We learned a lot more from Dr. Corcos during the Q & A part of the meeting on January 23. I have tried to summarize some of the more important points brought up during this time.

1. A 70% heartrate is not considered vigorous. It has been shown that a heart rate of 60-65% does not get you the same benefit as a heartrate of 80-85%. As you get older and as disease progresses, it gets harder to get to 80-85%

2. The best way to know how you are doing is to watch what your heartrate is doing. Work out with a heartrate monitor while on treadmill – apple watch, garmin, etc.

3. Consistency is the most important thing. Do what you like. That’s what works best. 3-4 times a week of 30 minutes endurance exercise at 80-85% is desired. You should mix up your exercise routines. You don’t want to do the same thing everyday, just as you would not eat the same thing every day. Swimming is great. You can’t hurt yourself. It takes a lot of pressure off your joints. If your heart rate is at 70% does it matter how you got there? Probably not, but you need to look at what you want to help most. If you are having mobility issues, then walking on a treadmill is what will help you the most because you are practicing walking. One of best things you should do is warm up for 5 minutes and cool down for 5 minutes. This is built into the SPARX studies. Then add 10 minutes of stretching and balance for a complete workout.

4. There are Physical Therapists who are trained specifically in PD. It is good to work with someone who has this experience. PT students are getting the material on PD, but not everyone understands the benefits of exercise for PD.

5. Bicycle vs Treadmill – Biking is terrific. Look at Jay Alberts work on forced exercise. Cycling at 90 rpms is recommended. One of the great things about a bike is there is a lot of software to make it great, whether you are indoors or outdoors.

6. The SPARX3 study designed to find the optimal prescription for exercise. We have to be careful in studies to make sure people don’t have heart issues while exercising at 80-85% max heart rate. Treadmills, which are used in the study, may have a couple of advantages over bike.

• People with PD do well with external cues. Look at freezing which uses cues to move. On treadmill you do have a cue. The treadmill is going so you have a cue. You have to keep going. On the bike you don’t have that. You can stop or go slower.

• The goal of Physical Therapists is to make a person be able to transfer an activity. Treadmill training transfers better for mobility than bicycle training. We don’t bike that much but we do walk.

What is not good is sitting on a couch all day. Once you get up and do something, you are helping yourself.

The recording of this meeting is available on Youtube. Click the image below to watch it.

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A New Study on Unmet Needs of Women Living with Parkinson’s Disease

Check out the latest blog post from Parkinson’s Secrets. Indu Subramanian, MD, talks about her recent paper on “Unmet Needs of Women Living with Parkinson’s Disease: Gaps and Controversies” with Soania Mathur MD, Annelien Oosterbaan MD, PhD, Richelle Flanagan RD, Adrienne M. Keener MD, Elena Moro MD, PhD.