In mid-August 2026, the Davis Phinney Foundation hosted a webinar on the importance of exercise for those with Parkinson’s disease (PD). Dr. Jay Alberts and Dr. Daniel Corcos explained that strenuous exercise is strongly encouraged because research shows it may slow the progression of PD. They gave guidelines for what intensity and frequency of exercise impart this effect, and suggested what exercises to focus on if you have limited time, energy, and/or mobility.
These are the major points from the webinar:
- Exercise is crucial for people with PD. Research supports the idea that significant exercise which raises the heart rate slows the progression of the disease. This helps people retain their mobility for longer, and can reduce the impact of non-motor symptoms as well.
- The best exercise for those with PD is whichever exercise you can and will do regularly. Consistent exercise and high heart rate are the keys to slowing disease progression. Tailor your exercise to what you need.
- If you’re struggling to find time to exercise, consider that exercise will protect your “health span” in the long term. Exercise now is an investment in your future wellbeing, and your ability to continue doing what you love.
- If you’re struggling with limited mobility, do what exercise you can. Anything helps. Work with a physical therapist to prioritize exercises that will help maintain your ability to do daily tasks, and which will help reduce the risk of falls.
- If you’re struggling with the mental health impacts of PD, continue to build community. Your care partner, spouse, family, friends, and/or care team can all help you stay accountable and motivated. Exercise can reduce the impact of depression, apathy, and anxiety.
You can find resources for exercise with PD on the Stanford Parkinson’s website:
Benefits of Exercise for Parkinson’s
If you are lucky enough to live in Northern or Central California, see the Stanford list of PD exercise classes and fall prevention programs run by local organizations or individuals:
PD Exercise Classes (Northern/Central California)
Fall Prevention Programs (Northern/Central California)
A recording of the webinar is available on the Davis Phinney Foundation’s YouTube channel:
Full version, 1 hour and 20 minutes
Below are my full notes, based on the full version of the webinar.
– Jordan
“Parkinson’s and Exercise: Your Questions Answered”
Speakers:
Jay Alberts, PhD, Cleveland Clinic
Daniel Corcos, PhD, Northwestern University
Webinar Host: Davis Phinney Foundation. This was part of their “Live Well Today” series.
Webinar Moderator: Chris Krueger, DPF
Webinar Date: August 13, 2026
Summary by: Jordan Dagan, Stanford Parkinson’s Community Outreach
WHY IS EXERCISE PUSHED SO MUCH FOR THOSE WITH PD? WHY DO PEOPLE WHO EXERCISE A LOT STILL GET PD?
People who vigorously exercised in their youth and young adulthood do have a lower prevalence of PD than those who are sedentary. Some people who are avid exercisers do develop PD. Ultimately, genetics and environment interact to influence PD symptom onset.
Exercise may delay PD symptom onset, even in those who do get PD eventually. Generally, exercise is neuroprotective. “Neuroprotective” means that frequent exercise at moderate to high intensity, especially cardio, helps slow the progression of the disease.
There are also great benefits for mental health; exercise can provide control over managing your PD. Dr. Corcos also pointed out that some people report their PD symptoms decrease in summer but return in winter; he suspects this is because they are active during the summer months, and sedentary during the winter months.
GUIDELINES FOR IMPACTFUL EXERCISE
Dr. Jay Alberts’ research on the impact of cycling for those with PD underpinned the Davis Phinney Foundation’s cycling program, Pedaling for Parkinson’s.
Dr. Daniel Corcos’ current research includes the SPARX3 trial, which is investigating high-intensity exercise as an intervention that may slow progression of Parkinson’s.
One can’t reach a high cadence of pedaling without raising your heartrate. The high heart rate during exercise, rather than the exercise itself, is what’s neuroprotective.
