Exercising safely at home. How to stay moving in the era of COVID-19

How to stay moving during the COVID-19 pandemic

The COVID-19 pandemic has upended many aspects of our daily lives and routines. The Parkinson’s disease (PD) community has been particularly affected since most people with PD fall into the category of people who are at higher risk of complications from the virus – the older population and those with underlying medical conditions. For a more complete discussion of COVID-19 and the PD community, please read here.

The President’s Coronavirus Guidelines for America state “If you are an older person, stay home and away from other people.” The same holds true for those with underlying medical conditions. Plus, in-person exercise classes have been cancelled and gyms and fitness centers have been closed. This is leaving the PD community in a quandary. We know how important exercise is in maintaining good motor function and well-being in PD, but for so many of us, our exercise routines are tied to a gym, or classes that are outside of the home. APDA is here for you with some helpful tips and suggestions to continue exercising despite the COVID-19 pandemic.

If you are able to stay six feet away from everyone else in your vicinity, then by all means, go outside and take a walk, jog, or bike ride. (As always, discuss with your neurologist the type of exercise that you are able to safely perform.) Fresh air is very important, and if it can be done away from others, spending some time outside, at least once a day, is a very good idea.

You can also continue to exercise inside your home. Thankfully, today there are a multitude of online exercise options that guide you safely through exercises designed specifically for people with PD.

Examples of FREE online exercise classes and resources for you to try:

  • APDA’s Greater St. Louis Chapter’s YouTube channel – This channel can serve as your home base for online PD exercise since it hosts a large number of pre-recorded classes that you can watch and follow. There are archived classes that feature tai chi, yoga, interval training, kickboxing, chair exercises and more. Additional classes will be added over the next few days and weeks, so keep checking back.
  • Dance for PD, administered by the Mark Morris Dance Group, offers specialized dance classes to people with Parkinson’s, their families, friends and care partners, typically held in person in eight locations around New York City (including at the National Headquarters of APDA on Staten Island) as well as . through their network of affiliates in more than 300 communities in 25 countries around the world. Since the in-person classes have been suspended due to the COVID-19 outbreak, Dance for PD is offering both free live classes (via Zoom) as well as a multitude of archived classes online for free. Check out the schedule and links for the live online classes, as well as the archived classes here.
  • The Jamestown, New York YMCA has two short instructional online videos demonstrating Moving for Better Balance, a fall prevention program (Part I and Part II ). Parts I and II take approximately 15 minutes if done together.

And if online classes are not your thing, you can download APDA’s free exercise guide Be Active & Beyond: A Guide to Exercise and Wellness for People with Parkinson’s Disease which shows an assortment of easy-to-follow exercises for people of all abilities.

So clear an area in your living room and get moving!

How do we know exercise helps people with Parkinson’s?

We keep telling you that exercise is important (in past blogs and webinars for example). But what is the evidence that these exercise techniques really help people with PD? Let’s review three of these types of exercise – tai chi, yoga and dance – and look at the data as to how effective they are for people with PD.

Tai chi

Tai chi is an ancient Chinese form of martial arts, which today is practiced as a style of exercise combining flowing movements, breathing techniques and meditative practices. Tai chi is low impact and is suitable for all ages and levels of fitness. It does not require any special equipment.

There has been research focused on the general health benefits of tai chi, and these may include reduction of stress, anxiety and depression, as well as improved flexibility, balance, agility, strength and stamina.

There have also been studies focused on the health benefits of tai chi specifically for people with PD and the available evidence is relatively strong. For example, a randomized controlled trial for Tai chi in people with PD was published in the New England Journal of Medicine in 2012. In this study, 195 people with PD were randomized to one of three exercise groups – tai chi, resistance training, or stretching. The patient performed their assigned exercise in 60-minute sessions twice weekly for 24 weeks. The tai chi group performed better than the other two groups on many fitness measures and measures of balance. In addition, the tai chi group had a lower incidence of falls as compared to the stretching group (but not as compared to the resistance training group). The effects of tai chi were maintained at a three-month follow up after the training sessions were complete. Additional smaller studies have continued to support these positive findings.

Yoga

Another exercise modality that has been studied in PD is yoga. Yoga is a Hindu philosophy that has evolved into a method of physical poses, breathing exercises and meditation. It is practiced widely for its physical and emotional benefits and has been studied specifically to determine its potential benefits for people with PD.  The yoga studies in PD are not as large or as compelling as the above cited tai chi study, but enough data is available to suggest that it is useful for certain aspects of PD. A recent study for example, investigated a twice-weekly, eight-week yoga program for people with PD who expressed a fear of falling and compared them to similar PD patients who were on a wait list for the program. Those who participated in the yoga group showed improvement in motor function, postural instability, measures of gait, freezing of gait and reduction in falls. Those on the wait list intriguingly showed improvement on postural instability, but not on any of the other measures including reduction in falls. A limitation of this study is that only 15 people were studied in each of the groups. Additional, larger studies are necessary to confirm these findings.

Dance

A third exercise modality that has been studied in PD is dance. A number of studies have shown benefits both for motor and non-motor symptoms of PD. For example, in one small study, 15 patients with PD participated in dance classes, twice weekly for twenty weeks, and were compared to a control group that received usual care. Those who were in the dance group showed increased coordination. In another study, non-motor benefits of dance were assessed. 17 patients with PD received twice-weekly dance classes for 12 weeks and were compared to PD patients who received usual care. Those in the dance classes showed improvements on measures of psychological symptoms and quality of life, as well as limited improvement of measures of cognition.

These are just three types of exercise that show promise and benefit for people with PD. So go ahead and try an online dance, yoga or tai chi class at home (and when life gets back to normal, you can also attend these classes in person!). Or you can try another exercise type that piques your interest and start moving!

Tips and takeaways

  • It is vital to continue moving and exercising despite the COVID-19 pandemic.
  • It is safe to walk, jog or bike outside if you are able to stay a safe distance away from others.
  • APDA’s Greater St. Louis Chapter hosts a YouTube channel with a myriad of free online classes for people with PD. Other free options are available as well.
  • There is data that indicates tai chi, yoga and dance offer health benefits for people with PD.

Do you have a question or issue that you would like Dr. Gilbert to explore? Suggest a Topic

Dr. Rebecca Gilbert

APDA Vice President and Chief Scientific Officer

Dr. Gilbert received her MD degree at Weill Medical College of Cornell University in New York and her PhD in Cell Biology and Genetics at the Weill Graduate School of Medical Sciences. She then pursued Neurology Residency training as well as Movement Disorders Fellowship training at Columbia Presbyterian Medical Center. Prior to coming to APDA, she was an Associate Professor of Neurology at NYU Langone Medical Center. In this role, she saw movement disorder patients, initiated and directed the NYU Movement Disorders Fellowship, participated in clinical trials and other research initiatives for PD and lectured widely on the disease.

A Closer Look ArticlePosted in Exercise & Parkinson's, Living with Parkinson's

DISCLAIMER: Any medical information disseminated via this blog is solely for the purpose of providing information to the audience, and is not intended as medical advice. Our healthcare professionals cannot recommend treatment or make diagnoses, but can respond to general questions. We encourage you to direct any specific questions to your personal healthcare providers.