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Parkinson’s disease (PD) is a progressive neurological condition with a global prevalence that has risen substantially in the past few decades,¹ with more than 10 million people reportedly living with the disease worldwide.² PD is the second-most common neurodegenerative disease in the US. Approximately 90,000 people are diagnosed each year, and while incidence of PD increases with age, an estimated 4% of those with PD were diagnosed before the age of 50.^2,3

An exact cause of PD is not known; however, interactions among many genetic and environmental factors such as exposure to pesticides and other toxicants influence PD risk and lead to a range of issues in the body, from gut disturbances to neuroinflammation.^4-7 Ultimately, this complex disease is associated with deficiency of the brain signaling molecule dopamine and both motor and nonmotor deficits. Symptoms of PD may develop slowly over time and progress differently for each patient. Primary medications such as levodopa help to replace low levels or missing dopamine in the brain, yet long-term use of these medications can cause additional movement issues.⁸

Research studies continue to explore lifestyle-based and complementary treatments that support patients with PD and reduce the progression of their disease symptoms. What therapies have shown benefit and may be appropriate for a personalized treatment strategy?

Exercise Routines & Mind-Body Therapies

Establishing therapeutic exercise routines, from aerobic and strength training to balance and flexibility conditioning, is an essential component of a PD treatment plan and helps maintain mobility and everyday activities and manage overall disease progression. Various exercises have been evaluated for their PD treatment efficacy. For example, results from clinical trials suggested the following for adults living with PD:^9-12

• Power training benefited motor symptoms and muscle strength.
• Treadmill training improved balance and gait velocity.
• Resistance training enhanced sleep quality and cognition.
• High-intensity interval training (HIIT) benefited motor function and functional mobility.
• Boxing workouts improved balance and quality of life.
• Several exercise modalities, including dance, improved depression.

Mind-body therapies such as tai chi, qi gong, Pilates, and yoga have also been studied heavily for their significant benefits in PD treatment. Studies have suggested the following benefits:^13-17

• Qi gong, tai chi, and yoga improved balance while tai chi and yoga increased functional mobility.
• Yoga also benefited anxiety and depression scale scores as well as quality of life.
• Pilates effectively improved functional mobility and balance performance.
• Qi gong enhanced gait speed.
• Dance benefited motor function and health-related quality of life.

Acupuncture-Related Therapies

In addition to exercise and mind-body therapy approaches, acupuncture-related therapies may also benefit individuals with PD.^18,19 In a first of its kind investigation, a 2021 systematic review of multiple clinical trials assessed the effects of different types of acupuncture as complementary PD therapies.²⁰ The review suggested that different types of acupuncture-related therapies may:²⁰

• Benefit the Unified Parkinson’s Disease Rating Scale (UPDRS) total scores.
• Decrease the UPDRS motor subscores. (Note: higher scores indicate more severe impairment).
• Improve the UPDRS activities of daily living scores.
• Improve behavior, mood, and depression scale scores.

Conclusion

While there is no cure for PD, personalized treatments based on a patient’s disease symptoms and disease progression may include medications, anti-inflammatory nutritional interventions,^21-23 or other approaches as described above. Functional medicine takes a comprehensive, whole health approach by treating root causes of disease and collaborating with patients to restore healthy function—all while being a vital partner to conventional medicine. Click on the links below to read more about the functional medicine approach and to find a functional medicine practitioner near you.

