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A physical therapy referral should be at the top of the to-do list after a diagnosis of Parkinson's Disease. It is the gold standard for PD care. Several years ago when I was working at the University of Washington we applied to be a Center of Excellence for PD and one of the questions was, "Are you referring to PT at time of diagnosis?" This is how essential it is---it is a must for any center that wants to be the best. Establishing a relationship with a PT will be key to lifelong fitness and health. Unfortunately, it is not yet the norm.
PTs all over the country have been trying to change this for decades. I can not tell you how much pleading I've done with patients, families, and providers to start PT right away. It doesn't mean you need to sign yourself up for 1-2 per week for 2 months. It means, get in the door, learn a few keys for fitness specific to PD, and come back every 1-2 years. The earlier the better.
The research on the disease modifying affects of exercise is promising. The Park-N-Shape trial (van der Kolk, et al. Effectiveness of home-based and remotely supervised aerobic exercise in Parkinson's disease: a double-blind randomised controlled trial. Lancel Neurol. 2019;Nov18(11):998-1008) was published in 2019 and evaluated the effects of aerobic exercise in the home setting.
How it works
There were two groups in the study. All persons were Hoehn and Yahr 2 or lower, so they participants were only mildly affected by Parkinson's Disease. One group exercised at home on a stationary bike for 6 months, 4 days per week for 30-45 minutes at an aerobic threshold (goal of 80% of heart rate max) and the other group did an equal amount of stretching.
The outcomes
The group who did aerobic exercise scored 4.2 points more on the motor scale of the Unified Parkinson's Disease Rating Scale after 6 months, indicating a significant difference in motor function for daily activities.
The Parkinson's Foundation has many resources on their page to get started if you can not find the right person right away. The site also has details about the neuroprotective effects of exercise on the disease.
So if you were just diagnosed with PD, know someone who was, or you have PD and haven't been to see a PT - reach out ASAP for resources. There is so much that exercise, the right exercise, can do for the disease. It is one of the few parts you can control.
Ashley Stanley PT, DPT
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