day doing things you enjoy

2.  Exercise improves your Thinking and Memory

1.  Exercise may help delay the progression of PD through Neuroplasticity!

To begin, let’s explore the #1 reason exercise can change your life!... 

Reason #1: NEUROPLASTICITY

Neuroplasticity is the process by which the brain adapts to new experiences and modifies the current circuitry to “learn” a new behavior. Exercise is one key that allows your brain to make important changes. This process can be identified scientifically by words such as neurogenesis, synaptogenesis, neuronal sprouting, etc.  In reality, it does a large variety of things. Neuroplasticity can refer to small scale changes, such as those on a cellular level, and also to large scale changes that involve cortical remapping. 

 

One of the revolutionary studies that made the connection of behavioral interventions leading to positive neuroplastic changes was performed by Randolph Nudo in 1996.  In this study, Nudo and colleagues were able to map out the area in the brain that functioned to control various body parts, but in particular- the fingers, hands, and arms. Then the researchers induced a very small lesion in the brain, similar to a small stroke, which lead to impaired hand movement. Subsequently, they provided skilled training that required the monkey to learn to use its hand again.  Nudo and colleagues then re-mapped the same area of the brain in both the monkeys that had hand training and those that did not. It turns out that the monkeys that were challenged with the task of getting a small item (pellet) out of a jar using their hand had significant more representation of their hand in the area that surrounded the infarct. The results of this study suggests that when areas of the brain become injured that the “real estate” that surrounds the injuries can be used to take over function and ultimately lead to recovery. 

In a subsequent study by Plautz et al. 2000, they compared the results of a very similarly designed study, but they used two different methods of hand training. One group of monkey’s were required to get a small pellet out of a large jar, which was relatively simple and did not require the monkey to “learn a new skill”.  In contrast the other group of monkeys were required to get a small pellet out of a small jar.  This required the monkey’s to make multiple failed attempts and to figure out how to best accomplish the task. When the cortical mapping was reevaluated, the group of monkeys that practiced getting the pellet out of the large jar did not show any task related cortical changes, and the group of monkeys that were given a more challenging task showed neuroplastic changes.  Therefore, the results of the study suggest that if an exercise is too easy, it might not lead to the necessary changes in the brain for recovery.  

These studies highlight the importance of picking the right type of exercise to drive Neuroplasticity. Here are some other factors to take into consideration and questions to ask yourself when choosing the right type of exercise for you…and YOUR BRAIN!

Principles to Drive Neuroplasticity:

1.    Difficulty Matters

a.     Does the activity or exercise program challenge you?

2.    Intensity Matters

a.     Are you constantly making your exercise activity harder overtime?

3.    Specificity Matters

a.     Are you challenging the parts or movements of your body that you want to see the most improvements?

4.    Repetition Matters

a.     Are you practicing your task frequently enough or for enough repetitions that you see improvement overtime?

5.    Time Matters

a.     Are you being proactive about your health and taking steps to prevent symptoms from coming on?

6.    Salience Matters

a.     Are the activities you are doing meaningful to you?

The fact is that there are multiple forms of exercise that have been shown to provide benefits to individuals with PD, such as Boxing, Tai chi, Cycling, etc., but the most important form is the one that individuals will actually do and enjoy! If you take away anything from this blog, I hope you remember to just keep moving!- and don’t do it for me, do it for your BRAIN!

Want to learn more about exercising for brain health?  Check us out at www.reactivept.com.

 

References:

1.    Nudo, R.J., et al., Neural substrates for the effects of rehabilitative training on motor recovery after ischemic infarct. Science, 1996. 272(5269): p. 1791-4.

2.     Petzinger, G.M., et al., Exercise-enhanced neuroplasticity targeting motor and cognitive circuitry in Parkinson's disease. Lancet Neurol, 2013. 12(7): p. 716-26.

3.     Plautz, E.J., G.W. Milliken, and R.J. Nudo, Effects of repetitive motor training on movement representations in adult squirrel monkeys: role of use versus learning. Neurobiol Learn Mem, 2000. 74(1): p. 27-55.