Exercise is medicine. That is the philosophy Dr. Philip Millar abides by, no matter the circumstances of one's health. When the University of Guelph professor and his team set out to gauge the impact exercise can have on people living with Parkinson's disease, the results further proved his belief correct.
In a study recently published in the Journal of Applied Physiology, Millar and his co-authors in the Department of Human Health and Nutritional Sciences embarked on first-of-its-kind research to understand how much exercise is needed to improve cardiorespiratory fitness and Parkinson's disease-related symptoms.
To explore this, researchers were the first to measure maximal oxygen consumption (V̇O2 peak), fatigue and fatigability, gait, balance and motor symptoms in participants completing either high intensity interval training or moderate intensity interval training.
"Prior work found that high intensity interval training may improve how far someone with Parkinson's can walk but this could be due to becoming more stable or confident in their gait," Millar explains. "It might have had nothing to do with cardiorespiratory fitness and the impact on motor symptoms was previously never studied."
Parkinson's disease is a progressive disorder that impacts the nervous system and parts of the body controlled by nerves. People living with Parkinson's experience uncontrollable movements such as tremors and stiffness and have difficulty with balance and coordination.
A person diagnosed with Parkinson's disease, regardless of their fitness level, often experiences depression and shame, Millar explains. Given the physical aspects of the disease, patients often stop exercising, which can exacerbate symptoms. "If you stop physical activity, your body adapts and you lose physical function," he says.
Parkinson's study's findings surprise U of G researchers
Dr. Philip Millar
The study was organized around three cohorts of participants, with about ten people in each. Participants both female and male represented ages 45 to 79, with a range of physical abilities, who were in various points along their journey with the disease. Each cohort exercised three times weekly at the YMCA of Three Rivers in Guelph for 10 weeks.
The participants built a small community, connecting with others living with Parkinson's, supporting, and encouraging one another, something Millar says, "was a real major benefit of the study."
In contrast to their hypothesis, the team found that both exercise modes led to similar changes in Parkinson's symptoms and fatigue ratings. The study showed that patients can choose the mode of exercise they are comfortable with, without the fear of losing out on some benefits only achieved through a certain level of exercise.
Motor symptoms were reduced by approximately 25 per cent across both exercise interventions.
"That is a very significant amount that can make a meaningful change to someone's life," Millar says, adding these findings strengthen the evidence in support of using exercise in the management of Parkinson's disease. "We want to help contribute to greater knowledge of the benefits of exercise for those with Parkinson's so that clinicians, rehabilitation specialists, community supports, partners and family can help advocate for patients to exercise as much as they should."
Canada's fastest growing neurodegenerative disease
This research builds on a previous study that found one Parkinson's patient's high-intensity exercising - he cycled across the country in 85 days - significantly reduced his disease symptoms.
One of the participants in Millar's study was Barbara Salsberg Mathews, a U of G instructor in the Bachelor of Creative Arts, Health and Wellness program, who uses mime as a therapeutic tool to manage her Parkinson's symptoms.
Millar hopes this study will draw more awareness to Parkinson's disease, one of the fastest growing neurodegenerative diseases in Canada. "The stats are alarming," he says. "Parkinson's was once considered rare. Now, hardly anyone does not know someone who has been diagnosed."
With word spreading about the positive impact exercise can have on people with the disease, Millar would like to see Parkinson's-focused programs made available in the community. To that end, he and his team presented their findings to the Three Rivers YMCA.
"A big push is convincing people of the benefits," he says. "Across any disease, when we think of taking medication, we should equally think of exercise as well."
This research was supported with funding from Parkinson Canada.
