View source for Fitness and Exercise Strategies for Persons With Parkinson’s

==== Mind-Body Fitness ====
A mind-body fitness regimen can include a variety of activities that combine body movement with mental focus. The practice of controlled breathing is often a feature. 

* '''[[Yoga]]''' is one such practice. It involves assuming and holding various physical postures while performing coordinated, diaphragmatic breathing.<ref name=":2">Z Altug. Parkinson's Lifestyle Medicine - Fitness Strategies. Plus Course. 2022.</ref> There is evidence that yoga may help manage depression, reduce [[falls|fall]] risk, and improve motor function in PWP.<ref>Sagarwala R, Nasrallah HA. The effects of yoga on depression and motor function in patients with Parkinson's disease: A review of controlled studies. Annals of Clinical Psychiatry. 2020; 32(3):209-215.</ref><ref>Van Puymbroeck M, Walter A, Hawkins BL, Sharp JL, Woschkolup K, Urrea-Mendoza E, et al. [https://www.hindawi.com/journals/ecam/2018/8516351/ Functional improvements in parkinson’s disease following a randomized trial of yoga]. Evidence-Based Complementary and Alternative Medicine. 2018;2018:1–8.</ref><ref>Kwok JYY, Kwan JCY, Auyeung M, Mok VCT, Lau CKY, Choi KC, et al. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6583059/ Effects of Mindfulness Yoga vs Stretching and Resistance Training Exercises on Anxiety and Depression for People With Parkinson Disease]. JAMA Neurology 2019;76(7):755.</ref>
* Traditional martial arts such as '''[https://www.nccih.nih.gov/health/tai-chi-and-qi-gong-in-depth tai chi]''' and '''karate''' may improve [[Balance Training|balance]], fall prevention and quality of life.<ref>Gao Q, Leung A, Yang Y, Wei Q, Guan M, Jia C, et al. Effects of Tai Chi on balance and fall prevention in Parkinson’s disease: a randomized controlled trial. Clinical Rehabilitation 2014;28(8):748–53.</ref><ref>Fleisher JE, Sennott BJ, Myrick E, Niemet CJ, Lee M, Whitelock CM, et al. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7480843/ KICK OUT PD: Feasibility and quality of life in the pilot karate intervention to change kinematic outcomes in Parkinson’s Disease]. PLOS ONE 2020;15(9):e0237777.</ref> Tai chi, also known as shadow boxing, involves gentle, slow movements and [[stretching]] combined with controlled breathing and [[meditation]]. '''Karate''', Japanese for "empty hand", involves the practice of specific stances along with kicking, striking, and defensive blocking movements using the extremities. '''[[Qigong for Health and Disease Management|Qigong]]''' is another Chinese martial art form which combines gentle flowing exercises with mindfulness. A particular form of qigong is '''Ba Duan Jin''', meaning the "Eight Section Brocades". Ba duan jin uses a combination of eight movements with deep, slow breathing. It is considered a form of medical qigong intended to improve health.<ref>Long L. Ba Duan Jin exercise, how to practice baduanjin [Internet]. China Educational Tours. China Educational Tours; 2021 [cited 2022Jan17]. Available from: https://www.chinaeducationaltours.com/guide/culture-qigong-ba-duan-jin.htm</ref>  There is evidence that qigong and ba duan jin qigong may improve gait and sleep quality in PWP.<ref>Wassom DJ, Lyons KE, Pahwa R, Liu W. Qigong exercise may improve sleep quality and gait performance in parkinson's disease: A pilot study. International Journal of Neuroscience. 2014;125(8):578–84.</ref><ref>Xiao C-M, Zhuang Y-C. Effect of health Baduanjin Qigong for mild to moderate Parkinson's disease. Geriatrics & Gerontology International 2016;16(8):911–9.</ref> {{#ev:youtube|P2wR3BWNqQE}}
* '''[https://www.pilates.com/ Pilates]''', initially developed for dancers, is an exercise method that emphasises abdominal and low back / hip muscle tone.<ref>Gilmerm. Everything you want to know about pilates [Internet]. Cleveland Clinic. Cleveland Clinic; 2020 [cited 2022Jan18]. Available from: https://health.clevelandclinic.org/everything-you-want-to-know-about-pilates/</ref> It can improve balance and physical function in a person with Parkinson's.<ref>Suárez-Iglesias D, Miller KJ, Seijo-Martínez M, Ayán C. [https://dx.doi.org/10.3390/medicina55080476 Benefits of Pilates in Parkinson’s Disease: A Systematic Review and Meta-Analysis]. Medicina 2019;55(8):476.</ref>
* The [https://feldenkrais.com/ '''Feldenkrais''' '''Method'''] is another mindful movement practice. It has an emphasis on the quality of movement, and it may result in improved quality of life for PWP.<ref>Teixeira-Machado L, Araújo FM, Cunha FA, Menezes M, Menezes T, Melo DeSantana J. Feldenkrais method-based exercise improves quality of life in individuals with Parkinson's disease: a controlled, randomized clinical trial. Alternative Therapies in Health and Medicine. 2015;21(1):8-14.</ref> A similar method is the '''[https://www.nhs.uk/conditions/alexander-technique/ Alexander technique].''' This technique puts more focus on dynamic posture. There is some evidence that  PWP may experience improvements in self-rated disability after practising the Alexander technique.<ref>Stallibrass C, Sissons P, Chalmers C. Randomized controlled trial of the Alexander Technique for idiopathic Parkinson's disease. Clinical Rehabilitation 2002;16(7):695–708.</ref>
* '''Meditative or reflective walking''' is another approach to mind-body fitness that may have positive effects on mood, affect and cognition.<ref>Gotink RA, Hermans KSFM, Geschwind N, De Nooij R, De Groot WT, Speckens AEM. [https://dx.doi.org/10.1007/s12671-016-0550-8 Mindfulness and mood stimulate each other in an upward spiral: a mindful walking intervention using experience sampling]. Mindfulness 2016;7(5):1114–22. </ref><ref>Yang C-H, Hakun JG, Roque N, Sliwinski MJ, Conroy DE. Mindful walking and cognition in older adults: A proof of concept study using in-lab and ambulatory cognitive measures. Preventive Medicine Reports. 2021;23:101490.</ref> This activity can be as simple as walking outdoors while focusing on the sights, sounds and smells of nature, of feeling the wind in your face or the sensations through the feet.<ref name=":2" /> Use of a '''labyrinth walking path''' is a novel way to participate in reflective walking.<ref>Lizier D, Silva-Filho R, Umada J, Melo R, Neves A. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313772/ Effects of Reflective Labyrinth Walking Assessed Using a Questionnaire]. Medicines 2018;5(4):111.</ref>