Editor’s note: A table was shown which detailed the differences between the type of exercise, basic measurements, protocol for Pedaling for Parkinson’s, and the SPARX3 training. This research uses certain guidelines, and these are what further questions during the webinar refer to. Whether using stationary cycling or running/walking on a treadmill, the exertion guidelines were as follows:
Minimum 3 or 4 times per week, minimum 30 minutes of exercise. The SPARX3 research is investigating the impact of exercise during which the participant reaches 60-65% of their max heart rate, compared to 80-85% of their max heart rate.
WHAT ARE THE BEST EXERCISES FOR PD RIGHT NOW?
Low-intensity exercise is good but not neuroprotective. Aerobic exercise such as cardio, which works the heart and the respiration muscles, is very good. High-intensity exercise is what shows a neuroprotective effect in the research.
Self-initiated movement, such as cycling, can be much harder for people with PD. In contrast, treadmill walking prompts the body to move, which may be easier, allowing them to get their heart rate up.
If you’re female it’s especially important to do strength training and flexibility training. Strength training around the core muscles will help maintain your ability to get up from bed and sitting positions. Exercise early to strengthen your muscles before they weaken when the disease progresses.
It is important to do “neuromotor” exercises, especially in the later stages of the disease. This kind of exercise trains the brain in agility, coordination, balance, and proprioception (the sense of where our body is in relation to itself and objects around us).
IS THE TYPE OF EXERCISE IMPORTANT?
The specific motion of exercise, such as jogging, bicycling, or swimming, is less important than the exertion itself. Consistent exercise is the key to long-term benefits, not type of exercise. Cross training, or exercising using multiple types of activity, will help keep novelty and interest intact, and will work different muscle groups. Try to find more than one type of exercise that gets your heartrate up.
Don’t conflate physical activity with exercise. Gardening is physical activity, as is a walk around the block, but these are not the neuroprotective type of exercise. High heart rate and exertion of muscles is the goal.
HOW DO I KNOW WHAT HEART RATE TO TARGET?
Exercise that gets your heart going faster than baseline is still good, even without aiming for a specific number. For most people, finding your peak heart rate is very helpful in making an exercise plan, and for some it’s irrelevant.
For those who want a specific heart rate to aim for, there are many devices designed to monitor it. To determine what your peak heart rate is, some general formulas may be useful, such as “220 minus your age.” Drs. Corcos and Alberts encourage those with PD who want to fine-tune their exercise routine to access a cardiopulmonary exercise test (CPET). This test measures your peak oxygen usage and measured heart rate. Try calling your local university with an exercise science program; they may have access to a CPET.
WHAT DOES “80% OF MAX HEART RATE FOR 30 MINUTES” ACTUALLY MEAN? CAN I TAKE BREAKS?
Nobody should worry about getting their heart rate up to 80% specifically! Some people like to do intervals, or alternate between intense and light exercise. Overall average heart rate can come out close to 80% using this method. Other versions will likely give similar effects, but the research hasn’t been done on those yet. Not many people who are new to intentionally exercising can hold a steady-state 80% of their max heart rate for 30 minutes, but this is what the research that’s found a neuroprotective effect is based on.
WHAT IS RATING OF PERCEIVED EXERTION (RPE)?
RPE is a scale of 1 to 10, sometimes 1 to 20, that asks the person to rank how heavily they’re exercising. It’s self-reported, so it can be faulty. Generally, you should be exercising heavily enough that you couldn’t hold a conversation with someone, but not so heavily that you couldn’t answer brief questions.
DO WE KNOW HOW MUCH EXERCISE IS ENOUGH OR TOO MUCH?
Because everyone’s PD is different, everyone’s exercise needs will be slightly different. The minimum exercise guideline supported by research is 3 times per week for 30-45 minutes, doing aerobic exercise.
However, researchers can’t always depend on study participants to exercise more than three or four times per week, which limits what research can be realistically done. Exercising five times a week, or even every day, will probably be better for your health.
If someone has pain or injury to muscles or joints from exercising, they’re likely exercising too much, or the motion is being done incorrectly.
IF THERE’S LIMITED TIME, WHAT SHOULD I PRIORITIZE?
