Introduction 

Does exercising lower the chances of getting Parkinson's disease? Research suggests that regularly exercising and the risk of developing Parkinson's disease (PD) are inversely related. Many studies have shown that participating in different types of physical activities can help prevent and manage Parkinson's, offering hope for people who want to take steps to keep their brains healthy.

Understanding how exercise affects the risk of PD is important for people who want to stay healthy. This article looks at the latest research to explain how exercise might protect against Parkinson's.

Understanding parkinson's disease

According to the Parkinson's Disease Foundation, 7 to 10 million people worldwide suffer from PD, a neurological condition.² PD is an age-related, chronic, and progressive illness that is uncommon in young people but can affect up to 4% of older adults. 

Currently, treatment can only manage symptoms; no medicine has been shown to be effective in halting the progression of the disease.⁹ 

Symptoms

Parkinson's disease (PD), a neurological condition brought on by degenerative changes in the nervous system, is caused by dysfunction in the cerebral basal ganglia. Despite the patient's best attempts to walk, they become increasingly slower, which increases the risk of unintentional falls and makes therapy more difficult for the patient.¹

The primary symptoms of Parkinson's are:

• Bradykinesia
• Stiffness
• Tremor
• Postural instability

Other common motor symptoms include: 

• Impaired motor coordination
• Changed gait pattern
• Gait freezing
• Rigidity 

Moreover, non-motor symptoms are also common in most individuals and can include cognitive impairment and dementia, insomnia, anxiety and melancholy, apathy, bladder malfunction, pain, and exhaustion.²

Although the exact origin of PD is unknown, genetic and environmental factors are considered to play a role. There is evidence linking some environmental factors to an increased risk of PD:

• Dairy products 
• Chemical pesticides
• Head injury 

Other factors have been related to a decreased risk:

• Smoking  
• Coffee 
• Urate  
• Being physically active 

There are, at present, no disease-modifying treatments available to stop, impede, or reverse the neurodegenerative process (by neuroprotection or neuro-restoration).⁴ 

Quality of life

The standard of health, comfort, and enjoyment that a person or community experiences is referred to as quality of life (QoL). PD affects every part of a patient's life, making it difficult to live with. 

The illness begins with minor symptoms and steadily worsens until it reaches a point where day-to-day tasks become challenging and negatively impact the person’s QoL. Stigma, deterioration of memory, and increased difficulty in mobility can result from a loss in QoL. 

A number of variables affect patients' quality of life. According to a study, patients with PD had lower QoL across both physical and psychological domains. When QoL concerns are not addressed, there are detrimental effects on the person and their family. Consequently, it's critical to deal with the variables affecting QoL and to take action to raise the patient's quality of life.⁶

As soon as the diagnosis is confirmed, physiotherapy treatment should begin. It is an excellent way to enhance movement and QoL because it increases their strength, coordination, and amplitude. This helps to prevent falls and contractures by lessening the otherwise unavoidable imbalance that characterises PD. The QoL of patients with PD is significantly impacted by a variety of motor and neuropsychological dysfunctions, including depression, lethargy, cognitive decline, and sleep impairment.³ 

Physical activity and risk reduction

For everyone, exercise is a vital component of a healthy lifestyle. Exercise is not only beneficial for people with PD, but it is also essential for preserving their movement, balance, and ability to carry out everyday tasks. Exercising and being physically active can help with non-motor PD symptoms like depression and constipation, in addition to maintaining and enhancing mobility, flexibility, and balance.

According to data from the Parkinson's Outcomes Project, individuals with PD who begin exercising at an earlier stage of the disease and maintain a minimum of 2.5 hours of exercise per week see a slower decline in their QoL than those who begin later. Developing an early exercise regimen is crucial for managing diseases in general.

A combination of aerobic workouts, moderate-to-intense strength training, balance training, gait training, functional activities, and agility-requiring exercises is recommended. Research has shown that combining exercise with intermittent fasting reduces inflammation, improves insulin sensitivity, and lessens damage to dopaminergic neurons.³

The majority of research studies have discovered a tendency or inverse association between physical activity and the eventual onset of PD. Additionally, they noted that people who played intense sports or moderate activity in adulthood had lower odds of getting PD. Exercise has been shown in studies to be associated with slower progression of non-motor (QoL, cognitive function, anxiety, and depression) and motor symptoms (parkinsonism, strength, balance, and gait).⁴

According to a study, engaging in regular moderate-to-intense physical activity lowers the risk of PD by 34%. The chance of developing PD in later life was found to be substantially inversely correlated with physical activity in school, college, or between the ages of 35 and 39. It relates to a neuroprotective effect from being active, an interpretation formed from experimental results from animal studies of PD. However, people susceptible to the disease have been found to avoid intense physical activity in their early adult years. The neuroprotective impact has been attributed to many processes, including elevated serum urate, increased release of neurotrophic factors (e.g., BDNF), activation of PGC1α, and control over dopamine turnover. There is ongoing research, including randomised trials, into the possible advantages of exercise for people with Parkinson's disease.⁵

There is now evidence that a lower risk of PD is linked to a higher degree of moderate-to-intense physical activity in middle or later life.⁷ Higher regular physical activity levels were robustly related, but only when sustained, with slower worsening of various clinical indices in PD patients. 

Additionally, it is documented that certain activities can have various impacts on the progression of PD. In particular, work-related activities were primarily linked to a slower decline in processing speed, moderate-to-intense exercise habits were preferentially associated with a slower decline in postural and gait function, and household activities were specifically linked to a slower decline in ADL (activity of daily living).⁸ 

Practical recommendations for incorporating physical activity

A person's daily life can benefit greatly from engaging in moderate to vigorous physical activity (VO₂ Max 50%–80%), 40–60 minutes per day, five days per week. For people assigned male at birth (AMAB), this equates to approximately seven hours of walking, five hours of aerobics, or three hours of lap swimming, while for people assigned female at birth (AFAB), it is equivalent to six hours of walking, four hours of aerobics, or two hours of lap swimming. 

Exercise that ranges from moderate to vigorous has a more potent protective effect on PD patients than does modest physical activity. Consistent with the importance of mild physical activity, moderate treadmill exercise and one-time exhaustion exercise can successfully reduce the risk of PD while also improving depression, cognitive impairment, and motor impairments in PD patients.⁹ 

Conclusion

Evidence supports the notion that engaging in regular physical activity might reduce the risk of developing Parkinson's disease. Numerous studies have consistently demonstrated a positive correlation between an active lifestyle and a lower incidence of Parkinson's, suggesting that exercise may play a crucial role in maintaining neurological health. Regular physical activity not only promotes overall well-being but also appears to have a protective effect on the brain, potentially reducing the risk of PD. Therefore, adopting and maintaining a physically active lifestyle emerges as a practical and beneficial strategy for reducing the likelihood of Parkinson's disease.