Video presentation by Cynthia Comella, MD (PDF Movement Disorder Center, Chicago) about "Exercise In Parkinson's Disease - Is It Worth The Sweat?" Posted on the UCSD Neurosciences website. Good survey of current animal model and human PD exercise research. Appears to be recent - January 2013. More evidence that certain types of regular exercise benefits PD patients.

http://neurostream.ucsd.edu/player.h...NGR%2001-25-13

After watching the video presentation, I wrote to Dr. Camilla about my experiences with cycling and exercise. I wrote at some length about how I had become involved with Pedaling for Parkinson's and what the results have been. She wrote back a most gracious note, asking that we keep in touch. Interestingly enough, her experiences parallel my own noting how difficult it is to keep people with Parkinson's motivated to do the exercise that will slow them from progressing in the disease. I shared with her that my sense is that the people with Parkinson's want camaraderie nearly as much as they want relief from symptoms. I am told that nearly every time I attend a PFP class and nearly every time I communicate with a PWP on the Internet or on the telephone.

...how difficult it is to keep people with Parkinson's motivated to do the exercise that will slow them from progressing in the disease...

And this is the big question (and maybe another non-motor symptom) - even though I know that I must exercise 50mins or more each day to slow PD progression, I manage to find a 1,000 other things to do, non of them exercise! - Why?

if i remember correctly, the presenter at the end related what she advises pd'ers, at least until more research is done, and she said follow the CDC guidelines for exercise.
http://www.cdc.gov/physicalactivity/...es/adults.html

those are obviously guidelines and if you want to bet more that exercise slows progression as hypothesized you can increase the time and/or intensity. she described a trial that will test that hypothesis which is hard to test, look at teva/azilect, using the same delayed start technique. she said they are using treadmills and can be done at home. these are all patients not yet taking meds so they can get to the desired exercise rates by themselves.
http://www.clinicaltrials.gov/ct2/show/NCT01506479

A slightly older article from 2009 on the pdf.org site written by Giselle M. Petzinger, M.D. (University of Southern California, Movement Disorder Division). It goes into some details as to how and why exercise benefits Parkinson's patients, including changes in the brain (from animal models and human data).

Full article at: http://www.pdf.org/en/parkinson_exercise_impact

Excerpt on "How Exercise Changes the Brain" below:

What happens in the brain to produce these visible benefits? To find out, we looked at the brains of the mice that had exercised under conditions parallel to the human study.

We found that exercising changed neither the amount of dopamine nor the amount of neurons in the animals’ brains. But in the ones that had exercised, the brain cells were using dopamine more efficiently. We found that exercise improves that efficiency by modifying the areas of the brain where dopamine signals are received — the substantia nigra and basal ganglia.

At the molecular level, at least two things are happening to make dopamine use more efficient. Dopamine travels across a space between two adjacent brain cells called a synapse. This process is called signaling and it is essential for normal functioning. To end the signal, a protein complex called the dopamine transporter normally retrieves dopamine from the synapse. The first thing we found is that animals that had exercised possessed less of the dopamine transporter, meaning that dopamine stayed in their synapses longer, and their dopamine signals lasted longer. Secondly, we found that the cells receiving the dopamine signal had more places for the dopamine to bind in animals that exercised, and so could receive a stronger signal. This binding site is called the D2 receptor. We also studied the D2 receptor in a subset of our human subjects who were within one year of diagnosis and not on any medications, using the imaging technique known as positron emission tomography (PET). We found that in humans, too, exercise increased the number of D2 receptors.

Lastly, animal studies have shown that intensive exercise may also play a role in controlling glutamate, another molecule that signals between brain cells. Dopamine is responsible for holding glutamate in check, so when dopamine levels drop in PD, a chain of events is set off that leads to a build-up of glutamate signaling. The resulting surplus of glutamate damages the cells that control body movements. But animal studies show that exercise may play a role in normalizing glutamate signaling, thereby helping the brain to function normally and to promote recovery of the ability to move.

