In fact, after six months of exercise, the neurons actually had grown healthier and produced stronger dopamine signals. Dopamine is a chemical that helps brain cells communicate with each other. The researchers published their findings in npj Parkinson’s Disease on February 9.
High-intensity Exercise Can Reverse Neuro... - Cure Parkinson's
High-intensity Exercise Can Reverse Neurodegeneration in Parkinson’s Disease
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Farooqji
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Thank you for sharing 🙏
I’m doing a lot better since I started weight training.
Wow, so cool that imaging has confirmed in humans what has been found in animal models. Here's the paper the article referred to, if anybody wants the gory details; nature.com/articles/s41531-...
The study (at Yale) enrolled people with early PD and the exercise program they used is high intensity. Subjects exercised for an hour 3 times a week, with a goal of increasing heartrate to 80% of maximum. Here's a link to the program they used; beatpdtoday.com
This level of intensity may be too challenging for some who's Parkinson's is more advanced. Researchers have developed robotic exoskeletons that allow those with disabilities to exercise at higher intensity, but they're not widely available yet. Until they are, it's possible "forced" exercise (think "assisted" exercise) could provide similar benefits. Here's a good article on the subject that Bolt Upright posted last year; somaticmovementcenter.com/r...
And a recent paper on robotic assisted exercise in Parkinson's; nature.com/articles/s41598-...
Thanks for those links. Can you help me find the reference to '3 times a week'?
As for the exercise itself the study says: 'A typical workout includes warm-up (5 min), exercise (30 min) with two consecutive circuits (composed of strength, cardio, and power exercises) each performed twice with 30 s rest periods between rounds, boxing (15 min), and cool-down (10 min). '
I was worried about how long I'd be able to maintain my target heart rate, but it sounds doable: 'Average HRs during the 20 min containing the highest mean HR during the exercise session were analyzed to confirm that participants had achieved and maintained their HR within the targeted range.'
If anyone struggles to achieve their target heart rate, watch this video: youtube.com/watch?v=Q6d0J81...
Somewhere on the video he explains that some PWP have a problem with a nerve connecting to the heart, so tailoring exercise intensity to breathing rate may be better.
You can find the video by searching for 'Bas Bloem exercise' on YouTube.
"A typical workout includes warm-up (5 min), exercise (30 min) with two consecutive circuits (composed of strength, cardio, and power exercises) each performed twice with 30 s rest periods between rounds, boxing (15 min), and cool-down (10 min). Trainers provided individual feedback to participants and logged class attendance to verify that each subject completed the required number of classes (72 in total)."
The study was for 6 months, so 12 classes per month, which comes to 3 classes per week. I think 3 times a week was referred to somewhere else as well, but this confirms it.
BTW, this study doesn't suggest that other intensities of exercise are useless or not worth doing. Personally, I'm in favor of an 80/20 exercise schedule for maximally increasing mitochondrial function and VO2max. This involves doing 20% of one's weekly exercise at zone 4 level (basically HIIT) and 80% at zone 2 (where you could go all day.) Of course this might have to be tweaked a bit, depending on the total amount of time one is willing or able to devote to exercise.
Using the age formula for determining max heart rate doesn't really work for those with autonomic involvement like my spouse, who has bradycardia (resting HR in the 40's.) Ideal is to be tested in an exercise lab, but if that's not possible, using "perceived rate of exertion," sometimes called the "talk test," can suffice. Lots of info on zone training and it's effect on mitochondria on the internet. 😊
Ah, good thinking and thanks for the detailed reply. I fully agree with you about other intensities of exercise. On the video I mentioned at around about 30 minutes in Bas Bloem mentions two relevant studies. One showed that volume of exercise (at whatever pace) reduced risk of dying from PD., the other that patients who did more exercise declined more slowly over time.
This is from the Yale Medicine article originally posted by Farooqji;
"Previously, two well-designed clinical trials have shown that engaging in high-intensity exercise—in which participants reach around 80% to 85% of their age-appropriate maximum heart rate—three times a week for six months is correlated with less severe motor symptoms. “These trials suggested that exercise really is disease-modifying in a clinical sense,” says Tinaz. The Yale team used these clinical trials as a model for its new study."
And the 72 classes completed over the 6 month study confirms that they did follow the 3 times a week model.
anyone know the specific exercise? duration each day? it says 80-85% of max heart rate...would love more details!
Te old saying goes "use it or loose it". If a musician wants to play an instrument he or she will need to invest time into developing the muscle memory and dexterity. That's why I've resisted using a walking stick after my stroke, to encourage my lege to strengthen and sense of balance to improve. I try to walk 4-6 miles every day the weather is'nt absolutely attrocious, and I'm a little stiff and wobbly for the first hundred yards or so but but after 300-400 yards I'm usually well into my rhythm. I try to walk briskly with normal strides rather than a shuffling gait and normally keep that up until the last couple of hundred yards.
