What exercise types are effective for Parkinson’s disease?

The Bottom Line

  • In older adults, Parkinson’s disease is the second most prevalent neurological disorder.
  • A variety of exercise types produce similar benefits on movement and quality of life in adults living with Parkinson’s.
  • Work with your healthcare team to develop a safe exercise plan that matches your preferences, wants, and needs.  

From celebrity diagnoses to viral internet challenges raising money for scientific research, every so often neurodegenerative disorders make their way into the news, our social media feeds, and conversations with friends and family. Neurodegenerative disorders are those in which the cells in our brain or spinal cord—also known as the central nervous system—no longer function or die (1), with symptoms often worsening over time. Examples include Parkinson’s disease, Alzheimer's, Lewy body dementia, and amyotrophic lateral sclerosis, better known as ALS or Lou Gehrig's disease (2;3).

Parkinson’s comes with a host of motor and non-motor symptoms and complications, which impact mobility, function, speech, and the quality of one’s life. These include tremors, involuntary and slow movements, muscle rigidity and painful contractions, difficulty balancing, depression, anxiety, sleep disorders, and cognitive issues like the development of dementia (2;4-10). In addition, disability and death are rising more quickly from Parkinson’s than any other kind of neurodegenerative disorder (10). 

Unfortunately, no cure currently exists for Parkinson’s. However, treatments such as medication and surgery are available to help people obtain some relief from their symptoms (2;11;12). Non-drug and non-surgical treatments, such as physiotherapy and other forms of exercise, are also garnering more research interest. But with so many exercises available, are some better than others? More clarity lies in a recent systematic review that compares how a variety of exercise types impact movement, quality of life, and the development of negative side effects in adults living with Parkinson’s (2).

What the research tells us

Good news! The review found that various types of structured and supervised exercise may enhance movement and quality of life in adults living with Parkinson’s compared to no physical exercise. Our confidence in the evidence ranges from high to very low certainty depending on the exercise type and outcome.

First, let us look at the evidence for movement. High certainty evidence shows that dance moderately improves movement. Low certainty evidence shows that aqua-based training, gait/balance/functional training, and training that combines multiple exercises may moderately improve movement, while endurance training and mind‐body exercises may enhance movement by a small amount. Unfortunately, flexibility training may have little to no positive impact on movement, and it is unclear if strength/resistance training and the Lee Silverman Voice training BIG (LSVT BIG)—a form of therapy specific to Parkinson’s—have any impact on movement.

Second, let us look at the evidence for quality of life. Moderate certainty evidence shows that aqua‐based training likely moderately improves quality of life, whereas low certainty evidence shows that gait/balance/functional training and combined exercises may enhance it by a small amount. Unfortunately, it is unclear if dance, mind‐body training, strength/resistance training, flexibility training, LSVT BIG, and gaming have any impact on quality of life.  

Third, we need to consider if these interventions have side effects. While the evidence is very uncertain and not all studies reported on side effects, those that did reported falls and pain as the most common. Despite the risk of falls and pain, the review authors note that overall, exercise for people with Parkinson’s appears to be “relatively safe.”

All in all, there appears to not be much difference between the exercise types. This means that if you are living with Parkinson’s, you have an array of exercises to choose from! Accordingly, you can work with your healthcare team to develop a safe exercise routine that matches your interests and needs, will help you fulfill what you want to achieve through exercise, and is adaptable to any limitations you may have. More research is needed to increase the certainty of the evidence base and our confidence in the results (2).   

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Author Details


  1. National Cancer Institute. Neurodegenerative disorder. [Internet] n.d. [cited June 2023]. Available from https://www.cancer.gov/publications/dictionaries/cancer-terms/def/neurodegenerative-disorder 
  2. Ernst M, Folkerts A-K, Gollan R, et al. Physical exercise for people with Parkinson’s disease: A systematic review and network meta‐analysis. Cochrane Database Syst Rev. 2023; 1:CD013856. doi: 10.1002/14651858.CD013856.pub2.
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  8. Muslimović D, Post B, Speelman JD, et al. Cognitive profile of patients with newly diagnosed Parkinson disease. Neurology. 2005; 65(8):1239-1245. doi: 10.1212/01.wnl.0000180516.69442.95.
  9. Martinez‐Martin P, Rodriguez‐Blazquez C, Kurtis MM, et al. The impact of non-motor symptoms on health-related quality of life of patients with Parkinson's disease. Mov Disord. 2011; 26(3):399-406. doi: 10.1002/mds.23462.
  10. World Health Organization. Parkinson Disease. [Internet] 2022. [cited June 2023]. Available from https://www.who.int/news-room/fact-sheets/detail/parkinson-disease
  11. Rizek P, Kumar N, Jog MS. An update on the diagnosis and treatment of Parkinson disease. CMAJ. 2016; 188(16):1157-1165. doi: 10.1503/cmaj.151179.
  12. Aum DJ, Tierney TS. Deep brain stimulation: Foundations and future trends. Front Biosci. 2018; 23(1):162-182. doi: 10.2741/4586.

DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of new and old blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with changing public health recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.