I do my best to try to motivate my friends with PD to exercise....
why is it like pulling teeth.????...even when they see how hard I exercise and know in their hearts it is beneficial. It is so detrimental to just sit / eat/ and watch the tv most of the day. Force yourselves to just get up and get moving....find something that is fun for you or you won't keep it up. So much to chose from.....swimming, stationary bike, floor exercise, dance, yoga , tai chi, etc. Just getting out and walking in the sunshine is wonderful.
The more you do, the more you will be able to do.
The more stationary you are....the worse it will be to do even simple tasks and the more depressed you will become. (a no win situation for sure)

I have the same issue, but I did this pre PD. I have read that exercise creates a positive feedback loop in our dopa mediated reward center in the brain. Essentially it gets slightly "addicted" to exercise, so you want to keep doing it because it released feel good hormones. It is just enough to keep you exercising but not enough to prevent another part of the brain from slacking.

I think for me a lot of it is that I am both skeptical and too hopeful at the same time. I see Nan's results for example and have too high expectations in it truly being disease altering. I am skeptical that is because there is no scientific means for comparison purposes and from what I have read symptoms return if you stop exercising. I think it is definitely good for us and cannot hurt.

BTW, with all respect to our pedaling Parkies, dopamine agonists will just as easily have one of us obsessively exercising. I see it in the YO groups on Facebook. Some are so focused on running that they would only post on it and quickly formed their own groups. Not all judging but we cannot separate how the meds may affect results of exercise for each of us. Further, we could just be tapping back into a compensatory mechanism or finding a new one.

I would like to think that it slows progression, but why do professional athletes or dancers, people with their bodies in peak form, still come down with PD in the first place? I think there is a lot scientists might uncover if they studied this at a deeper level, but I think meds are a confounding factor in all of our research.

On a practical note the easiest way to form a new good habit is to schedule it and reward your self for sticking with it. It helps if you have an exercise partner too.

i think the long term goal is to find the biochemical basis for whatever benefit exercise has for neuroprotection and botltle it. i heard there are over 80 clinical studies on exercise listed, 25 in progress, SOME on pd'ers not on meds with delayed start, so we'll know soon enough what the real benefits are on slowing progression.

would i exercise vigorously if a YOPD? You betcha, worse that happens is i get in great shape and gain the general mental and physical benefits of exercise, best is i slow progression. and you'll know soon enough what the real benefits are. no worse than joining a 18month long clinical trial where you take a drug, eh?

i'm not a YOPD'er anymore, i'm doing well when medicated on only sinemet for having been diagnosed in late 2001, i've exercised more than avg. pd'er and will continue to do so, if only for the general benefits.

I understand the skepticism about exercise slowing the progression of PD but for me it is a moot point, I exercise because it makes me feel better. And if my PD progresses slower …YAHOO!

My regime for exercise is simple, just plain (as brisk as I can) walking. I’m too frugal to pay money to join a gym and I know I would not go consistently. I’ve been walking for 10 years, starting because of breast cancer treatment, currently hoping to help my PD. I take advantage of my walk and go through what I call “the files in my mind” aka things bothering me, deleting some, solving others.

I find it very therapeutic to also use visualization while I walk. For BC I would visualize Luke Skywalker searching for cancer cells and vaporizing them. Now I picture oil rigs deep in my brain, pumping that black gold dopamine while I hum the theme to the Beverly Hillbillies or young, or healthy neurons with arms and fingers stretching out forming synapses to the tune of Mighty Mouse…“Here I come to save the day!” Will it help my PD? I hope so, right now I can only say it helps me feel better. At the very least I get outside for an hour every morning enjoying nature and getting a dose of vitamin D!

Tomorrow night there is a program on the Connecticut PBS station called The Truth About Exercising with Michael Mosley, not PD specific but it might be informative. It is also being broadcast on other PBS stations and I’m sure it can be watched online after the broadcast date.

http://www.kpbs.org/news/2013/apr/08...ichael-mosley/

Check out David Bloom, MD's personal stories and his training classes, philosophy and training classes about exercise and PD:

http://www.exerciseforparkinsons.com/

Also check out some of his skiing, juggling and exercise videos 16 years into PD:

http://m.youtube.com/watch?v=jGEI6_G9NLA

http://m.youtube.com/watch?v=vdEBRKKT5FM

http://www.exerciseforparkinsons.com...isease-in-1997

I love this one:

http://m.youtube.com/watch?v=yxihPFpsdbU

Amazing!