What Kind of Exercise Is Best for Parkinson’s?

Written by: Colleen Bridges, M.Ed, NSCA-CPT, PDFS, Belmont University Occupational Therapy Advisory Board, 2020 MedFit Education Professional of the Year & Renee Rouleau- M.S. Neuroscience and Bridges for Parkinson’s Medical Science Advisor

Parkinson’s affects how the brain communicates with the entire body. It doesn’t impact one muscle or one movement  For this reason, the most effective exercise for Parkinson’s must be comprehensive, including:

• Cardio

• Strength

• Balance

• Movement in multiple planes of motion

• Coordination

• Agility

• Dual and Triple Tasking

• Fine Motor 

• Voice and Facial Skills

• Cognitive skills

  
  

At Bridges for Parkinson’s, we recommend 2–3 days per week of a comprehensive,  PD-specific exercise class, led by a certified Parkinson’s Disease Fitness Specialist (PDFS)—someone who is trained, educated, and certified in the unique needs of Parkinson’s.

Why does this matter so much?

Parkinson’s requires a very specific type of routine—one that addresses Parkinson’s symptoms, challenging strength, balance, coordination, cognition, posture, and confidence all at the same time. And it all begins with the foundation, a comprehensive routine based on the Forced-Intense Exercise Method (FIE).

FIE is when a Certified Parkinson’s Disease  Fitness Professional such as me or a member of the Bridges for Parkinson’s team—intentionally and safely encourages a participant to go beyond what they might do on their own (or what they think they are able to do). -  This is NOT about pushing to exhaustion—but  about motivating someone to go just a little bit further than they think they can, with common sense, recognizing an individual’s strengths and challenges and support along with a little tough love on the side. 

This could look like:

• “Let’s do 5 more curls.”

• “Give me 10 more punches!”

• “Make that movement bigger—reach with those rainbow arms.”

• “Can you walk or jog for 30 more seconds, making footprints in the sand?”

•  Fighter, how many reps do you think YOU can do today?  Let’s do it!

  
  

To ease any concerns you may have about being challenged, we use common sense and respect each person’s limits, medical needs, and energy levels.

But here’s the magic: when PD fighters engage in that extra effort, even in small doses, powerful results take place

Not only can FIE  help slow the progression of PD symptoms, it also triggers incredible neurological reactions.

Check out the benefits of Forced-Intensity Exercise (FIE) for Parkinson’s Disease

• Boosts dopamine release and prolongs dopamine signaling between neurons, which improves communication in motor pathways.

• Protects remaining dopamine-producing neurons which may assist in preserving neurons in the substantia nigra,- the result - slowing functional decline.

•  Promotes the brain’s ability to rewire and adapt, strengthening alternative neural pathways to compensate for dopamine loss  - aka neuroplasticity

• Reduces the severity of tremors, rigidity, and bradykinesia, leading to better coordination and movement efficiency.

• Boosts mood and cognitive function in turn, supporting mental health and executive function (those non-motor symptoms)

• Reduces chronic inflammation because chronic inflammation contributes to more severe PD symptoms.

• Reduction in insulin resistance- exercise can increase the body’s sensitivity to insulin which allows cells to absorb glucose more effectively.

  
  

Several studies, including some from Nature (a highly reliable source for scientists and medical professionals) have detailed FIE as a non-pharmalogical way to treat PD symptoms, and even slow disease progression at the cellular level. For instance, intensive treadmill exercise 3x/week reduced the amount of alpha-synuclein (a harmful protein tangle) in the substantia nigra, which helps keep dopamine neurons healthier for longer (Balfauf et al., 2025). Forced exercise can even increase brain connectivity, which ties to better voluntary movement, at a rate comparable to medication use as well (Beall et al., 2013)! This means that exercise can TRULY be medicine!

The second critical component of a comprehensive PD routine focuses on the 7 functional daily movements:

Examples of 7 functional movements in day to day activities

• Squat - sitting down at the kitchen table or using the toilet

• Lunge - climbing stairs

• Push - closing the refrigerator

• Pull - pull down a window shade or opening the refrigerator

• Carry - carrying bags of groceries

• Rotate - changing position in bed

• Hinge - bending over to tie shoes

  
  

These movements translate directly into everyday life—carrying groceries, vacuuming, navigating social spaces, and moving safely and confidently through your environment.So, you can expect that we will perform these movements in each and every class!

Repetitive movements are also really great for the brain and PD symptoms. The brain will over time create new connections, which stems from repetition of stimuli, in this case, exercise. Once you create that new connection, your brain will reinforce the pathway over and over and create more smooth and coordinated movements because it knows to expect it. This promotes neuroplasticity in the brain because it’s constantly rewiring and creating new circuits--essentially, the brain is exercising while you’re exercising! Over time, as your brain figures out what to do and how to do it, it gets easier, and that pathway gets solidified into a new “normal” for your brain…which is where we tell you to kick it up a notch and start the whole process over again!

When guided with purpose and knowledge, exercise becomes more than movement—it becomes a powerful tool for protecting the brain, maintaining independence, and building confidence. It helps people discover strength and ability they may not realize they still have.

These classes are more than workouts—they are neuro-training sessions. Every movement is designed to help the brain and body work together more effectively.

That’s why Rock Steady Boxing and Stretch & Strength remain the cornerstone programs at Bridges for Parkinson’s. They don’t just train muscles—they train the brain and body to work together, on purpose.

The MIRACLE is in the MOVEMENT!

References

Baldauf, L., Feja, M., Stanojlovic, M. et al. Depending on intensity, exercise improved or worsened pathology in a model of prodromal Parkinson’s disease. npj Parkinsons Dis. 11, 335 (2025). https://doi.org/10.1038/s41531-025-01200-y

Beall, E. B., Lowe, M. J., Alberts, J. L., Frankemolle, A. M., Thota, A. K., Shah, C., & Phillips, M. D. (2013). The effect of forced-exercise therapy for Parkinson's disease on motor cortex functional connectivity. Brain connectivity, 3(2), 190–198. https://doi.org/10.1089/brain.2012.0104

Xu G, Ma C and Yang Y (2025) Intervention strategies for Parkinson’s disease: the role of exercise and mitochondria. Front. Aging Neurosci. 17:1519672. doi: 10.3389/fnagi.2025.1519672