Medical Health Encyclopedia

Exercise early in adult life may help protect men against later development of Parkinson’s disease. Exercise is also an important component of rehabilitation. Physical therapy is extremely important for the Parkinson's patient and usually follows an approach that uses active and passive exercise, gait training, practice in normal activities, and if needed, hot or cold treatments, water therapy, and electrical stimulation. Exercise is also essential for well-being; it is a common denominator in patients who are able to maintain productive years. To date, no specific approach has been proven to be better than others.

Exercise Programs. Exercise programs are used defined as passive or active.

• Passive exercise, mostly stretching and manipulation of muscles by a physical therapist, is aimed at preventing muscles from shortening. A passive exercise program that begins with slow and gentle exercises and becomes progressively more intense may improve mobility in patients with early and mid-stage Parkinson's disease.
• Active exercises are used to help range-of-motion, coordination, and speed. Patients should continually make efforts to practice movement, even simple ones, such as marching in place, making circular arm movements, and raising the legs up and down while sitting. Patients who enjoy sports or the use of exercise equipment should continue with these activities even if their skills diminish, assuming there are no other medical conditions that would prevent them.

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Gait Training. Practicing new methods for standing, walking, and turning may help retain balance. The following tips may be helpful:

• Take large steps when walking forward, raising the toes at the forward step, and hitting the ground with the heel.
• Take small steps while turning.
• When walking or turning, have the legs 12 to 15 inches apart to provide a wide base.
• Do not wear rubber or crepe-soled shoes because they grip the floor and may cause the patient to fall forward.
• Using devices that keep a rhythmic beat, such a metronome (a simple device used by musicians to keep time), may be very effective, possibly more than music itself, in helping patients to walk faster and take longer steps. One study found that setting a metronome rhythm to about 10% faster than the patient's fastest gait offers significant improvement over walking to no rhythm at all or to a rhythm that matches the gait.