Best Exercises to Slow Parkinson’s Progression: Science-Backed Routines You Can Start Today

Can exercise really slow the progression of Parkinson’s disease? In this episode we break down the latest research on how movement impacts Parkinson’s symptoms and progression.

Drawing from multiple clinical studies, including the SPARX trial and a 2022 npj Parkinson’s Disease meta-analysis, you’ll discover which types of exercise provide the biggest benefits — and why. From aerobic workouts and strength training to yoga, balance drills, and even high-intensity interval training (HIIT), we’ll explore practical strategies you can start today.

You’ll also learn how to:

• Build a weekly exercise plan that works for your body
• Improve balance, mobility, and independence
• Overcome common barriers like fatigue, freezing of gait, and low motivation
• Stay consistent with realistic, enjoyable routines

Whether you’re newly diagnosed or have been living with Parkinson’s for years, this episode will give you clear, science-backed tools to take control of your health and quality of life.

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👉 Get Chris Kustanbauter’s book Spectacular Life – 4 Essential Strategies for Living with Parkinson’s on Amazon.

Chapters

• 0:10 Welcome and Episode Introduction
• 1:20 The Science Behind Exercise and Parkinson's
• 3:44 Five Essential Exercise Categories
• 15:59 Building a Sustainable Weekly Plan
• 21:12 Overcoming Exercise Barriers
• 25:33 Real-Life Success Stories and Takeaways
• 29:07 Resources and Closing Thoughts

Transcript

Speaker 1: 0:10

Hello and welcome to Live Parkinson's Live an Exceptional Life. I'm your host, chris Kustenbader, and I've been living an exceptional life with Parkinson's for the past 15 years. The mission of this podcast is to help as many people as possible living with Parkinson's to lead a great quality of life. Now, today, we're diving into something that many of you have been asking, and that is which exercises actually help slow down Parkinson's disease progression. Not just what's helped you feel better today, but what may change how your Parkinson's moves forward. So if you've ever wondered, is exercise just symptom relief or can it actually slow the disease, then this episode is for you. I'll walk you through the latest clinical science, the best types of movements to include how to build a safe weekly plan and how to overcome some of the common roadblocks that hold us back. And, before we jump in, if this podcast adds value, later I'm going to share with you how you can get free resources, join my newsletter and support the program and learn more about my personal journey. But for now, let's get into movement, the science and how you can start today to build an exercise routine that doesn't just help, it fights back.

Speaker 1: 1:20

Okay, first, why does exercise matter? Not just for strength or mood, but possibly for slowing progression. Now there's some growing compelling evidence. For example, there was a study titled Clinical Trial Highlights Aerobic Exercise for Parkinson's Disease, and what it did is it reviewed six randomized clinical trials ranging from 28 to 370 people with Parkinson's, and the duration was eight weeks to 18 months, and what the study showed was that the outcomes show that aerobic exercise improves motor symptoms and may slow clinical progression. And then, in addition, there was a meta-analysis called a Symptomatic and meta-analysis on effects of aerobic exercise that was published in NPJ Parkinson's disease in 2022. That found that aerobic exercise significantly improved things like balance, gait speed, stride, step length and motor function, based on the UPDRS-3 scoring scale in people with Parkinson's. And then, finally, there was another long-term study called Long-Term Effect of Regular Physical Activity and Exercise Habits in Parkinson's Disease that was published in Neurology in 2024. And what that study showed was that people who maintained regular, vigorous exercise had more stable disease progression over time. Now I think that's pretty fascinating.

Speaker 1: 2:49

So why does this happen? Well, some of the hypotheses are that exercise seems to promote neuroplasticity Remember we talked about that in other podcasts, but that's making new connections in the brain. Reduced inflammation could be another contributing factor, improved cardiovascular health, which helps support your brain function, and then, in some studies, augment neurotropic factors like BDNF or brain-derived neurotropic factor, which I talked about in previous podcasts. It's like a fertilizer for your brain. So the bottom line is this Exercise isn't just a filler and it's just not something nice to do. It's one of the few non-drug tools that we have in our toolbox that can really help with potential disease-modifying impact.

