Adam Margolias, MD, a movement disorders specialist at Cleveland Clinic, helps lead a multidisciplinary clinic for people with advanced Parkinson’s and palliative care needs. He explains the overlooked power of therapy and exercise in managing Parkinson’s progression.
Transcript
So in terms of treatment of Parkinson’s, nonpharmacologic therapies — or things that aren’t pills — are probably more useful overall than medications, or at least just as important.
The number one most important treatment of Parkinson’s that’s not a pill, I would say, is exercise. And that’s true for any stage of the disease.
The pills we have for Parkinson’s are good at treating symptoms of the disease, but they don’t actually slow the progression. But exercise does. That’s the one intervention we have that can actually slow progression — specifically aerobic exercise.
More specifically, as years go on, services of a physical therapist, speech therapist, or occupational therapist can all be really helpful for Parkinson’s-related problems with walking and balance, which become more prevalent as the disease advances.
A physical therapist is a great resource that can help find ways to prevent falls and stay safe, and also help you decide which assistive device might be best for you — whether that’s a cane or a walker. There are many types of walkers, too. So we rely on the physical therapist’s expertise in trying things out and figuring out what’s a good fit.
Occupational therapists focus more on daily activities—at-home tasks and activities of daily living. Things like eating, dressing, and hygiene activities like showering or brushing your teeth. Those can certainly become affected in Parkinson’s, and an occupational therapist can be a big part of treatment there.
Then there’s speech therapy. But it’s not just speech—it’s also swallowing and cognition. And those are all areas a speech therapist can help with. These are symptoms that can have a big effect on quality of life as the years progress.
So in terms of a treatment that’s maybe overlooked a little bit, I think exercise is probably the number one thing. Even in advanced disease, a patient might think they can’t exercise like they used to.
But there are still things they can do, no matter what stage of Parkinson’s they’re in. Whether it’s just some aerobics in a chair or even in bed, or getting your feet moving on a pedal — even if you’re not going out and biking around the block—you can still get those benefits from exercise.
