Parkinson's Disease

Acupuncture

It can be difficult to gather high-quality scientific evidence on acupuncture, because the nature of the practice makes randomizing and blinding difficult (though some studies have used “sham” acupuncture on control groups). But there are a growing number of small studies that suggest acupuncture - or in some cases, electroacupuncture, which adds a small current of electricity to the needles - may help with gait and pain. A more substantial body of research indicates that acupuncture can be an effective treatment for nausea and chronic pain, which are sometimes associated with Parkinson’s. 

Additionally, there is anecdotal evidence that acupuncture can address non-motor symptoms, such as anxiety or depression. Whether this is simply the placebo effect at work is unclear. The Michael J. Fox Foundation for Parkinson’s Research states that “Acupuncture could be a helpful add-on therapy for PD motor and non-motor symptoms, and it appears to be generally safe and well tolerated.”

Aromatherapy

While there isn’t specific research dedicated to the impact of aromatherapy, or essential oils, on Parkinson’s disease, there is significant data to show that it can help with quality of life for everyone. Certain oils can be used - either applied to the skin or inhaled - to help ease nausea and pain, relieve anxiety, and promote relaxation. Bergamot, for example, has a mild antidepressant effect, while peppermint can help with nausea and fatigue.

Even if you experience an altered or diminished sense of smell, you may still find that essential oils have therapeutic benefits. Some research indicates that physiological benefits still occur, even when the user cannot fully experience the fragrance. 

Boxing

For people living with Parkinson’s, the opportunity to “fight back” against the disease is appealing - and boxing provides just that. Modified boxing exercises, provided within the context of classes for people with PD, have been effective in improving both motor and non-motor symptoms. 

Among the small studies that have been conducted so far, all report improvement in gait, posture, hand-eye coordination, and balance. Additionally, a majority of participants report improvement in anxiety, depression, and fatigue. “[Boxing has] brought about a lot of joy, to be honest...which makes a huge difference,” says one participant. 

Group classes (in which participants spar with punching bags, not one another!) offer a sense of camaraderie and fellowship, which can help ease the sense of isolation that often comes with Parkinson’s. Rock Steady Boxing, the first Parkinson’s boxing organization, offers classes throughout the world - both in-person and online. Title Boxing also has classes for PD patients in many locations throughout the country.

Massage

There are many different styles and techniques of massage therapy, which can be helpful for symptoms of Parkinson’s and improve overall quality of life. Most of the research points to the benefits of relaxation provided by massage, as well as relieving muscular stiffness and rigidity. Many people also report a decrease in pain, fatigue, sleep disturbances, anxiety, and depression after using massage therapy. 

Some massage styles - including Thai massage, Traditional Japanese massage, and neuromuscular therapy - seem to improve motor symptoms as well.

You’ll need to do some research to ensure you find a massage therapist who is experienced and makes you feel comfortable. If you have Deep Brain Stimulation (DBS), do not allow the therapist to massage along any of the system components. Be sure to ask what styles of massage they use and if they have experience working with symptoms of Parkinson’s. A good place to start is to ask your healthcare provider for recommendations.

Tai chi and Qigong

For people interested in improving balance and mobility through gentle movements, tai chi or Qigong are excellent choices. Both are mind-body exercises based on Chinese philosophy and martial arts, and integrate focused attention, imagery, mindful breathing, and repetitive flowing movement (typically while standing, though some classes for people with Parkinson’s will modify these movements to a seated version). Robust research on tai chi supports reduced falls and enhanced balance and gait. Both tai chi and Qigong show promise for improving non-motor symptoms, including depression, pain, memory, and stress reduction - but evidence for these benefits is still preliminary.
 
When starting a tai chi program, “Try out 2 or 3 different classes or programs - either in-person or virtually,” says Peter Wayne, PhD, professor and Director of the Osher Center for Integrative Medicine. “And start with a buddy. It’s great to have someone to learn with and you can keep one another motivated to stay the course.” Be sure to talk to your healthcare provider before starting any exercise program, and if balance is a concern, make sure you have someone nearby when trying these movements. 

