Is vigorous exercise a miracle for Parkinson’s?

 By Lee Evslin, MD - Special to The Garden Island |  January 10, 2018

Lee Evslin, MD

Two years before my mother died, she asked me to take her to the pool in her assisted living center. She had been battling Parkinson’s for 18 years and was not able to move well.

When we got to the pool, I noticed that the lifeguard was looking at her with some apprehension. I asked her why he looked so nervous. She replied that the last time she had come to swim, she sank to the bottom and had to be saved. She said that the near drowning was not her first.

She went on to say they had actually banned her from the pool but she hoped they would let her swim with me present. I grudgingly accepted the role I was given and they let her swim again. It was the last time she used the pool. This column is an apology to her.

Parkinson’s disease, as too many of us know, is characterized by a slow, shuffling, stooped over gait sometimes accompanied by tremors and the gradual progression of disability.

Several years ago, I read a fascinating account of a man who had been diagnosed with Parkinson’s disease 10 years previously. He had almost completely reversed his symptoms. He stated that he done this by a vigorous exercise program. His reversal was so dramatic that he was accused of faking his original Parkinson’s diagnosis. His story was written up in a book by Norman Doidges, MD entitled, “The Brain’s Way of Healing.”

Because this was just one man’s story, it did not meet the criteria of proving that there was now a miracle cure for Parkinson’s. But there is now increasing evidence that he was on to something very important.

A doctor at the Cleveland Clinic had another interesting story. He took a patient with Parkinson’s on a tandem bicycle and noticed that her symptoms were dramatically better after the ride. The improvement was temporary but appeared quite real.

Since then the Cleveland Clinic has done a study showing improvement with stationary bicycle use for patients with Parkinson’s. There is also a YouTube video that went viral. It showed a man with Parkinson’s disease that is so severe that he can barely walk. He then gets on a bicycle. He rides it almost normally before he gets off and starts to shuffle again.

Last week, the New York Times reported on a study just published this month. This study provides even more evidence that vigorous exercise can have a dramatic impact on the progression of Parkinson’s.

The study enlisted patients from multiple universities. The patients were divided into three groups. One group had no change in their exercise routine (meaning very little exercise), one group did moderate exercise on a treadmill and the third group did vigorous exercise, also on a treadmill. They exercised for one half hour 3-4 times per week. The study followed them for six months.

The results showed the expected progression of Parkinson’s disease in the first two groups and virtually NO progression of disease in those that had been in the vigorous program. All of these patients were in the very early stages of Parkinson’s. They were not yet on medication and they were only followed for six months. Hopefully, there will now be many more studies looking at longer periods of time and at different stages in the disease.

Fortunately though, even before this study came out, the word has been spreading that vigorous exercise may dramatically decrease Parkinson’s symptoms. Dance, boxing routines, tai chi like exercises and even Xbox programs are being used increasingly by those who carry this diagnosis and increasingly their stories are of positive results.

It seems that it is important that the exercise be safe and vigorous. It has been proposed that large motions appear to be important. An example of this would be large steps and big arm swings when walking. These large motions are the opposite of how one with Parkinson’s might walk.

Nobody is quite sure why exercise seems to make such a difference. Theories have ranged from increased blood flow to the brain to the possibility that exercise is training another part of the brain to do what the usual part of the brain can no longer do.

If I had Parkinson’s, I would not wait though for further studies or proof of how it works. I would find safe ways to be very active.

My mother valiantly battled Parkinson’s for 20 years before she died. She loved to exercise but after her Parkinson’s became more severe she fell and broke her hip and as mentioned above, several times she had near drownings.

As concerned children, we pushed her hard to use her wheelchair and to stop swimming. She listened to us, perhaps because three of her children were in the medical field. She listened to us despite the fact that she was desperate to exercise.

Mom, we were wrong and your instincts were right. We should have found a way for you to safely exercise vigorously and often. I am sorry and I hope you can hear me.

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Lee Evslin, MD is a retired primary care physician. He was former CEO of Kauai Medical Group and Wilcox Hospital. His columns cover recent research on health issues. The information presented here should not be taken as medical advice but only as a sharing of information.

http://www.thegardenisland.com/2018/01/10/lifestyles/is-vigorous-exercise-a-miracle-for-parkinsons/