Exercise and Parkinson's Disease: Why Movement Matters for Both Body and Brain

What I Learnt from The Michael J. Fox Foundation's Exercise Guide

Recently, I spent some time reading Make Your Move: Exercise for Brain Health and Life with Parkinson's, an excellent guide produced by The Michael J. Fox Foundation.

For those unfamiliar with Michael J. Fox, he is the actor best known for starring in Back to the Future, Family Ties and Spin City. Michael was diagnosed with Parkinson's disease at the age of 29 and has since become one of the world's leading advocates for Parkinson's research, education and support.

In 2000, he established The Michael J. Fox Foundation, which has gone on to become one of the largest funders of Parkinson's research globally. Through research, education and patient support, the Foundation has helped improve understanding of Parkinson's disease and continues to work towards better treatments and, ultimately, a cure.

The guide I read is a fantastic resource for people living with Parkinson's disease, their families and healthcare professionals. Rather than focusing on a single exercise programme, it explores the growing evidence showing how movement and exercise can positively influence both physical and brain health.

As a physiotherapist, many of the messages strongly resonated with what I see in clinical practice. This article is inspired by that guide and combines some of its key evidence-based messages with my own experience supporting people living with Parkinson's disease in their homes and communities.

One of the things that surprised me most whilst reading the guide was the growing recognition that exercise is increasingly being viewed as brain training as much as physical training. For many years, exercise was seen primarily as a way of improving strength, flexibility and cardiovascular fitness. We now understand that movement may be doing much more than that.

Exercise Is More Than Keeping Fit

When people hear the word exercise, they often think about fitness, weight loss or going to the gym. Whilst these benefits are valuable, exercise appears to offer something much more important for people living with Parkinson's disease.

Research suggests that exercise stimulates the release of chemicals known as growth factors, sometimes referred to as "brain fertilisers". These help support brain cell health, improve communication between nerve cells and encourage the brain's ability to adapt and reorganise itself, a process known as neuroplasticity.

In simple terms, neuroplasticity is the brain's ability to learn, adapt and build new pathways. For many years scientists believed the adult brain was relatively fixed. We now know that throughout life the brain continues to change in response to what we ask it to do. Every time we practise a movement, challenge our balance, improve our walking or learn a new physical skill, the brain is receiving information and adapting accordingly.

This is one of the reasons exercise is now viewed by many specialists as a key component of Parkinson's management rather than simply an optional lifestyle choice. It may be helping the body and the brain at the same time.

Why Movement Matters in Parkinson's Disease

Parkinson's disease affects the nervous system and can gradually alter how movement is planned and carried out. As dopamine-producing cells within the brain become damaged, people may experience slower movement, muscle stiffness and rigidity, reduced arm swing, stooped posture, smaller movements, difficulty turning and reduced balance and confidence.

One of the challenges is that movement often becomes progressively smaller over time. Steps shorten, reaching distances reduce and turning movements become more restricted. Everyday activities such as getting out of a chair, turning in bed, walking around the supermarket or reaching into a cupboard may gradually require more effort.

Without realising it, many people begin moving less because movement simply feels harder. This can create a cycle where stiffness increases, confidence reduces and everyday tasks become more difficult. Exercise helps challenge this pattern by encouraging larger, more purposeful movements and helping people maintain mobility, flexibility and confidence.

Exercise as Brain Training

One of the most fascinating concepts discussed throughout the guide is the idea that exercise may directly support brain health.

Research suggests exercise encourages the release of substances that help support brain cell survival, communication and adaptation. One growth factor that receives particular attention is

Brain-Derived Neurotrophic Factor, often shortened to BDNF.

A useful way of thinking about BDNF is as fertiliser for the brain. Just as plants need nutrients to grow and thrive, brain cells appear to benefit from growth factors that help them survive, communicate and adapt. Researchers believe exercise may stimulate the release of these chemicals, helping support the brain's ability to learn and reorganise itself.

Whilst scientists are still exploring exactly how these processes work, it provides an exciting explanation for why exercise appears to offer benefits that extend far beyond physical fitness. It may help explain improvements in movement, confidence, thinking, mood and overall wellbeing that many people report after becoming more active.

Benefits You May Notice

Whilst the science behind exercise is fascinating, most people are interested in a simpler question: how might exercise help me?

The benefits of regular exercise extend far beyond physical fitness. Many people report improvements in walking ability, balance, posture, flexibility, strength, confidence, mood, sleep quality, energy levels and overall day-to-day function.

Exercise can also help people maintain independence and continue participating in the activities that matter most to them. Whether that is walking the dog, gardening, playing with grandchildren, travelling, socialising or simply feeling more confident moving around the house, maintaining activity can have a significant impact on quality of life.

