Parkinson’s disease | Physical activity could curb symptoms

(Montreal) Physical activity appears to be able to slow the progression of symptoms of Parkinson’s disease, including symptoms that are otherwise refractory to medication, a new study indicates.


Symptoms such as postural instability, gait disturbances and impaired processing speed could thus be susceptible to the positive effect of a high level of regular physical activity.

“This longitudinal observational study found that higher levels of regular physical activity, only when maintained, were robustly associated with slower deterioration of several clinical parameters in patients with Parkinson’s disease,” write the authors.

These findings are from the large, international, multicenter Parkinson’s Progression Markers Initiative (PPMI) study, which was launched in 2012 and is ongoing. Some 240 participants for whom the necessary data were available, particularly regarding their level of physical activity, were studied, among other things by comparing them to healthy subjects.

Regular physical activity of moderate to high intensity was associated with a slower decline in postural instability and gait disturbances, the authors said. Physical activities associated with work have been associated with a slower decline in processing speed. And physical activities associated with daily household tasks were associated with a slower decline in tasks related to personal care, such as hygiene and feeding.

“This is a good, well-controlled study that actually shows that for some symptoms of Parkinson’s disease, regular physical activity over a long period of time can have a positive impact on different aspects of the symptomatology of the disease, particularly balance. patients,” commented Professor Louis-Éric Trudeau, a Parkinson’s disease specialist at the University of Montreal.

Postural instability, or difficulty maintaining balance, is often the cause of falls, and is a problem that is not very well addressed by current medications that primarily target dopamine activity in the brain. , he continues.

But Parkinson’s disease is not just a dopamine problem, Mr. Trudeau emphasized. Other regions of the brain are also affected, “and current medication, unfortunately, does not compensate for all these other problems.”

“And this is where we have been looking for many years for other strategies, either pharmacological, therefore other medications, or methods like this for changing lifestyle, essentially diet and activity. regular physics that have been studied a lot,” he said.

These results, say the study authors, “underline the importance of supporting patients with (Parkinson’s disease) in daily practice to enable them to maintain their level of physical activity. […] It is essential that they themselves are convinced of the benefits of a high level of physical activity. »

But convincing patients who have just been diagnosed with Parkinson’s, and who may have been sedentary before the diagnosis, to start moving can be quite a challenge, admitted Mr. Trudeau, “even if now we have a big motivation to slow down the progression.” progression of the disease.

“You know the saying”Use or lose it “It basically means, the more we use our systems, whatever they are in our body, the more likely we are to keep them functioning,” he said.

And that’s a bit of what emerges in this study, in connection with Parkinson’s disease, he adds: you have to keep moving.

“During the years following the diagnosis of the disease, we see that people’s net physical activity tends to decrease, and that is unfortunately inevitable,” said Mr. Trudeau. The fact remains that the decline in motor functions is still less rapid in people who make efforts in their everyday lives to maintain a higher level of physical activity. »

This study, he emphasizes, does not demonstrate that physical exercise can reverse the course of the disease and we should therefore not “have too much hope of slowing down the physiopathological process which causes the disease”.

That being said, our brain has an incredible capacity for compensation and physical exercise will most likely activate these compensation mechanisms.

“Despite the loss of certain types of neurons and their connections, we manage to improve the functioning of the circuits in our brain that control movement with regular exercise,” said Mr. Trudeau. There is added value which is very clear. The improvement will not be day and night, but this study demonstrates beyond any doubt that there is an advantage. »

The findings of this study were published by the influential medical journal Neurology.


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