Parkinson’s disease (PD) significantly affects daily exercise tolerance through a combination of motor and non-motor symptoms that interfere with physical activity. The disease primarily causes movement difficulties such as tremors, muscle stiffness, slowness of movement (bradykinesia), and impaired balance, all of which reduce the ability to perform and sustain exercise. Additionally, non-motor symptoms like fatigue, pain, cognitive challenges, and mood disturbances further diminish exercise capacity and motivation.
At the core of Parkinson’s impact on exercise tolerance are the motor symptoms. Tremors, often described as “pill-rolling” movements of the hands, can make controlled, precise movements difficult. Muscle stiffness or rigidity limits joint flexibility and range of motion, making movements feel effortful and slow. Bradykinesia, or the generalized slowness of movement, means that initiating and maintaining physical activity requires more time and energy. Impaired balance and coordination increase the risk of falls during exercise, causing many individuals to reduce their activity levels out of safety concerns. These motor impairments collectively reduce endurance and the ability to perform sustained or vigorous exercise.
Non-motor symptoms also play a crucial role in limiting exercise tolerance. Fatigue, which is common in Parkinson’s, can be profound and persistent, making even short bouts of activity exhausting. Pain, including muscle cramps and joint discomfort without clear cause, can discourage movement. Cognitive difficulties such as memory problems and slowed thinking may interfere with following exercise routines or adapting to new physical activities. Emotional symptoms like depression and anxiety can reduce motivation and increase perceived effort during exercise. Autonomic nervous system dysfunction may cause fluctuations in blood pressure and heart rate, leading to dizziness or faintness during physical exertion.
Despite these challenges, exercise remains one of the most effective non-pharmacological strategies to manage Parkinson’s symptoms and improve quality of life. Regular physical activity can help reduce stiffness, improve balance, enhance mobility, and even slow symptom progression. Various forms of exercise, including treadmill training, overground walking, traditional Chinese exercises, and balance-focused rehabilitation, have shown benefits for motor function and overall well-being. Optimal exercise programs often involve sessions lasting at least 60 minutes, performed multiple times per week, tailored to the individual’s abilities and disease stage.
Exercise may also combat underlying biological processes in Parkinson’s, such as chronic inflammation in the brain and nervous system, which contributes to symptom worsening. By reducing inflammation, physical activity can help delay disease progression and maintain function longer. Furthermore, exercise positively influences mood and cognitive function, helping to alleviate some non-motor symptoms that impair exercise tolerance.
However, the fluctuating nature of Parkinson’s symptoms means that daily exercise tolerance can vary widely. On some days, motor symptoms may