Speaker 1: 3:37

All right, so let's talk a little bit about which exercises are going to deliver the most bang for the buck and how and how much we need. All right, now, here are some of the top categories of exercises and what literature suggests, and then we'll give you some practical examples and some safety modifications, because that's important too, because we're all in different stages of progression. So we want to make sure that we give a broad range of safety options as well, and then you want to pick a mix that works best for you. Now, before I give these, I do want to give a broad range of safety options as well, and then you want to pick a mix that works best for you. Now, before I give these, I do want to give a disclaimer that before you start any exercise program, please consult your movement disorder specialist or neurologist and your primary care physician to make sure that the exercise plan that you're developing meets your personal specific needs. And then it's also important, if possible, to work with a physical therapist that has experience with Parkinson's or a certified physical trainer that has experience with people with Parkinson's as well.

Speaker 1: 4:38

All right, now that we've got that out of the way, let's talk about number one, and that's aerobic exercise, or what we call cardio. So what is it? Well, cardio is brisk walking, cycling, and that could be either stationary bike, like you're taking a spin class I teach pedaling for Parkinson's, and that's a great way to get a cardiovascular workout or it could be riding your bike out on the road if your balance is good, swimming bike out on the road, if your balance is good. Swimming, dancing, treadmill, walking, elliptical those would all be examples of cardio. So why does cardio help?

Speaker 1: 5:16

Well, as I mentioned earlier in that meta-analysis that was published in the NPGA Parkinson's Disease Journal, it showed that aerobic exercise significantly improves your gait speed, your stride length, your balance and your motor function compared to the control group. And then there was another study that was called the SPARKS trial, and I talked about this in one of my earlier podcasts, but the SPARKS trial stands for Study in Parkinson's Disease of Exercise of exercise and that was completed in 2017, and it involved 128 newly diagnosed Parkinson's patients that were not yet on Parkinson's medications like Levodopa. And what they did is they compared high-intensity treadmill exercise where the people got their heart rate up between 80% to 85% of their maximum heart rate, versus low-intensity, versus control, and what they found was that over six months, the control group worsened slightly, while the high intensity group stayed more stable. So that begs the question, then how much aerobic exercise do we need? Now? Many studies suggest that moderate to high-intensity exercise should be done about three to five times per week and sessions should last anywhere from 30 to 50 minutes. Now the SPARKS 3 protocol, for instance, uses four days a week at 30 minutes per session. Now some modifications for safety. So if high-intensity feels overwhelming or risky to start out, start small. We all have to start somewhere, so it's better to start slowly and build into it than it is to go all out and then quit after the first day because you're so sore. So one way to start out slow is just do 20 minutes of moderate pace and throw some rest breaks in there. You can use the talk test. At a moderate effort you can talk, and when you're at a really high effort, you can only get a few words out. Now again, make sure you get the okay from your doctor, especially if you have any heart or lung issues.

Speaker 1: 7:22

All right, next up is strength training. And what is strength training, you may be asking. Well, that would include things like resistance bands, free weights or dumbbells, weight machines. So there's a lot of different machines out there that you can use. And then body weight exercises, and they could include squats, push-ups, and you can do push-ups on your knees, you can do push-ups against the wall and then sit to stand where you're sitting in a chair and you stand up. Those would all be examples of body weight exercises.

Speaker 1: 7:53

Now why do they help? Well, number one is they improve your muscle strength. Well, that's pretty obvious. That's why we call it strength training. But it also helps with your posture, your stability, because if you have a strong core, and that's going to help with your center of gravity, that's going to make you more stable, it's going to help reduce the risk of falls. And then strong muscles also help with your movement speed, and then they're going to help reduce some of the rigidity that you feel and then possibly they might help with some motor decline as well. Now some studies show that combining aerobic and strength training gives the best results on motor function and gait than just doing aerobic exercises by itself. The actual studies, while the meta-analysis focused more on aerobic, many of the clinical trials that were done included the mixed programs, where they mixed aerobic and strength training. So how often should you do strength training? Well, it's recommended that two to three times per week, and you want to do non-consecutive days, so maybe you want to do Tuesday, thursday, saturday, something like that, or Monday, wednesday, friday, because you want to allow your muscles time to recover.

