Empowering Movement and Inclusion on World Parkinson’s Day

Today is World Parkinson’s Day, a global opportunity to raise awareness about Parkinson’s disease and the importance of creating inclusive spaces for those living with this condition. As fitness professionals, we can play an important role in fostering environments that empower individuals with Parkinson’s to stay active, connected, and confident. Exercise is not only beneficial for physical health but also has profound effects on emotional well-being and social connection—two key factors in managing Parkinson’s disease effectively.

The Growth Rate and Impact of Parkinson’s Disease

Parkinson’s disease is the fastest-growing neurological condition globally, with over 10 million people currently living with the disease worldwide. In Australia, more than 150,000 individuals are affected, and the incidence continues to rise at a rate of approximately 4% annually, driven by population aging and improved diagnostic capabilities.

This steady growth places significant strain on healthcare systems and economies. For example, Parkinson’s disease costs the Australian healthcare system over $10 billion annually, including expenses for hospitalizations, medications, and caregiving support. Notably, Young-Onset Parkinson’s Disease (YOPD) accounts for 10–20% of all Parkinson’s cases, affecting individuals in their 20s to 50s.

The Physical Symptoms and Their Impact on Exercise

Parkinson’s disease is a progressive neurological disorder caused by the loss of dopamine-producing neurones in the brain. Dopamine is essential for smooth and coordinated movement, and its depletion leads to the hallmark symptoms of the disease: tremors, rigidity, slowness of movement (bradykinesia), and impaired balance.

Tremors: These involuntary shaking movements often begin in the hands or arms while at rest. Tremors can make it challenging for participants to hold weights, maintain posture, or perform precise movements.

Rigidity: Muscle stiffness occurs in both flexor and extensor muscles, restricting range of motion and causing discomfort during exercise. For example, rigidity in the trunk can make twisting or stretching exercises difficult.

Bradykinesia: Slowness of movement affects coordination and reaction time, making activities like walking or transitioning between exercises more laborious.

Balance Issues: Postural instability increases the risk of falls, particularly during dynamic movements like lunges or step-ups.

Why Exercise Matters for Parkinson’s Disease

Exercise is more than healthy—it is medicine for individuals with Parkinson’s disease. Research shows that regular physical activity can improve motor symptoms like balance, mobility, and gait while also addressing non-motor symptoms such as depression and cognitive decline.

Studies have revealed that individuals who exercise at least 2.5 hours per week experience a slower decline in quality of life compared to those who start exercising later. High-intensity aerobic exercise has even shown potential neuroprotective effects, helping slow disease progression.

Strategies for Accommodating Exercises

Symptoms vary in severity among individuals but can significantly impact their ability to engage in physical activity. Fitness instructors must adapt exercises thoughtfully to accommodate these challenges while ensuring participants feel safe and supported.

1. Prioritise Safety

Safety should always be the first consideration when designing exercises for Parkinson’s participants:

- Use stable equipment: Incorporate chairs or railings to provide support during exercises.

- Supervised sessions: Offer close supervision to prevent falls or injuries.

- Warm-up and cooldown: Ensure proper stretching before and after workouts to reduce stiffness and prevent strain.

2. Modify Exercises for Tremors

Tremors can make holding equipment or maintaining precision difficult:

- Use lightweight equipment like foam dumbbells or resistance bands.

- Focus on open-hand movements rather than gripping weights tightly.

- Provide seated options for exercises requiring fine motor control.

3. Adapt for Rigidity

Rigidity restricts range of motion:

- Incorporate flexibility exercises like yoga or Pilates to improve mobility.

- Use dynamic stretches targeting stiff areas such as the shoulders, hips, and trunk.

- Encourage slow progressions to avoid discomfort.

4. Address Bradykinesia

Bradykinesia impacts coordination:

- Break complex movements into smaller steps.

- Focus on rhythmic activities like walking/marching to improve motor function.

- Use music or verbal cues to help participants maintain timing.

5. Balance Training

Balance issues increase fall risk:

- Incorporate dynamic balance exercises that emphasize weight shifting.

- Practice static balance drills (e.g. standing on one leg) with support nearby.

- Add agility exercises like stepping drills to improve stability.

Motivational Techniques for Long-Term Success

Supporting and encouraging individuals with Parkinson’s in a group fitness setting doesn’t have to take attention away from the rest of the class or single anyone out. By using inclusive strategies, instructors can create an environment where everyone feels motivated and empowered to participate. 

Here are some practical tips:

1. Create a positive atmosphere - Use upbeat music, encouraging language, and a welcoming demeanour to foster enthusiasm and energy. A positive environment helps everyone feel motivated and engaged throughout the session.

2. Incorporate group challenges - Introduce team-based activities or friendly competitions that encourage camaraderie and collective effort. For example, set a class-wide goal to complete a certain number of repetitions or minutes of activity together.

3. Celebrate class achievements - At the end of each session, highlight group accomplishments, such as completing a challenging workout or maintaining great energy throughout the class. This reinforces a sense of collective success.

4. Generalised modifications - Offer modifications that are applicable to anyone, not just those with Parkinson’s. For example, say, "If you need to take it easier, try this version," while demonstrating a lower-impact alternative.

5. Universal cues - Provide cues that apply to the entire group, such as "Take a deep breath and relax your shoulders" or "Engage your core for stability." These cues help everyone focus on proper form and technique without singling out specific participants.

6. Encourage peer support - Foster connections among participants by making introductions before class, asking regulars to set up equipment for those with limited mobility, or encouraging them to motivate one another during partner exercises or group activities. Peer encouragement can boost morale and create a supportive class culture.

Empowering Participants Through Movement

Exercise classes are an opportunity to empower individuals with Parkinson’s disease by improving their quality of life both physically and emotionally. By accommodating their needs thoughtfully, fitness professionals can create safe spaces where participants feel supported, motivated, and capable.

On this World Parkinson’s Day, let us commit to building inclusive fitness environments that help individuals with Parkinson’s move forward—one step at a time.

Sources

Parkinson’s Foundation. Exercise. https://www.parkinson.org/living-with-parkinsons/treatment/exercise

HealthPartners. The best exercises for Parkinson's disease & their benefits. https://www.healthpartners.com/blog/the-best-exercises-for-parkinsons-disease-and-why-physical-activity-is-important/

Parkinson's Foundation. Exercise and PD. https://www.parkinson.org/library/fact-sheets/exercise

Neurorehabilitation & Neural Repair. Two Year Exercise Program Improves Physical Function in Parkinson’s Disease: the PRET-PD Study. https://pmc.ncbi.nlm.nih.gov/articles/PMC4276552/

Agility Physiotherapy & Pilates. Parkinson's Disease and Exercise

https://agilityphysiotherapy.com.au/services/exercise-physiology/parkinsons-disease-and-exercise

Johns Hopkins Medicine. Fighting Parkinson's Disease with Exercise and Diet https://www.hopkinsmedicine.org/health/conditions-and-diseases/parkinsons-disease/fighting-parkinson-disease-with-exercise-and-diet

American Parkinson Disease Foundation. Best Exercises for People with Parkinson's Disease https://www.apdaparkinson.org/article/what-exercise-to-do-with-parkinsons/

Yale School of Medicine. High-intensity Exercise May Reverse Neurodegeneration in Parkinson’s Disease. https://medicine.yale.edu/news-article/high-intensity-exercise-can-reverse-neurodegeneration-in-parkinsons-disease/