Parkinson's disease: Everyday activity more beneficial than occasional strenuous exercise

Parkinson's patients often become sedentary because of motor symptoms such as gait, balance problems or falls, said study principal investigator Nicolaas Bohnen, M.D., Ph.D., director of the U-M Functional Neuroimaging, Cognitive and Mobility Laboratory.

Once patients feel unstable on their feet, they may develop a fear of falling and then get scared to do any activity at all. Bohnen's team investigated whether participation in exercise, like swimming or aerobics, could help alleviate the motor symptoms that made these patients want to stay sedentary in the first place.

"What we found was it's not so much the exercise, but the routine activities from daily living that were protecting motor skills," Bohnen said. "Sitting is bad for anybody, but it's even worse for Parkinson's patients."

The imaging study, now available online in Parkinsonism and Related Disorders, was conducted by U-M faculty who hold appointments in both radiology and neurology.

Researchers investigated the relationship between the duration of both non-exercise and exercise physical activity and motor symptom severity for 48 Parkinson's disease patients over a 4-week period. They performed PET brain imaging to measure dopamine levels and used a questionnaire to learn about how physically active the patients were, including both exercise and non-exercise activity. They found that non-exercise physical activity was linked to less severe motor symptoms.

Although loss of dopamine is a key brain change for Parkinson's patients, and has been thought to be the main reason why Parkinson's patients become more sedentary, the researchers found non-exercise physical activity protected motor skills even among patients with differing levels of dopamine.

"This may have a big impact for Parkinson's patients," said co-author Jonathan Snider, M.D., clinical lecturer of neurology at the University of Michigan. "Not only worsening Parkinsonism but also increasingly sedentary behavior may explain more severe motor symptoms in advanced Parkinson's disease."

"I tell my patients to stand up, sit less, and move more," said Bohnen, also professor of radiology and neurology at the University of Michigan, VA Ann Arbor Healthcare System staff physician and investigator in U-M's Udall Center for Excellence in Parkinson's Disease Research.