Many people simply describe feeling looser, more mobile and more capable after regular exercise. These improvements are often small at first, but they can add up over time.

Physical Activity Versus Exercise

One point that stood out from the guide was the distinction between physical activity and exercise.

Physical activity includes any movement throughout the day. Walking around the house, gardening, housework, shopping, climbing stairs, walking the dog and playing with grandchildren all count. These activities are important because they reduce time spent sitting and keep the body moving throughout the day.

Exercise is slightly different. It is more structured and performed with a specific goal in mind, such as improving strength, fitness, balance or flexibility.

Both are important. The goal is not simply to attend an exercise class once a week and spend the remainder of the time sitting down. Increasing daily movement whilst incorporating regular exercise sessions often produces the greatest benefits.

What Type of Exercise Is Best?

Many people ask, "What is the best exercise for Parkinson's disease?"

The answer may be simpler than expected. The best exercise is often the one you enjoy enough to continue doing.

Research supports a wide variety of activities including walking, cycling, swimming, dancing, boxing, yoga, Tai Chi, Pilates, strength training, stretching programmes and Parkinson's-specific exercise classes.

Rather than searching for the perfect exercise, the aim is usually to build a balanced routine that includes several different types of movement. The Michael J. Fox Foundation guide highlights the importance of aerobic exercise, strength training, flexibility work and balance exercises, with each contributing different benefits.

Strength, Stretching and Posture

As physiotherapists, we frequently see stiffness developing through the chest, shoulders, trunk, hips and calves. This stiffness can gradually contribute to the rounded posture commonly seen in Parkinson's disease.

Simple stretching and mobility exercises can help maintain movement and comfort. Activities such as trunk rotation, chest opening exercises, reaching movements and calf stretches may seem straightforward, but they address some of the most common movement challenges associated with Parkinson's disease.

Maintaining posture is particularly important. As the shoulders and upper back gradually drift forwards, breathing, balance, walking and reaching can all become more difficult. Regular stretching and posture-focused exercises can help people maintain a more upright position and move more freely.

Many people notice they feel taller, less stiff and more comfortable after incorporating these exercises into their routine.

Don't Forget Balance

Balance changes are common in Parkinson's disease and can affect confidence as much as physical ability.

Balance exercises can help maintain stability, improve confidence and reduce falls risk. Importantly, balance training should always be appropriate for the individual and carried out safely, particularly if there is a history of falls.

For some people this may involve standing exercises, stepping activities or dynamic balance work. For others, seated exercises may provide an excellent starting point. The key is finding activities that are both challenging and safe.

Consistency Beats Perfection

Perhaps the most encouraging message from the guide is that exercise does not have to be extreme to be beneficial.

You do not need to become a marathon runner. You do not need expensive equipment, a gym membership or hours of free time each day. Small amounts of regular movement performed consistently are often more valuable than occasional bursts of intensive exercise.

A short walk, a few stretches, ten minutes of movement or an exercise class once a week are all positive steps. These small actions may not seem significant on their own, but they add up over weeks, months and years.

Many people delay exercise because they feel they need more energy, fewer symptoms or more confidence before they begin. Unfortunately, the perfect time rarely arrives. The evidence increasingly suggests that starting earlier and remaining consistent is often more important than doing everything perfectly.

A Final Thought

Parkinson's disease undoubtedly brings challenges, but exercise provides something incredibly valuable: an opportunity to take an active role in your own health.

It is one of the few interventions that can positively influence physical function, confidence, wellbeing and potentially brain health at the same time. Whether your goal is to walk further, stand taller, improve balance, maintain independence or simply feel less stiff, movement matters.

Reading The Michael J. Fox Foundation's guide reinforced something physiotherapists see every day. Movement is not simply about muscles and joints. Every walk, every stretch, every balance exercise and every effort to stay active is providing valuable information to the nervous system.

Scientists continue to investigate exactly how exercise influences the brain, but one thing is becoming increasingly clear: exercise is not simply training the body. It may be helping train the brain as well.

The most important thing is not finding the perfect exercise programme. It is finding ways to keep moving.

At Physio at Home, we provide physiotherapy and rehabilitation throughout Mid Cornwall within the comfort of your own home. By assessing people within their everyday environment, we can provide personalised advice, rehabilitation and practical solutions that support independence, confidence and mobility for as long as possible. Please visit https://www.physioathome.uk/ for more information

Further Reading

This article was inspired by Make Your Move: Exercise for Brain Health and Life with Parkinson's produced by The Michael J. Fox Foundation.

The full guide can be downloaded free of charge here:

https://www.michaeljfox.org/sites/default/files/media/document/Exercise%20Guide_singles_02.01.24.pdf