Muscle weakness is an almost universal symptom in Parkinson’s Disease. Or is it? This is actually a topic of some debate. People with Parkinson’s certainly perceive muscle weakness, which is attributed to low levels of the neurotransmitter dopamine. However you look at it, the motor related symptoms of PD lead to decreased muscle usage, which compounds the problem, resulting in decreased muscle mass. Strength training exercises for all major muscle groups is a common sense strategy to counter the effects of PD.
Grip strength, in particular, has been singled out as a primary indicator of PD progression. (See “The Association of Grip Strength With Severity and Duration of Parkinson’s: A Cross-Sectional Study” and “Handgrip Strength Related to Long-Term Electromyography”.)
If you don’t exercise your grip, you will gradually lose it.
The World Health Organization (WHO), and the US Center for Disease Control and Prevention (CDC) agree that everyone can benefit from 2-1/2 hours per week of minimum to vigorous exercise, and strength training on 2 days per week. Parkinson’s exercise studies have shown that these recommendations are also beneficial for people with Parkinson’s, and have emphasized that vigorous exercise can slow the progression of Parkinson’s and benefit brain health. As a result, there is a tendency to focus on higher intensity aerobic exercise, and strength training is overlooked.
A study from Brazil caught my attention, because they measured the effects of strength training. In the study “Low-volume resistance training improves the functional capacity of older individuals with Parkinson’s disease”, they studied 54 people with Parkinson’s (stages 1-3) who were over 60 and had not participated in an exercise protocol in the last 3 months.
One group did not exercise. The other group followed a low volume (8-12 repetitions per exercise) resistance training exercise program for 6 months. Two days a week, they did 2 sets of 5 different exercises: bench press, deadlift, unilateral rowing machine, standing calf raise and abdominal reverse crunch. These exercises were chosen because they involve the major muscle groups of both the legs and arms.
Progressive resistance principles were followed. Training load (weight) was increased (by no more than 10%) when the participant was able to carry out 12 repetitions in all sets of a given exercise in two consecutive training sessions presenting a full motion range.
After 6 months, what were the results?
The control group, who didn’t exercise got worse in every area that was tested.
The exercise group saw improvements in flexibility, strength, walking speed, balance and grip strength. Grip strength was quite interesting, because it is easily quantifiable. The exercise group saw an 18% improvement in grip strength, while the non-exercise group saw a 7% reduction in grip strength, over this 6 month period.
In a recent post, I demonstrated some resistance training exercises that focus on grip strength and forearm strength: Targeting Tremors with PD Strength Training: Forearm, Wrist and Grip
And interestingly enough, 3 years ago, I posted about another study that looked at progressive resistance (weight) training for a period of 2 years. Participants in that study saw a 7.3% improvement in their Parkinson’s UPDRS score after 2 years. Revisiting that study is also quite interesting: Study: Weight Training Improves Parkinson’s Disease Symptoms
Whatever type of exercise you do as part of your Parkinson’s exercise protocol, please consider dedicating at least 30 minutes, 2 to 3 times per week, dedicated to progressive resistance/strength training.