The Relation between Exercise and Non-Motor Symptoms in Parkinson's Disease

Most exercise programs for persons with Parkinson's disease (PwPD) focus on improving motor function but not non-motor symptoms (NMS).

We investigated the relation between self-reported exercise and NMS including depression, anxiety, cognition, fatigue, and non-motor experiences of daily living.

PwPD (n = 347) responded to an online survey of questionnaires assessing exercise engagement and NMS. Of this larger sample, exercisers (n = 186; 105 women) were demographically matched to non-exercisers (n = 72; 39 women) and their scores were compared. Among exercisers, we examined associations between exercise dosage (number of days of exercise/week and continuous minutes of exercise/day) and NMS. We also assessed differences in NMS between groups defined by number of days/week of exercise: high (4-7 days), moderate (2, 3), and low (≤1). Logistic regression analyses examined factors associated with exercise engagement.

PwPD who endorsed exercising at all reported fewer and less severe NMS than non-exercisers (P's < 0.05). More days of exercise/week were correlated with lower fatigue (ρ = -0.16, P = 0.03) and better subjective cognition (ρ = 0.15, P = 0.04). Moderate- and high-frequency exercise groups endorsed less depression, fatigue, and non-motor daily living symptoms than the low-frequency group. The high-frequency group further endorsed less anxiety, better cognition, and fewer total NMS than the low-frequency group. Higher levels of fatigue were associated with less likelihood of exercising (OR = 0.93, P = 0.025).

Healthcare professionals may highlight the observed associations between exercise and NMS in clinical interactions with PwPD. As NMS may also affect the ability to exercise, interventions to alleviate NMS, particularly fatigue, may be valuable.