Yoga

The ancient practice of yoga can have a holistic effect. While many people with Parkinson’s do yoga to improve motor skills (including balance, mobility, and strength), research also shows that it can alleviate depression, make breathing easier, and help you feel calm. 

There are many types of yoga, from Hatha to Power to Vinyasa. Because every person with Parkinson’s experiences the disease differently, there isn’t one single recommendation for a type of yoga that is most beneficial. Talk to your healthcare provider, or ask your local Parkinson’s organization to offer recommendations - many places have online or in-person classes that are modified to address symptoms of PD. The Parkinson’s Foundation has a sample yoga sequence for beginners on their blog. 

Dance 

Dance therapy isn’t as intimidating as it sounds - when led by a certified dance therapist, you’re not required to learn difficult choreography or perform. According to the Parkinson’s Foundation, dance therapy “allows individuals to move and find comfort in their bodies and to express what words might be too difficult to uncover.” Dance is an increasingly appealing activity for people with PD, as it has been shown to improve mobility, balance, and emotional wellbeing. It is also helpful to stimulate new learning, which is important for cognitive health.

Argentine tango in particular has been shown to improve balance and reduce motor symptoms such as rigidity and tremors. Tango also helps build connections with others, leading to greater feelings of wellbeing. Participants in dance classes do not have to learn complex step sequences - rather, the focus is on learning to improvise with spontaneous movements to the music. Most people find dancing fun, which helps them stick to it.

Tango classes for people with PD can be found online as well as in-person and may be offered through community centers or through local chapters of the American Parkinson’s Disease Association. Go! Tango PD is a national organization that offers virtual classes designed specifically for people with Parkinson’s. To find a dance therapist, visit the American Dance Therapy Association.

Music therapy

Because dopamine loss is a feature of Parkinson’s disease, and listening to enjoyable music increases dopamine, many people find joy and ease of symptoms by listening to music, singing, or even writing their own songs.

Rhythm in particular can be helpful - drumming circles, for example, have been shown to increase quality of life for people with PD. Rhythmic Auditory Stimulation (RAS) - in which the beat from a metronome or music sets the pace for ordinary movements, such as walking - can help with freezing, speed, and step coordination. Some people respond better to a faster rhythm, while others need slower, depending on what specific issue you’re working on. 

Music-based movement, which includes singing and playing percussive instruments, has also been shown to improve gait and motor function. Therapeutic singing encourages you to take deeper breaths and project volume. For people with speech issues, sometimes singing a phrase can help you remember how to say it. 

While many hospitals and Parkinson’s organizations offer programs led by a certified music therapist, you can also try listening to music you love at home, tapping your feet or hands along with the beat, or singing - either alone or with friends.

Nature-based therapy

The healing benefits of being in nature are well-documented, including stress reduction, decreased blood pressure, improved mood, and an easier time coping with pain. It’s no wonder places like Struther’s Parkinson’s Center in Minnesota are investing in outdoor therapy areas - including gardens, benches, birdfeeders, and walkways - as well as indoor landscapes so that patients can connect with nature even during inclement weather.  

Nature-based activities primarily target cognitive and emotional symptoms of PD, such as anxiety and depression. There are many ways you can reap the benefits at home, such as:

• Planting a garden, flower pot, or herbs
• Holding or petting an animal (borrow a friend’s cat if you don’t have one!)
• Placing beautiful landscapes of nature - either photos or paintings - where you can see them
• Installing a bird feeder (walking to the feeder each day can also be a good form of exercise)
• Having a comfortable seat near a window so you can look outside regularly
• Going outdoors as much as possible, even to simply stand outside for a few minutes
• Watching nature videos or programming on television

Mind-body practices

In addition to mind-body movement practices such as yoga, tai chi, and Qigong, there are non-physical mind-body practices that may be helpful for PD symptoms. Mindfulness meditation, imagery, and intentional relaxation have all been shown to reduce the perception of pain, reduce stress, and improve sleep in healthy adults. 

This Parkinson's disease resource is made possible through funding from the Medtronic Foundation. Learn how people living with Parkinson's Disease are changing the world by visiting http://livelifeamplified.org/