In this blog, we covered some of the basics of how exercise is vital to those living with Parkinson’s Disease (PD) in slowing the progression of the disease and managing symptoms. Now let’s chat about creating a Parkinson’s specific group fitness class for your members with PD. For me, group fitness is one of my favorite ways to exercise – something about the fun and engaging group atmosphere, accountability, motivation, and support from peers makes solo-exercise feel especially unappealing some days. Participating in group exercise can have huge benefits for your PD population too, but not just any group class is appropriate. Parkinson’s specific exercise classes can address common symptoms of PD including impaired balance and coordination, stiffness, freezing, poor posture, and limited flexibility/mobility which can in turn help to improve quality of life and help perform ADL’s more easily. Through a carefully developed exercise routine, individuals with PD may be able to slow the progression of the disease and improve their mobility and independence.
First, ensure that you (if you are the instructor), or your fitness staff have had adequate training and educational background on PD and are specialized in the training of individuals with PD to ensure classes are both safe and effective. You’ll want to encourage your members to check with their physician prior to starting a program and we recommend obtaining medical clearance as well.
While considering the unique training needs of members with PD, classes should be adapted to accommodate a variety of ability levels and include a variety of exercises which require both focus and effort. Each member should also be working at a moderate to vigorous intensity for the most effective workout. Utilize the RPE scale to ensure they are feeling somewhere between a 4-6 (moderate) or 7-8 (vigorous) out of 10. The components you want to include are aerobic, strength, balance, multitasking and flexibility for a complete workout. We recommend timing classes to be 50+ minutes in length so you have adequate time to warm up and training time inclusive of all components.
Structuring your classes: Start off with a warmup which includes raising the heart rate, warming up the body, stretching and flexibility exercises and of course some deep breathing. We want our PD members to really focus on deep breaths so they can relax and get a good stretch which in turn will combat muscle rigidity and assist in ADL’s.
Next, shift your focus to include aerobic training and strengthening exercises. Again, for aerobic exercise we want our participants to be working hard! This might be a time to consider adding in some dual tasks for cognition and coordination too! Dual tasks can be combined with any of the other training modalities so make sure to pepper those in often throughout your class. Try things like walking while counting backwards, catching a ball, standing on a foam pad while answering questions, or a variety of compound exercises. For this, just think “multitask” and have participants do two (or more!) things at once. For strengthening exercises, aim to hit the major muscle groups, but at the very least, you want to strongly address the muscles of the core, quads, glutes, back and triceps as they all lose strength and lead to poor postural changes.
Balance training is another essential training component in class as members with PD are two times more likely to fall when compared to those without PD due to slower reaction time, freezing, decline in mobility and balance, and lower body muscle weakness. You’ll definitely want to practice balance exercises and safe movement techniques in every exercise session!
Some other movements to add into your classes include boxing movements, yoga or tai chi practices, big movements, utilizing the voice loudly by counting or singing, and brain teasers or cognitive challenges. As always, end with adequate time to allow the body to cool down, stretch and some more deep breathing.
A few additional considerations as you develop your PD class include choreography and music! Studies have shown dancing and choreographed movements can help with balance, gait, confidence, movement initiation and QOL. Similarly, using music can reduce stress, improve breathing and voice quality, and make it FUN for you participants!