Tricia Creel, DPT, NCS is a physical therapist and co-founder -- along with Dr. Madeleine Hackney, Ph.D. and Dr. Doherty Riebesell, DPT, GCS -- of MDT Education Solutions, an organization dedicated to equipping health and fitness professionals, care partners, caregivers and people with Parkinson's with the knowledge and resources to form and participate in community-based exercise programs. 

Recent literature strongly suggests that exercise has a therapeutic benefit for people with Parkinson's disease (PD). There is evidence of benefits from varied types of exercise such as Tai Chi, treadmill training, boxing, progressive resistance training and adapted tango. It can be confusing to understand which type of exercise is optimal for you and how often you need to be exercising. 

In addition to deciding which type of exercise is appropriate, you may also be wondering how intense your workout should be. There is growing evidence that vigorous exercise may have a neuroprotective effect for people with PD. It may help to know that the terms "intense" and "vigorous" can apply to a number of aspects of exercise, including high repetition, velocity, complexity and cardiovascular response.

So, at what intensity should you be exercising? And what type of exercise should you be doing? The research hasn't yet given us exact answers. We still need large, well-designed, randomized controlled trials to establish the impact of different doses of a range of exercise types on the long-term impairments of individuals with PD. But here is what you can take away from the research that has already been completed:

1. People with PD have a wide variety of symptoms, differing rates of disease progression and different mobility levels. As a result, exercise programs should be tailored to the individual. A physical therapist can help you design a tailored exercise program.
2. People with PD need to develop long-term, sustainable exercise habits. Even the most advantageous exercise program is helpful only if you stick with it. Find something you enjoy!
3. Try to participate in a variety of exercises. Group classes, especially those designed specifically for people with PD, can help you achieve this.
4. Challenge yourself to perform complex (multi-step or multi-task) exercises. For example, both boxing and dance-based exercise require coordination, concentration, and balance.
5. Include exercise that provides a cardiovascular challenge. On a scale of 0-10, try to reach an exertion level of 5-7.
6. If there is something specific that you are having trouble doing, such as turns or rolling in bed, find an exercise that mimics that activity as closely as possible. Specificity of training matters!

It's always a good idea to consult with your physician before starting a new exercise program. And remember to keep moving!

Editor's note: Join our online study Fox Insight to tell researchers what type of exercise you do and how it's helped you manage life with Parkinson's. Fox Insight could lead to new insights and areas of study, including on the impact of exercise on Parkinson's disease.