Prioritize the exercise you’ll do! Aerobic exercise is best at providing neuroprotective effects. What you should prioritize depends on where you are in your PD progression; if you’re older and/or have greater disease progression, just doing your daily tasks may need to be your focus. Dr. Corcos recommends dance, or high intensity circuit training. Circuit training rotates through various exercises with minimal rest in between. This is a whole-body method that takes less time.
Regarding dance for PD, Dr. Corcos said, “If I had PD, and I only had one day per week, I would take my lovely wife dancing.” There are great benefits to dance for those with PD. If your time and energy is limited, there’s a good chance that your loved one’s time and energy is limited as well. Try switching up who leads a dance; those with advanced PD may struggle to lead, and may need to follow. Everyone can find music they enjoy, and this can help with apathy and depression as well. There are many dance classes available, for all levels and many styles of dance. Dancing does a lot to improve affect and mood, which cycling or yoga or rowing may not improve in the same way.
Dr. Corcos encourages those concerned with time constraints to consider their priorities; if you have PD, you’ll feel better if you prioritize taking care of yourself, including exercising.
WHAT IF I CAN’T EXERCISE DUE TO INJURY OR DISABILITY?
If you can’t do something without making a problem worse, find a different exercise to do that still gets your heart rate up. Self-evaluate what you can do, and make the time to do what you can. Tailor your exercise routine for what you need; someone whose concern is falling may benefit more from motor dual task training and balance training. Dual-task activities require someone to do two activities at the same time. These could be two motor tasks, such as walking while carrying an object, or a motor task and a cognitive task, such as walking while solving math problems.
Find a rehabilitation specialist, and get creative! There are many, many resources online. Some people have made moving while seated a high-intensity art form! Keep a mindset of what you can do, rather than specific problems that limit you.
EXERCISE WITH ADVANCED PD AND MOBILITY CHALLENGES
If you can’t do some exercises, you can do others. The aerobic aspect is still important. Even if you’re not in an area with many resources, the exercise is the key, as is the community you do build. The community provides accountability to exercise, and encouragement. The healthcare system isn’t set up to support people in rural areas well, but there are some professionals who will come to your home. Technological advances are making exercise groups and classes more and more accessible and convenient.
Dr. Corcos notes that strategies to maximize your health span will change over time. As more complexities arise in your PD progression, seek out trained health professionals. Build relationships with your care team early, so you can have consistent help. People with advancing PD tend to have freezing of gait, difficulty turning, and exercise-induced dystonia (involuntary muscle contractions); to help these issues, neurophysiotherapists tend to offer training that challenges both cognition and mobility.
Dr. Alberts acknowledges that there haven’t been many studies on the impacts of exercise on the health of those with advanced PD, especially those who use deep brain stimulation (DBS) as a treatment. DBS patients are generally left out of exercise studies because of a need to reduce variability.
QUESTIONS AND ANSWERS
Question: How can people with PD navigate apathy, and stay motivated?
Answer from Dr. Alberts: Apathy does increase with PD. Community is crucial. Exercise on its own can decrease the impact and experience of apathy.
Answer from Dr. Corcos: It’s a chicken-or-egg problem. Severe apathy, depression, or anxiety are all helped by exercise, and are also reasons why people don’t exercise. If your mental health is limiting your ability to exercise and do your daily tasks, talk to your doctor to see if you can get a referral for counseling.
Question: How can cyclists challenge their balance?
Answer from Dr. Alberts: Dr. Alberts doesn’t recommend exercising outdoors unless you have good balance and the ability to exercise even while processing distractions and other cognitive input. He prefers those with PD use a stationary bike indoors for safety and avoiding falls, and so you can keep an eye on your heart rate. Falls rarely happen when someone is stationary; usually people who fall are distracted or anxious. If it’s safe, you can challenge your postural control by practicing dual tasking.