Speaker 1: 9:04

All right, the next type of exercise, number three, is balance and agility. Now, what would this include? It's things like tai chi yoga, doing some agility drills like sidesteps or obstacle courses. Now a couple of the Parkinson's programs that I participate in. We walk on stepping stones where you can use poles to help for balance. We do a lot of moving through cones, stepping over cones, stepping over little bars. So those would be examples of little obstacle courses Could do. Dual task. Walking would be another thing, where you're walking and doing another task at the same time, and that might include saying the months of the year backwards, or counting by threes to 60, or spelling, or doing the alphabet and saying every other letter. So it's using cognitive and exercise functions at the same time. And then dance is another way to improve your agility as well, as there's some martial arts out there that taekwondo, or some of those type of things that you can do as well. Boxing is also another great way to work on your balance and agility.

Speaker 1: 10:18

Why is balance and agility important? Because balance is one of the biggest challenges that we all face. We all know that falls are going to lead to injury and then they also lead to fear. If you don't have good balance, then you become fearful that you're going to fall and then you start to limit your social activities and then you become socially isolated. So fear and isolation are big concerns if you don't have good balance. And there was a meta-analysis done that looked at aerobic exercise and what it found was that it improved scores on balance tests and, for instance, the timed up and go, where you sit in a chair, you stand up and you walk. But also doing balance and agility is going to help with training for quick adjustments, so that if you have to make a quick adjustment or in reaction times like, for instance, I have a boxer dog and I had two boxer dogs, one passed away, but Katie, my one boxer dog, loves to come up and stand behind me and if I'm not paying attention I turn around too quickly and then I have to make a quick reaction so that I don't fall over or knock her down. So balance exercises I do every day because it's going to help me. It helps me with those quick reaction times.

Speaker 1: 11:32

And then next up is flexibility and mobility. So what does this include? This includes stretching, and there's a couple of different types of stretching where there's dynamic stretching and then there's static stretching, where you hold a particular stretch for an extended period of time. Maybe you're doing a hamstring stretch and you hold that for 30 seconds. Yoga is another good way to work on flexibility and mobility Gentle joint mobilizations, where you're rolling your ankles, you're doing shoulder rolls, you're doing hip movements, movements and some rotational movements. Those are all good for flexibility and movements.

Speaker 1: 12:13

So why is it important that you work on flexibility? Well, because Parkinson's causes stiffness and rigidity and it's going to reduce if you're not moving your joints, it's going to reduce your joint range. For instance, if you're not moving your shoulders, you can get frozen shoulder, and then it's also going to lead to posture issues. One of the things that we already experience in Parkinson's is your shoulders start to roll in and you start to hunch over. So it's important to do wide chest stretches for flexibility, to keep your chest open, as an example. And then flexibility is going to help keep you limber. It's going to help with everyday functions like reaching, turning, bending, and it's going to help reduce discomfort, because if you're stiff, it's very uncomfortable. So if you're constantly doing flexibility and stretching exercises, it's going to help keep you limber and help reduce some of that discomfort. Now, while flexibility alone may not slow the progression as much as like aerobic or strength training, it's essential for your quality of life and it's going to enable you to do some of the exercises more safely without having to worry about, you know, pulling a muscle or something like that. And then research comparing aerobic versus strength showed that aerobic had effects on brain connectivity and less brain atrophy, while stretching did not in those particular metrics that they studied. So that's a personal example.

Speaker 1: 13:41

And then, finally, number five in terms of exercise. Now, we talked about aerobic, we talked about strength training, we talked about balance and agility, flexibility and mobility, and the last one's going to be high-intensity interval training, what they call HIIT, h-i-i-t, and what is it? It's real short bursts of high effort. So it could be example would be a fast pace on an uphill walk, or you're doing a sprint for 30 seconds or 45 seconds and then you take a 15 second break. Those would be examples of some high intensity interval training. And then so it's a quick burst of energy followed by rest or periods of low effort, and you can do it on the treadmill, you can do it while you're cycling, you can even do fast walking. You can be walking at a normal pace and then speed up for 30 to 45 seconds and then rest for 15 to 30 seconds. And you can do that whether it's on walking flat, going upstairs or hills, and some of the strongest signals in trials come from high-intensity exercises.

