Exercise as Medicine for those with Neurological Conditions
Over the last 10 years, many research studies have been conducted to determine the benefits of exercise on the body. Specifically, the benefits are great for progressive neurological conditions such as Parkinson’s Disease (PD), Alzheimer’s Dementia (AD), and Multiple Sclerosis (MS). In addition, other similar studies have also been directed at the benefits of this on individuals with non-progressive neurological conditions such as a Stroke (CVA) in improving in walking ability and overall function. Research has helped highlight the importance of aerobic exercise on neuroplasticity of the brain. Whether newly diagnosed to end stages of a progressive condition, benefits have been found for therapeutic exercise to improve function, slow progression of the disease and help the brain and body connectivity to be more efficient to complete tasks with less difficulty or effort. The key to progressive diseases is to keep the cells alive longer to slow the progression.
With aerobic exercise, the intensity matters greatly. It has been noted that greater improvements have been achieved when individuals were forced to push themselves harder than a self-selected pace or intensity. Specifically, those that reached 60-65% of their heart rate max were shown to remain the same in function over a six-month period. However, those that reached 80-85% of their heart rate max have been found to improve in function and scores. Intensity also refers to a high volume of exercise or a frequent amount of at least 2.5 hours each week. Overall, it is a very powerful thing to know that with consistent aerobic exercise of 60-85% of HR max for a total of 2.5 hours each week, that people can get better or at a minimum stay the same despite the diagnosis of a progressive condition.
Specifically with Parkinson’s Disease the rationale behind the progress noted or maintenance is because exercise provides an increase in release of dopamine which allows more of this to be available for the brain in the moment. Also, it causes decreased synaptic clearance (less cleanup) allowing the brain to keep it in the system longer. Furthermore, aerobic exercise leads to an increase in dopamine D2 receptors and other protective receptors in the brain allowing more dopamine to be released and creating a more stress-free environment for cells to stay alive longer. Within the five stages of Parkinson’s Disease, those with a new diagnosis (stage 1) were found the potential to get better, moderate stages to remain the same with little to no decline and those with end stages were found to perform simple tasks better. This is due to the enhanced neuroplasticity allowing an individual to use other parts of the brain more effectively to take over and help complete the task (i.e., to use other portions of the brain to bypass the roadblock at the basal ganglia).
Aerobic exercise is not one fits all and many individuals with neurological conditions will need a specific exercise prescription based on where they are within the disease process. This can be done by a therapist that specializes in neurological conditions. Please contact Colorado in Motion to schedule an Occupational Therapy evaluation to see how we can help.
Article Reference: Treadmill SPARXS study, SPaRXS 2 and 3 Trials, Animal Models-Jay’s lab