Tailored Exercises

The idea, he added, is to tailor exercises to the state of the disease for each individual. All patients with PD, even those at stage 4 who have severe disability but are still able to walk or stand unassisted, and those in stage 5 who are wheelchair bound or bedridden unless aided, will benefit from some exercise intervention.

Patients with PD who are in a wheelchair can use an exercise band to work their ankle and arm muscles. These kinds of activities are recommended for travelers in airplanes and hotel rooms, said Dr. Corcos.

Many patients with PD, even those in their 50s and 60s, are in “pretty good shape” apart from their disease, said Dr. Corcos. “They can certainly do this weight training and certainly benefit from it.”

Patients with PD might also benefit from tai chi, an exercise system that incorporates slow, smooth body movements to achieve a state of relaxation of the body and mind. A recent randomized controlled study, published in the New England Journal of Medicine and reported by Medscape Medical News at that time, suggested that tai chi training reduces balance impairments in patients with mild to moderate PD, with additional benefits of improved functional capacity and reduced falls.

“When you have PD, you have a balance problem, especially as the disease progresses,” said Dr. Corcos. “I would argue that people with a balance problem should spend some time every week working on their balance; it’s a tremendous thing to do.”

Research Lacking

Reached for a comment, Giselle Petzinger, MD, assistant professor, University of Southern California, Los Angeles, said the study is interesting, but it didn’t convince her that weight training is any more beneficial than other types of exercise. In her view, the study adds little to what’s already known about the benefits of exercise in patients with PD, she said, adding that there are “a gazillion” papers out there on this topic.

Some measures, such as the amount of resistance the exercises had, are unclear from the abstract, she said.

“We still need to get down to specific issues of parameters such as resistance training, skill training (learning a new skill such as skiing or playing tennis), and aerobic training, and that has yet to really be well addressed,” said Dr. Petzinger. “This research is far from doing that. It just reintroduces the idea that, gosh, we should really look at this carefully.”

And the study adds little on how exercise changes the brain in humans, said Dr. Petzinger, who researches the impact of exercise in animal models.

“We’ve got compelling animal data showing that there are brain changes occurring that we believe are meaningful in terms of changes in how dopamine is handled, changes in how other neurotransmitters such as glutamate are being handled, and changes in neurotrophic factors, all of which promote connectivity,” she said. “The question at the end of the day is, what is happening in humans and what are aspects of exercise that are really meaningful in the context of the disease state?”