Speaker 1: 14:51

Both the SPARKS and the SPARKS 3 study suggest that high-intensity aerobic exercise, where you get your heart rate up to 80% to 85% of maximum, is going to slow the motor progression more than moderate-intensity exercises. Now, so how often should you do these. Well, some of the data shows that. Maybe one to two times per week initially, just until you get your body accustomed to doing it, and you want to mix that in with your moderate aerobic workouts and then monitor to see how you're doing. Now, one of the things that you don't want to do is push through the pain. If you feel pain, discomfort, dizziness, chest pain, stop immediately and then respect the rest. Ensure that you do good warm-ups and good cool-downs.

Speaker 1: 15:37

Now, before attempting any type of high-intensity interval training, it's important that you get clearance from your doctors, because it's something where you're getting your heart rate up to 80% to 85% of its maximum. So please, please, please, make sure that you get approval from your doctor before you attempt any type of high intensity interval training. All right, so now that you know what kinds of exercise, let's talk about how you put them all together in a plan that you can stick with, because you want to pick things that you enjoy, because if you don't enjoy them, you're not going to do them and then you're not going to get the benefits of exercise. So let's talk about how we can build a plan that you can stick with and this is just a sample plan and you know it's important that you work with your doctor to help develop a plan and a physical therapy and or a physical therapist and a certified personal trainer that's experienced in people with Parkinson's. So, for instance, this is again is a sample plan, sample one week plan, and this could be for someone with mild to moderate stage that you've been cleared by your doctor.

Speaker 1: 16:42

So Monday you might want to do some type of moderate aerobic exercise like a brisk walk with some intervals. You do that for 30 to 40 minutes. Tuesday maybe you do strength training. You do some upper and lower body, so you do some chest presses, you do some shoulder presses, you do some bicep curls, some tricep work, and then you could do some chair squats and push-ups and maybe some lunges, and you do those for 30 minutes, plus maybe some flexibility and mobility work included in there for 15 minutes. Then Wednesday maybe you do balance and agility and you take a yoga or a Tai Chi class and one of the things that's nice about the group fitness classes is that the instructors will modify the exercises so that you can participate and you want to do those for 30 to 45 minutes and then maybe Thursday, once you're up to speed. You could do some aerobic exercise with some high intensity interval training or light intervals for 20 to 30 minutes, and then Friday do some strength and mobility training and stretching, and then Saturday maybe you do some longer aerobic exercise, like maybe you go for a long walk or you swim for a half a mile or you go to a dance class and then maybe throw in some balance drills and then Sunday you want to rest or just do some gentle stretching and mobility exercises and just recover. So that would be just as an example sample plan. So that's going to help us build some consistency.

Speaker 1: 18:20

So start with what you can. Everybody has to start somewhere. So start small and then gradually build into it. Whether it takes you a month, two months, it doesn't matter. Just each week try to add just a little bit more and you'll start to see progress and then you're going to turn around and really be proud of yourself at how far you've come.

Speaker 1: 18:41

So start small Even two sessions a week is better than doing nothing at all and then again do what you enjoy. And then, if you like music, dance might be something for you. If you like the outdoors, then go for a walk. If you like doing classes. Maybe do a group fitness class and some people just like to exercise with a buddy. So find a buddy and do something that you both like and then try to keep a log, if you can Write in there how you feel, what you did, how long you've done it for, and then what type of improvements you saw. And then you start to look back over that and you say, wow, I'm really proud of myself. Look how far I've come and look what I can do now.

Speaker 1: 19:21

So those are all important to keep in mind and so it is important to track your progress so you can do a baseline where you measure. Maybe do a couple simple things like timed up and go how long does it take you to stand up and then walk 10 feet? You could do a six-minute walk test how far can you walk in six minutes and then three months later measure it again. All those things are ways that you can look at how well you're progressing and then also look at how's it affecting your mood, how's it affecting your sleep quality and how's it affecting your energy. Hopefully you're going to see improvements in all those. So it's important to do tracking.

