If exercise is good enough for your dog, it is good enough for you!

Daniel Corcos, PhD

On Sunday, January 23, Daniel Corcos, PhD, Department of Physical Therapy and Human Movement Sciences at Northwestern University, spoke to an oversold crowd of Twitchy Women about why they should exercise. I first heard about Dr. Corcos last summer when a friend with PD, who runs Rock Steady Boxing classes at his gyms in Chicago, told me that this doctor mentioned me in a speech. I had never heard of Dr. Corcos, so Jim sent me the video and told me what time stamp to go to. And there was this doctor I had never heard of explaining that he was looking on the internet for resources for his speech “and found this lady with Parkinson’s who calls herself Twitchy Woman and she is terrific…” Of course I had to get him to talk to us. And he was pretty terrific, too!

Epidemiology of Parkinson’s Disease

Parkinson’s is becoming more and more prevalent.  By studying the population, it has become clear that those in mid-life who engage in regular exercise have a lower risk for developing Parkinson’s than those who don’t.  Implicit in this is the idea that exercise is good for you.  Cardiovascular exercise is important. Those with Parkinson’s who exercise have better cognitive and motor scores than those who don’t. Longevity in PD is also associated with increased physical activity.

Fitness is important as you age. Quoting Dr. Jose Obeso from Madrid, who tells his patients on their first visit: “first we worry about your health. Then we worry about your Parkinson’s.  The better your overall health is, the better you are able to deal with your Parkinson’s.”  When you are fit, you are better able to overcome other age related problems that can complicate PD, such as balance problems, back pain, arthritis, and osteoporosis.  You are also not immune to having a stroke or other co-morbidities.  So remember that exercise must be part of your daily routine to keep you in shape.

What exercise does:

• Improves cognitive function
• Improves depression
• Improves sleep impairment
• Decreases fatigue
• Stops or slows osteoporosis
• Improves motor performance
• Improved Drug efficacy

How does exercise protect the brain against decline?  

• Enhances dopamine signaling
• Increases nerve growth factors
• Increases the blood flow in the brain
• Promotes beneficial changes to the brain immune system
• Decreases oxidative stress
• Increases nerve connection
• Increases production of new nerve cells.

Unified Parkinson’s Disease Rating Scale (UPDRS)

Ask your doctor for you UPDRS score. The higher your score, the more severe your PD.  In a two year study, Dr. Corcos and his team compared a group with a gentle stretching exercise routine to a group prescribed vigorous exercise.  Generally if you do nothing, your disease progresses 1-2 points every year.  For those who do nothing, any exercise is good for you.  After 6 months, there was an improvement for the gentle stretching group, but at the end of 2 years, they were back to where they were at the beginning.   The strenuous exercise group’s scores were considerably better over the 2 years.

In another study, people with mild cognitive impairment showed an improvement with resistance training and instability exercises.

SPARX2 Study

128 early PD patients, not on dopamine were divided into three groups

• High-intensity treadmill exercise: 4 days per week, 80-85% max heart rate
• Moderate intensity treadmill exercise: 4 days per week, 60-65% max heart rate
• Wait list Control group ( after 6 months assigned to one of the first two groups)

After 6 months, the High Intensity group had a 0.3 change in their UPDRS. The control group had a 4 point change, and the moderate intensity group was in the middle.

Shall we Dance?

Skilled Exercise, such as dance can be very good. Studies of Tango have shown that it can improve symptoms and reduce fall risk.  You can be both a Warrior (as in SPARX2) and a Diva! Check out Rock Steady Boxing (and other classes) even if you think it is not for you. You can either let the disease take ownership of you, or you can be empowered to take ownership of the disease in these classes.

Exercise Prescription 

Dr. Corcos worked with the Parkinson’s Foundation to produce Parkinson’s Exercise Recommendations Weight training twice a week

Endurance training 3 times per week (No real benefit from HIIT)

Balance training 1-2 times per week. Tai Chi, Yoga, Dance, Balance

Task specific training 2 times per week for specific deficits

Current Studies you can participate in

SPARX3. This is a follow up to SPARX2

You must have been diagnosed less than 3 years ago and not taking dopamine meds, to learn more go to: https://www.sparx3pd.com

TOPAZ Study for fracture prevention. To learn about the study and if you qualify go to: www.TOPAZstudy.org

I encourage you to watch the recording if you were not able to join us live.