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References

1. Parkinson disease. World Health Organization. Updated August 9, 2023. Accessed October 9, 2024. https://www.who.int/news-room/fact-sheets/detail/parkinson-disease
2. Who has Parkinson’s? Parkinson’s Foundation. Accessed October 9, 2024. https://www.parkinson.org/understanding-parkinsons/statistics
3. Willis AW, Roberts E, Beck JC, et al. Incidence of Parkinson disease in North America. NPJ Parkinsons Dis. 2022;8(1):170. doi:1038/s41531-022-00410-y
4. Simon DK, Tanner CM, Brundin P. Parkinson disease epidemiology, pathology, genetics, and pathophysiology. Clin Geriatr Med. 2020;36(1):1-12. doi:1016/j.cger.2019.08.002
5. Qu Y, Li J, Qin Q, et al. A systematic review and meta-analysis of inflammatory biomarkers in Parkinson’s disease. NPJ Parkinsons Dis. 2023;9(1):18. doi:1038/s41531-023-00449-5
6. Dong-Chen X, Yong C, Yang X, Chen-Yu S, Li-Hua P. Signaling pathways in Parkinson’s disease: molecular mechanisms and therapeutic interventions. Signal Transduct Target Ther. 2023;8(1):73. doi:1038/s41392-023-01353-3
7. Mani S, Sevanan M, Krishnamoorthy A, Sekar S. A systematic review of molecular approaches that link mitochondrial dysfunction and neuroinflammation in Parkinson’s disease. Neurol Sci. 2021;42(11):4459-4469. doi:1007/s10072-021-05551-1
8. Gandhi KR, Saadabadi A. Levodopa (L-dopa). StatPearls Publising; 2023. Accessed October 9, 2024. https://www.ncbi.nlm.nih.gov/books/NBK482140/
9. Yang Y, Wang G, Zhang S, et al. Efficacy and evaluation of therapeutic exercises on adults with Parkinson’s disease: a systematic review and network meta-analysis. BMC Geriatr. 2022;22(1):813. doi:1186/s12877-022-03510-9
10.  Tian J, Kang Y, Liu P, Yu H. Effect of physical activity on depression in patients with Parkinson’s disease: a systematic review and meta-analysis. Int J Environ Res Public Health. 2022;19(11):6849. doi:3390/ijerph19116849
11.  Sena IG, Costa AVD, Santos IKD, et al. Feasibility and effect of high-intensity training on the progression of motor symptoms in adult individuals with Parkinson’s disease: a systematic review and meta-analysis. PLoS One. 2023;18(11):e0293357. doi:1371/journal.pone.0293357
12.  Chrysagis N, Trompouki G, Petropaulis D, et al. Effect of boxing exercises on the functional ability and quality of life of individuals with Parkinson’s disease: a systematic review. Eur J Investig Health Psychol Educ. 2024;14(5):1295-1310. doi:3390/ejihpe14050085
13.  Jin X, Wang L, Liu S, Zhu L, Loprinzi PD, Fan X. The impact of mind-body exercises on motor function, depressive symptoms, and quality of life in Parkinson’s disease: a systematic review and meta-analysis. Int J Environ Res Public Health. 2019;17(1):31. doi:3390/ijerph17010031
14.  García-Muñoz C, González-García P, Casuso-Holgado MJ, Martínez-Calderón J, Heredia-Rizo AM. Are movement-based mindful exercises (qigong, tai chi, and yoga) beneficial for stroke and Parkinson’s disease? A scoping review. Complement Ther Med. 2023;72:102912. doi:1016/j.ctim.2022.102912
15.  Mustafaoglu R, Ahmed I, Pang MYC. Which type of mind-body exercise is most effective in improving functional performance and quality of life in patients with Parkinson’s disease? A systematic review with network meta-analysis. Acta Neurol Belg. 2022;122(6):1433-1446. doi:1007/s13760-022-02070-4
16.  Aras B, Seyyar GK, Fidan O, Colak E. The effect of tai chi on functional mobility, balance and falls in Parkinson’s disease: a systematic review and meta-analysis of systematic reviews. Explore (NY). 2022;18(4):402-410. doi:1016/j.explore.2021.12.002
17.  Ban M, Yue X, Dou P, Zhang P. The effects of yoga on patients with Parkinson’s disease: a meta-analysis of randomized controlled trials. Behav Neurol. 2021;2021:5582488. doi:1155/2021/5582488
18.  Sun Y, Sheng J, Liu T, et al. Combination treatment of acupoint therapy and conventional medication for motor function of Parkinson’s disease: a systematic review and meta-analysis. Complement Ther Clin Pract. 2023;50:101677. doi:1016/j.ctcp.2022.101677
19.  Fan JQ, Lu WJ, Tan WQ, et al. Effectiveness of acupuncture for anxiety among patients with Parkinson disease: a randomized clinical trial. JAMA Netw Open. 2022;5(9):e2232133. doi:1001/jamanetworkopen.2022.32133
20.  Wen X, Li K, Wen H, et al. Acupuncture-related therapies for Parkinson’s disease: a meta-analysis and qualitative review. Front Aging Neurosci. 2021;13:676827. doi:3389/fnagi.2021.676827
21.  Bianchi VE, Rizzi L, Somaa F. The role of nutrition on Parkinson’s disease: a systematic review. Nutr Neurosci. 2023;26(7):605-628. doi:1080/1028415X.2022.2073107
22.  Dos Santos MG, Schimith LE, André-Miral C, Muccillo-Baisch AL, Arbo BD, Hort MA. Neuroprotective effects of resveratrol in in vivo and in vitro experimental models of Parkinson’s disease: a systematic review. Neurotox Res. 2022;40(1):319-345. doi:1007/s12640-021-00450-x
23.  Xie L, Chen D, Zhu X, Cheng C. Efficacy and safety of probiotics in Parkinson’s constipation: a systematic review and meta-analysis. Front Pharmacol. 2023;13:1007654. doi:3389/fphar.2022.1007654