Exercise may slow Parkinson's downward spiral

Today's treatments can control tremors, for at least a while, but can't slow the disease's worsening.

Exercise sounds too simple a remedy. But consider that Parkinson's puts people into a downward spiral: The harder it becomes to move normally, the less patients try to move. Quickly their muscles become weak, making it harder for the remaining neurons to force them to move.

More intriguing is evidence that exercise actually may exert a brain-protective effect:

• University of Texas, Austin, researchers found that forcing rats to exercise limbs with Parkinson-like damage preserved their ability to move those legs.
• Building on that work, Zigmond's lab made rats exercise before injecting their brains with a toxin that kills dopamine-producing neurons much like Parkinson's does. The exercise stimulated production of neuron-protective chemicals that shielded the rats' brains from the toxin _ they lost almost no dopamine-producing cells and suffered no symptoms.
• Harvard researchers last year reported that men who exercised regularly as young adults were 60 percent less likely to get Parkinson's later in life than non-exercisers.
• University of Texas, Galveston, researchers put 18 Parkinson's patients into harnesses to keep them from falling and had them walk on a treadmill for an hour three times a week. After two months of the exercise, the patients walked a little faster when they weren't on the treadmill _ with fewer falls.
• A pilot test of treadmill and other exercises by Pittsburgh physical therapists is finding signals of improvement, too, Zigmond says.

None of that is proof. But it's provocative enough that Zigmond is planning a clinical trial where neurologists will perform brain scans and other tests on Parkinson's patients before, during and after certain exercises -- to see if their brains are protected against further dopamine depletion.

Patients don't need to wait: "If we were using ... an experimental drug, I would be the last person in the world to say go get it," Zigmond says. "But in general, the kind of exercise we're talking about is certainly not going to hurt."

What kinds? Consult a physical therapist knowledgeable about Parkinson's to tailor the moves, Heydrick advises. Treadmills, weight-bearing exercises and balance techniques, such as walking backward, may be useful.

Zigmond thinks even more advanced patients might benefit, saying researchers need to develop useful exercises that can be done from a chair.

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