Parkinson's disease had caused 61-year-old John Cullen to slouch and drag his foot while walking. Then Cullen started powerlifting. He's since become strong enough to dead lift 465 pounds. Beyond strength, exercise ameliorated many of the Parkinson's symptoms he experienced in everyday life.
It took about six months for his gait to improve, he says. "I was able to walk backwards. I felt like I could go up and down stairs better. Things were really rocking and rolling. I felt almost like I didn't have it, even though I knew I had it. It was just that good."
A Neurodegenerative Disease
With Parkinson's disease, the loss of cells that make dopamine leads to an impairment of automatic movements, including walking, balance and mobility, as well as deficits in thinking and mood.
According to Dr. Giselle Petzinger, a neurologist at the Keck School of Medicine at University of Southern California in Los Angeles who specializes in Parkinson's disease, about 1 in 100 people over the age of 50 will be affected by Parkinson's disease. While there's no cure, healthy lifestyle choices like exercise may help ward off the disease and improve quality of life.
Exercise-Induced Neuroplasticity
The brain is modified by experiences - including exercise. As a lifelong athlete, Cullen, who now resides in Sanibel, Florida, first noticed he had a problem in 2014, when his right leg was not in sync with his left while biking.
About a year later, Cullen was officially diagnosed with Parkinson's. He handled the news like he did any other physical challenge he went up against.
"My attitude was, 'Bring it,'" Cullen says. "I think some people when they get this diagnosis, it's very hard for them, they're devastated, they might think their life is going to come to an end. My reaction was, 'Let's go. I'm ready to take you on.'"
Research reviews in Lancet Neurology in 2013 and in Brain Plasticity in 2015 show that exercise bolsters circuitry in the brain to help prevent Parkinson's and slow disease progression. Petzinger is one of the scientists who published these findings.
"It doesn't mean it stops it, but it definitely attenuates or decreases the risk of getting Parkinson's disease," Petzinger says. "We can't stop every injury, but we can certainly handle them better by bolstering lifestyle through our life."
Aerobic and Skill-Based Exercise for Optimal Brain Benefit
Cullen, who is also taking medication for Parkinson's, recently found benefit in an exercise program that's novel to him. He focuses on three heavy lifts: bench press, squat and deadlift. He also does cardio workouts with weighted sled pushes and pulls and tire flips. Variety makes his workouts new, engaging and effective. He started lifting weights when he moved to Florida and hired a trainer who specializes in heavy lifting.
"It has changed my life," Cullen says. "You're going to have issues with balance. You're going to have issues getting out of a chair. Heavy weight training taught me there was some other way to battle Parkinson's that was actually effective for me."
Just as Cullen experienced, different types of exercise that are challenging both physically and mentally are helpful in Parkinson's disease.
"For me, it's really the intensity of the weight lifting," Cullen says. "I put 300 pounds on my back, there's an immediate reaction to my central nervous system. There's a high awareness. When you put that kind of weight on your body, you've got to be ready for it. It alerts my entire body that I need to be ready. I think it's that process that's working for me."
There are two ways to define intensity. One involves the cognitive challenge of the task itself that requires skill. The other is aerobic exercise, which elevates heart rate.
Skill-based activities such as yoga, boxing, tai-chi, hiking, dance and golf, for example, tap into automatic movements such as gait, balance and processing .
Aerobic exercise like cycling, swimming and running has been extensively studied in aging where its shown benefits in memory and cognition. Completing about 150 minutes per week of moderate to vigorous exercise is generally effective. These benefits are also seen in Parkinson's disease.
Cardiovascular exercise helps maintain new circuits, engaging the brain and body through changes in the immune system, blood flow and metabolism. The body can communicate to the brain through neurotrophic factors or cellular growth factors that act as fertilizer made by body tissues like muscle.
"Ultimately, we're really talking about keeping connections hearty because it's these cellular connections that drive behavior," Petzinger says. "At the end of the day, resilience is a behavioral outcome, meaning I'm thinking well, I'm moving well. We think of exercise as the big game-changer in PD."
Mindset and Community
Cullen has a personal trainer who knows when to challenge and support him.
"He'll have to help me put on my arm sleeves, my knee pads, sometimes tie my shoes," Cullen says. "Just because I can't do all those micro-movements. He's extremely dedicated to me."
Petzinger believes that the messaging around Parkinson's and how exercise empowers people to take their health into their own hands is crucial.
"First and foremost, we're teaching individuals, particularly Americans, that health is not simply about a pill and certainly isn't simply about going to see the doctor," Petzinger says. "Health is a real world practice. It's what you invest in day-to-day. And the data is so compelling, that really one can easily say without a doubt that 50% of any treatments in the brain are going to be lifestyle."
For Cullen, "It's just Parkinson's" is his mantra. In other words, to help him cope and work with it, he has to approach having the disease as if it were no big deal. His Instagram page is where he builds awareness and helps others take on Parkinson's. Cullen has goals to dead lift 500 pounds and contend in a powerlifting competition.
"I know the weight lifting is really just a battle with Parkinson's," Cullen says. "I want to lift 500 pounds and that's great. But really, I know every day when I'm going to the gym, I'm battling a bigger monster. That's just how it is."
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