An endless list of available exercises to consider for overall health promotion exists (i.e., weight lifting, conditioning, isometric/pilates, aerobic, stretching, martial arts, specific sports, etc.). Exercise can positively impact any person's health and in particular a person with PD by increasing muscle strength (thereby increasing one's ability to get up, walk, swallow, speak, and breath), flexibility (reducing muscle rigidity/joint stiffness and increasing range of motion), and bone density (reducing the risk of a limb fracture related to falling). Additional benefits include enhanced cardiovascular and respiratory function and subsequent blood flow and delivery of oxygen and nutrients to the brain. Exercise may also increase daily energy levels, reduce emotional and mental stress, improve mood by raising endorphin levels, and result in better sleep patterns. Many controlled, randomized clinical studies of the benefits of exercise in the elderly can be found in the medical literature (26-28). Exercises that improve balance and promote more efficient body movement such as yoga and tai chi may be of particular interest to persons with PD. A randomized, single-blind, controlled study of 30 persons with PD found that those who practiced tai chi regularly over three months had an 18 times greater reduced risk of falling compared with the control group (29). Similar benefits have been reported with smaller open-label studies along with numerous anecdotal reports of the benefits of yoga for PD. There is also animal data from the 6-hydroxydopamine mouse model of PD suggesting the possible neuroprotective role of aerobic exercise by increasing the production of endogenous neurotrophic factors in the brain (30). Human clinical studies with newly diagnosed PD patients are examining whether aerobic exercise can increase neurotrophic factors and improve motor function and possibly slow the progression of PD.

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