Answer from Dr. Corcos: Yoga and tai chi are good for working on focus and balance at the same time. The best results from yoga are from more intense versions of the practice, which are essentially weight training using the body. PD is a disease which limits movement, and staying active requires exercise which includes multiple forms of movement. Understand your current needs in order to work out what kind of exercise works for you.
Question: What accountability tools are helpful to maintain long-term motivation? How should we make it a team effort?
Answer from Dr. Alberts: Find someone in your exercise program or routine who you relate to. This could be your spouse, someone else with PD, your brother, your friend, etc. Frequent communication is important, so build accountability through daily contact and socialization; monthly or weekly contact with your accountability buddy may not be enough. This is also helpful for accountability with keeping your medical appointments.
Question: How can those with PD vet exercise programs to ensure they are evidence-based?
Answer from Dr. Corcos: Unfortunately, many people try to make money from people who are struggling. Start by finding exercise classes already vetted by major Parkinson’s foundations such as Davis Phinney.
Question: How should we prepare for appointments with our neurologist?
Answer from Dr. Alberts: Take an active role in your treatment. Neurologists don’t have much time, and are under a lot of pressure. Go in with a list of questions for your neurologist. Your doctor won’t be offended if you stay on task and don’t engage in small talk.
Answer from Dr. Corcos: If you don’t have a need to go, then don’t go. In the early stages of the disease, someone may only need to see their neurologist once per year. If you do have reason to visit, then prioritize which questions are most important. If you do really need more time with your neurologist, push for it. You should be the main manager of your PD! Some people don’t have a good understanding of why they’re even taking their medications, and that’s concerning.
Question: I’m concerned about fainting post-exercise, and temperature regulation during exercise. What should I do?
Answer from Dr. Alberts: The autonomic nervous system is impacted by PD, which affects temperature regulation and blood pressure. The best way to prevent problems is awareness and going slow, especially when changing posture, and when starting and stopping exercise.
Answer from Chris (moderator): Make sure you’re well hydrated.
Question: How should we be timing our exercise with when we take our medication, especially levodopa? What if we exercise strenuously, then need more medication?
Answer from Dr. Corcos: The idea that someone should delay taking their levodopa, and/or take as little levodopa as possible, is not true. The up to date recommendation is that those with PD “medicate to exercise.” Take your meds before exercise or before you see your physical therapist.
If you’re taking an extended release levodopa, sometimes there’s not enough in your system early on in your workout. Work with your physician to manage your medication so that you can exercise regularly, since exercise is very important for maintaining mobility and quality of life. If you make a large change in medication, a three-month follow-up appointment is a good idea; listen to your body and your physician.
Question: Is “reactive” exercise, such as tennis or pickleball, good for those with PD?
Answer from Dr. Corcos: These sports can be very beneficial, and they can also be risky. Any intense exercise can lead to musculoskeletal injury. Make sure you warm up rather than jumping straight in.
Question: How does menopause impact exercise and PD?
Answer from Dr. Corcos: This is very complicated. If you have hormone replacement therapy, it can interact with dopaminergic therapy, resulting in an increase in certain symptoms. Work with your neurologist and endocrinologist together, possibly a nutritionist as well. It may take time to experiment with meds, diet, exercise, and hormone treatment, before you find a balance that works for you.
Question: Since I was diagnosed with PD, my max heart rate has decreased. Is this because of my PD progression?
Answer from Dr. Corcos: Everyone’s heart rate max drops by about one beat per year, on average. You cannot improve your peak heart rate. This is part of normal aging. You do get the same benefit from exercise, even if your peak heart rate is lower than it used to be! The decline in maximum heart rate over time may be a bit greater in those with PD, though this hasn’t been well studied. Some people with PD have chronotropic incompetence, which means they have a heart rate lower than that predicted by their age.
Beta-blocker medications also lower peak heart rate, so some taking beta-blockers may have lower heart rate than expected as well. Where possible, get a cardiopulmonary test done to accurately measure peak heart rate and oxygen consumption.