I also have a three kilo steel bar which I use for weight training and at first I could only manage ten reps but I'm now up to thirty reps and am considering getting something heavier.
Looking forwards to warmer weather when I can get out on my bike regularly as I only managed a handul of rides last Summer.
Your headline said "High-intensity Exercise Can Reverse Neurodegeneration in Parkinson’s Disease".
However, the first paragraph of the article that you referred to said, "High-intensity exercise induces brain-protective effects that have the potential to not just slow down, but possibly reverse, the neurodegeneration associated with Parkinson’s disease, a new pilot study suggests.
Potential means maybe.
Possibly is not positive.
Suggests is not a precise definition.
Sorry, this is a little misleading.
'Potential means maybe.' So yes, maybe it will work.
'Possibly is not positive.' Possibly is also not negative.
Instead of negativity, I will take motivation from possibilities anytime
Good for you jay
I’ve been going to a boxing gym here in South Africa it’s the best run by a ex pro boxer I’m here from Scotland on hols for 2 months we do circuits run and sparring and skipping cycling etc
Hopefully I can find a boxing g gym back in Scotland
And further on in the article.....
"Following the six-month program, brain imaging showed a significant increase in both the neuromelanin and DAT signals in the substantia nigra. This suggests that high-intensity exercise not only slowed down the neurodegenerative process, but also helped the dopaminergic system grow healthier."
“Where we would have ordinarily expected to see a decline in the DAT and neuromelanin signals, we saw an increase,” says Bart de Laat, PhD, associate professor adjunct in psychiatry and the study’s first author. “We had hoped to see that the neurodegeneration would not progress as quickly or stop temporarily, but instead we saw an increase in nine out of 10 people. That was remarkable.”
Sounds pretty "positive" to me.
"“Where we would have ordinarily expected to see a decline in the DAT and neuromelanin signals, we saw an increase,” says Bart de Laat, PhD, associate professor a..."
I was diagnosed with Parkinson's Disease. I never felt I had a disease. I didn't freeze, I didn't walk slowly. I didn't have balance problems and I didn't fall down. BUT the DAT scan confirmed that I have Parkinson's. If I'm an out-lier, meaning I have a mild version of the disease, I'd say it's because of a life-long running habit.
I wonder why exercise is so good for people with this disease. Hard exercise burns up the available blood glucose. When it's gone the body switches to burning fat for energy. That's the Krebs Cycle I learned about in organic chem class 50 years ago.
So the trick is to use up glycogen which is another word for glucose. Doing that means working the large muscles such as the quads. Other muscles such as the pecs or biceps aren't large enough to use up much glycogen. You must be out of breath. In college I took a scuba diving class. We had to get in the pool with all the scuba gear, hold onto the edge of the pool and pedal our legs as fast and hard and possible as the instructor yelled at us to work harder, work harder, work harder He was an ex-Green Beret. There was a large potted plant next to the pool. He expected us to work hard enough that we might barf into the potted plant.
The point is anything that raises your heart rate is burning glycogen. Sitting in a sauna raises the heart rate if it's hot enough. Try jumping jacks, try holding your breath, try filling the tub with ice, try anything that forces your heart to work harder. I found that standing squats with a heavy weight on my shoulders brought my heart rate to its maximum. That's using the quads and lumbar muscles together.
I don't know whether this theory is valid. I really don't. But I'm going to keep doing the HIIT three times a week.
I agree, the science of exercise is fascinating. One fairly recent finding I find interesting is that lactate might be an important mediator of the brain effects of exercise. It used to be thought that lactate was just a waste product that made you sore and tired, but now it's thought to play an important role in brain health, by increasing BDNF and acting as fuel for neurons. And high intensity exercise produces the most lactate. frontiersin.org/journals/ph...
it’s not that easy to get to 80-85% max heart rate. And the more fit you are, it’s even harder. Would be helpful to know what at-home exercise you could do to get there and how long do you need to stay in that zone.
Nobody said the protocol they used was easy, just effective. 😉 From the study that I posted above;
"Subjects reached HRs of 70% of their maximum and higher in more than 85% of classes, which is consistent with their rating 90% of their classes as very intense. This suggests that subjects exercised at more than moderate-intensity level (typically, 60–65% of the maximum HR) in most classes. Participants reached the target HR of 80% of their theoretical maximum in two-thirds of classes. The discrepancy between the ratings and HR data may be due to mechanisms such as cardiac sympathetic denervation which is common in PD and would restrict increases in HR in response to an exercise challenge. Importantly, we did not find any significant motor progression or increase in levodopa equivalent daily dose. Together, these points suggest that our exercise program resulted in clinical benefit despite not always exceeding the prescribed HR threshold."