Speaker 1: 20:02

And again, one thing I do want to remind everybody is medical clearance. So check with your neurologist, pt and your primary care physician before you start or before you start upping the intensity, and then they're going to keep in mind some of the comorbidities that you might have. Do you have arthritis, do you have diabetes? Do you have heart disease? Do you have COPD? All those come into play and your doctor is going to be able to help you with that. And then try to work with a physical therapist or a certified physical trainer, because they're going to be able to help you build an exercise plan that's right for you All right.

Speaker 1: 20:39

Now, one of the things that we all struggle with, and that's barriers. I don't care who you are, there's going to be days you're going, oh, I don't feel like doing this, or oh, I don't feel very good today. There's going to be days like that. And then you know, to be honest with you there, I have days like that myself. So there's some days where my balance is off and I say what I had planned I'm not going to be able to do, but I'm still going to do something and I'm going to do it the best I can. So we all face challenges and barriers. It's just, and we may have to make modifications and it's important that we stay consistent. So how do we break some of these barriers? No-transcript walk and then in the evening do another 10-minute walk so I can break my exercise into smaller chunks, and then I'm also going to try to schedule my exercise when I have the most energy. Now me no-transcript important to prioritize rest and then eat well at the same time.

Speaker 1: 22:29

Now, if you're a person that has freezing of gait or rigidity or pain, you can use visual cues to get going, so they make lights that you can focus on to help you. Where you can count one, two, three go those type of things. If you have a rigidity and pain, it's important to really take a lot of time to warm up and stretch first before you go diving into any type of exercise, and then also, if you have freezing of gait or you have rigidity, use assistance. So use railings, use walking poles, spend time exercising in a chair All those things are important or see a physical therapist, but it's important to use tools and assistive devices that are going to help you be able to exercise but do so in a safe manner.

Speaker 1: 23:18

And then motivation and consistency, and this is one that we all run into it's oh, I don't. I just don't feel like doing it today, but it's important that you maintain consistency. So one of the ways you can do that is to find a buddy that's going to push you to be consistent. Or do a fitness class, because there's always accountability. People are going to say like, for instance, I teach the peddling for Parkinson's class and when someone's not there we get concerned, and especially if they're not there the second day, we really become concerned. So everybody calls and says hey, bill, or hey Frank, or hey Susan, we haven't seen you, where are you? And that helps them stay consistent because they feel like they're part of the group and that everybody cares about them. So make sure that you try to find a buddy or you're in a group exercise class, because it's going to help you stay consistent, but it's also going to help other people as well.

Speaker 1: 24:13

And then you could use apps or reminders, schedule exercise like you would any other doctor's appointment or dentist appointment. Put it on your calendar and schedule a time every day saying I'm going to exercise at this particular time. I'm going to set an app and I'm going to set a reminder that's going to remind me to do it and then keep your sessions meaningful. One of the things I like to do is I love listening to music while I exercise. So if I'm walking outside or I'm walking on a treadmill or I'm doing strength training, I'm always listening to music because that gets me motivated and it gets me pumped up, so that's another way that you can stay consistent. Plus, I do outdoor walking and I love being outdoors, so that's another way to do it.

Speaker 1: 24:53

And then, finally, fear of falling is another barrier and safety concerns. So one of the things you do, you start with balance exercises in a safe environment, and that could be standing, holding on to a firm stationary object. It could be using poles, any other type of assistive devices that you need, sitting in a chair, and so use supports when you need them. And then also wear good footwear. You want to make sure that you're wearing non-slip, non-skid shoes so that you're not slipping and sliding all over the place and potentially falling, all right. So those are some of the common barriers that we run into and how you can possibly and some of the ways that you can work through those.

