Sports activity in Parkinson's disease

Parkinson's disease is an age-related neurodegenerative disorder that is characterised pathologically by preferential loss of dopamine neurons in the pars compacta of the substantia nigra. The clinical hall marks are akinesia, rigidity, tremor and loss of postural reflexes. Non-pharmacological treatment, such as sports and exercise therapy, is used as additive treatment to medical therapy using dopaminergic drugs. The capacity of patients to participate in sports activities depends on the severity of the disease and also on the occurrence of autonomic dysfunction i.e. arrhythmias, sweating, dyspnoea and falls. Cognitive deficits may also impair sports activities, some patients are not able to learn new movement patterns or are not able to respond quickly to new situations. Comorbidity and the relations between medication and exercise have to be considered. So far, there is no specific physical treatment for symptoms of Parkinson's disease. The sports therapies applied in the past most often included a combination of exercises aimed at improving strength, flexibility, balance, and gait. External triggers were used for amelioration of gait initiation and to sustain movements. Although the approaches varied, positive effects on muscle strength, gait, balance, and flexibility could be observed. In addition, patients were more content and confident in managing the activities of daily living. Controlled intervention studies with larger patient collectives are needed in future to further specify the application of sports therapy in Parkinson's disease.