Also from the study;
"Beat Parkinson’s Today offers high-intensity interval training and boxing, both of which have been shown to benefit people with PD. The high-intensity interval training circuits are designed to improve aerobic capacity, muscle strength and endurance, gait and balance, physical function, and flexibility. "
"A typical workout includes warm-up (5 min), exercise (30 min) with two consecutive circuits (composed of strength, cardio, and power exercises) each performed twice with 30 s rest periods between rounds, boxing (15 min), and cool-down (10 min)."
These classes can be taken online, and if anybody decides to try one, I hope they'll report back here. beatpdtoday.com/class-schedule
A spin bike is an easy way to do it. Peloton makes it easy to monitor your heart rate during your work out, but there are cheaper ways to do it than buying a Peloton bike (though I'd go with a Peloton if you can find a deal on a second-hand one and can afford the monthly All-Access fee.) If you can't, you can buy a cheaper non-Peloton bike and use the Peloton app (which does cost money but is very reasonably priced and offers massive return on investment if you are committed to exercising.) There's a Peloton subreddit with info about how to take Peloton classes on a non-Peloton bike. You can also take Peloton running (or walking or hiking) classes on any treadmill and use an Apple watch or other heart rate monitor to monitor your heart rate.
This may explain similar studies on cold plunging. Cold water plunges do significantly increase heart rate. This is due to the body's cold shock response. Assuming it is the increased heart rate that prompts neurological regeneration, these may have a similar effect and are not limited by mobility.
I do an HIIT workout three times a week. It 's based on Dr Mercola's method. At first he used a stat bike but eventually went to an elliptical trainer. It starts with using a heart rate monitor to find your maximum heart rate. My max is 170. Then it's 30-second sprints with 90-second rests.
I talked to Mercola a few times. I use a treadmill. He told me a treadmill increases the odds of an injury. Maybe he was right as I ultimately needed surgery on my Achilles tendon.
But I still use the treadmill. I set it to 15% incline and 5MPH speed. Once it's rolling I jump on for 30 seconds then jump off for 90 seconds. I do 8 to 10 sprints. The sprints get my heart rate to 150 which is 90% of maximum.
5 mph is a very good speed. for how long you jog at this speed
5MPH is 12:00 minute per mile pace. A slow jog. I've done marathons at a better pace. But what makes 5MPH difficult is the 15% grade. That's the most incline my treadmill can do. 30 seconds is difficult to do especially on a treadmill where you risk tripping and falling off. The hand rails have saved me several times. The standard is working hard enough that you can't hold a conversation. HIIT stimulates BDNF: brain derived neurotrophic factor.
kaypeeoh How long have you been doing this? Has it slowed your progression?
I ran my first marathon in 1985. I've lost count of how many races I've done.
this study just confirms old news. All these studies use recently dx or less than 4 years(mild pd) as their subjects. I could maintain 80 cadence on bike when first dx.
I would like to see if they get the same results with folks over 5 years-10 At 8 years I can only last 60-70 cadence for 30 minutes
This is wonderful news!! Thank you for posting.
I wonder how long this can last for. Has anyone here been doing intense workouts like this for over 10 years? How is your progression?
I know of kaypeeoh
I should definitely consider purchasing a smartwatch! This is indeed a confirmation of what Bas Bloem showed us a year ago in the nosilverbullet4pd Zoom presentation by Michel0220 titled "What type of exercise is best for people with PD?" Watch the highly motivating video (again) and you really have no reason not to get started:
I think high intensity exercise is elevated heart rate over a sustained period of time, while high intensity interval training is short bursts of high intensity followed by low intensity, in cycles.
Experts seem to agree that HIIT is better than HIT in boosting BDNF, and overall health.
Sorry if this is a duplication of any comment.
Healthier body better mind, always thought there was something in that, been through a bad phase of health last couple of years, have restarted use of exercise bike sessions, swear old grey cells in better fashion🤔👍
I posted this to a running website that I've been on for 35 years.:
"A different scheme for calculating max heart rate The old method was 220 minus age. That method says my max is 156. The new method says 170.
On the treadmill sprinting at 10% grade, 10 mpm pace the HRM displays 170 at the end of each 30 second sprint. 1
The new method is 0.64 time age. For me that's 41. Then 211 minus that number so 211 minus 41 equals 170. The same max I get when sprinting my hardest.
So the new method is more accurate, at least for me."
I did this when I was 65. Now I'm 68. I've had to increase the speed and incline since then. I wrote, "10% grade, 10 mpm pace ..." Now I use 12% grade, 12mpm pace. I tried going faster on the treadmill but tended to be thrown off because of stepping too close the edge of the belt. Slower speed but higher incline seems to work for me.
Sorry for the braggadocio. Typically PD causes weight loss. For me it's the opposite. I weighed 165 before developing PD. Now I'm at 210. I can't seem to lose any weight even with regular treadmill exercise. Prolly because I spend all day on the couch except when using the treadmill.
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