Speaker 1: 25:33

And then, finally, let's talk about some real life inspiration, and I wanted to share a story from someone in the Parkinson's community and I'll just for namesake I'll just call her Jane and Jane was diagnosed about three years ago with early Parkinson's and she felt her walking was slower, that she felt more rigid in the morning and she was worried about losing ground. She was you know, I can't do the things I used to do. I can't keep up. So she started with small changes. She started doing two walks a week and then started with some basic strength training at home, doing just bodyweight squats. She was sitting in the chair, getting out of the chair, she was doing reaching exercises, twisting exercises, and then she started to notice that her energy was improving, she was becoming more physically fit and then pretty soon, over time, she added some HIIT training one day a week. And then she also decided she was going to try a group fitness class and she went to a Tai Chi class for balance and she started stretching on a daily basis and what she found was that after six months she told me that her neurologist said her motor scores had barely changed, so she wasn't losing ground, and that made her really excited. Where she had talked to a couple of her friends that seemed that their symptoms were seemed to be worsening that weren't exercising. So she was really seeing the benefits of exercise and it really got her motivated and excited to do more. And she said she felt stronger, she felt more confident, less rigid and she was able to do all the things that she wanted to do on a daily basis. Now she said she didn't feel perfect every day and I told her look, I don't feel perfect every day either, but she said she feels so much better exercising than if she would have just stayed sitting in the house not doing anything. So that's the power of being intentional when you exercise and then doing it on a consistent basis. So you put those two things together and it's going to provide great benefits and you're going to be able to reap a great harvest at the end.

Speaker 1: 27:31

So let's wrap this up and talk about some of the key takeaways. Number one exercise is medicine. It's just not how you feel now, but possibly how your Parkinson's is going to progress. Exercise is going to be beneficial and it's going to help you in the long run. So the more you exercise, the more benefits you're going to get out of it.

Speaker 1: 27:51

Number two is a key takeaway is you want to mix up your routine. You want to do a mix of all those things that we talked about Aerobic exercise, strength training, balance and agility, flexibility and then, if you're capable, maybe throw in some HIIT training, because each of them is going to offer you unique benefits that if you just stuck with one, you're not going to reap the benefits of including a mix Plus. That way you don't get bored and it helps with consistency as well. Number three you want to remember to start small and build up. Remember, consistency is going to matter more than perfect sessions. You don't have to be perfect, you just have to show up and give your best, no matter how you feel, because there's going to be days you don't feel great, but at least if you show up and do the best you can, that's better than showing up and trying to be perfect. And then, remember, you want to track and adjust and get support from other people. So use some measures, ask for professional advice from physical therapists or certified trainers, and then join communities like group fitness classes or pedaling for Parkinson's or rock steady boxing. All those things are going to help you in the long run, to help to slow your progression down.

Speaker 1: 29:07

Now, if this episode adds value, I'd ask you to please visit liveparkinsonscom and subscribe to the free monthly newsletter, where I share some more resources and information, such as webinars, seminars and some things that are going to come up, as well as what's new in clinical studies and new medications that are on the market. And also there I've created a bunch of free resources on the site that you can download and, for instance, balance exercises to help you improve your balance, and then there's a Parkinson's medication and symptom tracker on there that's going to help you as well. Plus, there's a number of articles on different topics that can help you. And then, if you feel that the podcast is helping you, consider supporting the program if, by visiting my ko-fi page at ko-ficom live parkinson's, even a small donation really helps me keep generating content, doing research and then offering these free tools.

Speaker 1: 30:03

And then, to learn more about my personal 15-year journey with parkinson's, you can pick up my book spectacular life four strategies for living with parkinson's disease that's available on amazon, and it goes deeper into how I built my own Parkinson's. You can pick up my book Spectacular Life Four Strategies for Living with Parkinson's Disease that's available on Amazon, and it goes deeper into how I built my own daily exercise routine, what some of my mental strategies were and how I use relationships to help me on my Parkinson's journey Everything that's going to help you support your quality of life. So I want to thank you for spending time with me and remember you want to keep moving, keep believing in yourself and keep living spectacularly. Believe in yourself because I believe in you. Now I'm going to want to thank you for listening and I hope to see you on future episodes and take care and thanks again, thank you.